That
Terrible Medicare Hurricane
By Dr Robert Goldberg
Vice-President
The Center for Medicine in the Public Interest
For the past several weeks a steady
stream of negative stories about the new Medicare
drug benefit has been blowing through the media.
Again and again, we hear of a program in chaos,
confusing seniors and even depriving millions
of needed medications. Politicians have raced
into the limelight to share their concern.
From all the rhetoric, you'd think Medicare Part
D was worse than Hurricane Katrina.
But stop a second.
Perhaps it's not the program itself that's scaring
seniors, but the media frenzy being drummed up
around it. After all, if you have an interest
in making a program fail, why not tell people
it's so complicated and hopeless they shouldn't
even try to enroll?
As it turns out, the hurricane surrounding Medicare
Part D is mostly just hot air. When you calm down
and look at actual statistics, the news is just
the opposite of what the Chicken Littles have
been saying.
Nearly 6 million seniors have signed up for the
new benefit in less than two months. That's over
250,000 people every week, which makes Part D
the fastest startup of any federal program in
recent memory.
In 1997 Congress created a program to give poor
kids health insurance. In 2006, nearly a decade
later, less than half of eligible children are
enrolled.
New York State's prescription drug program has
been in operation for nearly 20 years and only
60 percent of eligible seniors have even heard
of it.
As of 2001, the same state's Medicaid drug benefit
program covered fewer than half of seniors with
incomes below the poverty line. And one-third
of those who indicated they were aware of the
program had not enrolled because they thought
they had too much money to qualify.
Meanwhile, Medicare Part D enrolled all of these
eligible seniors automatically in nearly one month.
The media and state officials complained that
thousands of seniors were denied medications during
the switch. That is untrue. A system was in place
allowing state agencies and pharmacies to bill
Medicare when problems arose. But the media never
reported that the backup system was there - and
working - the whole time.
The fact is, the Medicare drug benefit was rolled
out with extraordinary speed for a government
program of its size. And now, for the first time,
millions who previously had extremely high out-of-pocket
drug costs will suddenly have coverage.
One million of America's poorest seniors spending
$4,000 or more a year - nearly 30 percent of their
income - on prescription medications will wind
up paying almost nothing for their drugs under
the new plan.
And middle class folks with high drug bills benefit
too. For example, Janet N., an 80 year-old senior
from Northridge, was paying more than $7,000 for
her prescription drugs each year. It took her
10 minutes to find a plan that will save her $3,000
each year.
I helped my friend's mother find a plan that cut
her $2,400 drug bill by 70 percent.
Because private companies are competing for customers,
seniors are seeing cheaper drug prices, more drug
choices and bigger savings than the so-called
experts anticipated. Many are getting free drug
coverage through Medicare HMOs.
Despite this good news, politicians on both sides
of the aisle are clamoring to change the new system.
They want to eliminate consumer choice by having
a government bureaucracy decide what drugs seniors
can buy and at what price.
Some want to turn Medicare into a Canadian-style
drug plan. I believe that would be an enormous
mistake. When governments are obligated to pay
for drugs, they try to save money by keeping cutting-edge
products from getting on the market.
In Canada, many seniors are still waiting to get
Aricept, a drug for Alzheimer's, four years after
it was available in America. Herceptin cuts a
woman's risk of getting breast cancer again by
half. It's not available throughout most of Canada.
I could go on and on with similar examples.
Other politicians want Medicare to be more like
the Department of Veterans Affairs' drug plan,
in which the US government dictates prices. But
the VA plan limits drug choices, just like Canada's
system: Though Gleevec is now considered first-line
therapy for stomach cancer, the VA forces patients
to fail first on an older drug with harsh side-effects
before they qualify for Gleevec.
Even worse, the VA automatically delays access
to new drugs for a year regardless of benefit.
How would you feel if the government told you
that a loved one afflicted with a deadly disease
would have to wait a year, and perhaps die in
the meantime, before getting access to a new cure?
Not surprisingly, seniors dependent on the VA
system live shorter lives.
While not perfect, the Medicare drug benefit has
been enormously promising in its short life. Media
accounts have in fact not deterred seniors from
signing up. But politicians still want to replace
it with a "money-saving" scheme where
government bureaucrats would set prices and ration
lifesaving drugs.
If I see another "Medicare Gives Seniors
a Headache" headline, I really will need
an aspirin. But what's far more troubling is that
if the folks trying to tear down the current Medicare
program succeed, the headlines won't have to be
sensationalized.
Imagine this: "People Die Waiting For Drugs."
(Robert Goldberg is Vice President for The Center
for Medicine in the Public Interest)
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