[QUAD-L] Fwd: The Sixth Step to Improving Prescription Drug Coverage

[DAANOO]

Dana (C 4-5, 31 years post, 51, KC)

--- Begin Message ---

Asclepios               

 

Your Weekly Medicare Consumer Advocacy Update

ACT NOW: The Sixth Step to Improving Prescription Drug Coverage

August 4, 2005 • Volume 5, Issue 31

 

Ouch!

 

 

Last week Medicare celebrated its 40th birthday, and lawmakers on both sides of the aisle touted its successes—basking in the glow of a program that consumers understand, a program that outpaces all private insurers in cost-effectiveness.  Politicians of all stripes are smart enough to know that 42 million Americans appreciate the good health care that Medicare allows them. 

 

In the heyday of the civil rights movement, Medicare was created by lawmakers who recognized that government’s job was to serve the people—all the people. Medicare was based on the value that older adults were entitled to health care, and most supporters of Medicare in 1965 considered it a first step toward a society with Medicare for all of America.

 

The program was designed to appeal to the American people. How? It allowed doctors to treat patients according to their clinical judgment. It offered a reliable and readily understood benefit. And Medicare was established as a program that would offer consistent benefits across the nation – not a benefit program twisting in the winds of a for profit market

 

Leaders from both political parties, in the wake of President Lyndon Johnson’s landslide election in 1964, created the enormously successful and enduring Medicare program.  To this day it remains a model of how government health care programs should be run. 

 

Fast forward to 2003. In sharp and bitter contrast to the lessons of decades of Medicare successes,  lawmakers created Medicare Part D—the new prescription drug benefit.   The White House and Congressional leadership stubbornly refused to accept that government-administered health care works and instead—by relying exclusively on private insurers—created the inefficient, costly and complex drug program now confronting millions of Americans with Medicare.   Lawmakers ignored, purposely, the lessons of the last 40 years in developing the drug benefit, and they will be judged by a potent electorate as the drug benefit is rolled out starting in January.

 

Built to afford insurance companies and drug makers enormous control over the types of drugs covered, pricing, benefit design and marketing, the drug law allows for an array of ever-changing drug plans.  Few Americans will be able to budget effectively for their drug needs or make an informed choice when a selecting a drug plan.  While Congress gave drug plans the right to change the drugs they cover and the price they charge consumers for their drugs over the course of the year, most consumers will have no ability to switch plans throughout the year when the plan they have chosen no longer meets their needs.

 

Rather than locking consumers into a drug benefit that may well change in the course of a year, Congress should consider creating a benefit that will offer plans that consumers do not need to be locked into.

 

Here’s the next step to improving the prescription drug benefit:

 

6.  Congress should ban drug plans from changing their benefit packages during the course of a year. Consumers should be assured that the plan they are paying for when they enroll, is the plan they will be receiving over the course of a year.

 

The drug benefit is heavily tilted to favor insurers and drug companies over the interests of the American people. This lock in of consumers is just one more example.   People rightly wonder what price prospective drug plans paid to get Congress to allow them to change covered drugs during the course of a year, while locking consumers into a plan that might well no longer serve the consumers’ interest.   And they rightly wonder who certain members of Congress truly think they represent.

 

Sign up here to help build a national campaign to give people with Medicare the drug program they deserve. Send an e-mail message or letter telling us why creating a real Medicare drug benefit is important to you.

 

Click here to tell what you would like to see improved about the Medicare drug benefit.

 

 

Medical Record

 

Traditionally vulnerable populations, such as dual eligibles—people with Medicare and Medicaid—may be seriously and adversely affected by the lock-in provision.  The combination of Medicare Advantage plans and new Part D prescription drug plan election limitations has the potential to further confuse and restrict beneficiaries’ decisions (“Estimating Medicare Advantage Lock-In Provisions Impact on Vulnerable Medicare Beneficiaries,” Health Care Financing Review, spring 2005).

 

A study on Medicare HMO disenrollment found that 60 percent of Medicare + Choice enrollees chose to move with their provider when forced to choose between their provider and staying with their health plan. Continuity of care is especially important to older Americans and people with disabilities who have chronic conditions (“The 2002 Medicare + Choice Plan Lock-In: Should It be Delayed?” Commonwealth Fund, November 2001).

 

The lock-in requirement will take away the ability of people with Medicare to make choices about how and where they get their health care. And given that Medicare HMOs have a history of disseminating misinformation about lock-in, people with Medicare who are currently enrolled or considering enrolling in Medicare HMOs won't even have the opportunity to make informed health care choices. (“Medicare HMO Lock-In,” Asclepios, November 2001).

 

Fast Relief: What You Can Do

Let everyone—your colleagues, friends, families—know how we can improve the Medicare prescription drug benefit for people with Medicare and American taxpayers. Help us build a national network of concerned citizens who want to create the Medicare prescription drug benefit Americans deserve.

Click hereto help build a national campaign for a real Medicare prescription drug benefit!

 *****

 

Don’t Let Your Suffering Go Unnoticed

Are you struggling to pay for your prescriptions drugs or get the health care you need? Work with the Medicare Rights Center to bring your story to the ears of policymakers, the press and the public in an effort to expose the shortcomings of the American health care system. To learn more about how to make your voice heard in the national Medicare debate, visit www.medicarerights.org/maincontenthiddenlives.html

The Louder Our Voice, the Stronger Our Message

Asclepios—named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly action alert designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.

 

Medicare Rights Center (MRC) is the largest independent source of health care information and assistance in the United States for people with Medicare.  A national nonprofit founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care.

Visit our online subscription form to sign up for Asclepios at http://www.medicarerights.org/subscribeframeset.html.

To unsubscribe from this mailing, please click here.

To modify your profile and subscription preferences, please click here.
--- End Message ---