Skeptical view of
Medicare Program...
Cost of drugs is 0ne
issue Medicare Cards don’t address
By Rosa DeLauro
(DeLauro is the
Democratic U.S. representative from Connecticut’s 3rd
District; she wrote this for the Hartford Courant)
May 7, 2004 -
Monday, the Department of Health and Human Services rolled out the new
drug discount cards it says will help seniors with the cost of their
prescription drugs until the full Medicare prescription drug benefit
starts in 2006. You’ve probably seen advertisements that mention it
(financed by taxpayers, of course), the ones that crow about the “same
Medicare you’ve always counted on.” But as seniors will learn, these
cards are little more than window dressing. Like the recently passed
Medicare reform bill, the cards will not help seniors with the one issue
most important to them: the skyrocketing price of prescription drugs.
And HHS couldn’t
have made the application process more burdensome. Seniors and Medicaid
recipients may be used to dealing with complicated forms, but they will
likely not have faced anything like this: income thresholds, convoluted
regulations about who can change cards and when, and more than 70 cards
in distribution across the country, some usable nationally and others
regionally. The result will be a confusing, constantly changing hassle
for many seniors.
To its credit, HHS
has made clear that once you have chosen a drug card sponsor, such as
AARP or an HMO, you are pretty much stuck with it until 2006. But there
are other important facts about the cards that HHS is not telling you.
First, there are no
rules to prevent the drug companies from raising prices. And prices are
already going up. In fact, since the idea of the drug cards was first
presented in 2001, commonly used prescription drugs such as Celebrex,
Coumadin and Lipitor have risen 23, 22 and 19 percent, respectively. And
so the discount of 10 percent to 17 percent on drug prices that have
already risen (and will continue to rise) 20 percent every year
effectively wipes out any discount that the card would have provided in
the first place.
Second, the card
sponsors might not cover what they say they do. At least, not for long.
Because drug card sponsors can change the terms of the deal once the
cardholder is locked in, seniors should be prepared to find that the
specific drug they were initially told was covered by their plan
ultimately is not. For instance, a senior who signs up for a plan that
offers the popular arthritis drug Vioxx might find that the sponsor has
decided to offer Celebrex instead and at a different price. What’s
worse, sponsors can change the drugs covered by the card as often as
every seven days, meaning a week later, that plan can offer yet another
arthritis drug at yet another price. As for whether seniors can change
cards, there are a few exceptions, but by and large, those who choose
Medicare-provided cards will only be allowed to change cards once during
the 2004 year-end open enrollment period. After that, they’re stuck.
Third, card sponsors
are not required to pass on any savings they negotiate with drug
companies. Card sponsors can negotiate rebates and discounts with drug
companies, but according to the regulations, there is no requirement
that they pass on any of those savings to seniors. In addition to
creating a clear conflict of interest, the result ensures higher profits
for card sponsors and higher costs for seniors.
Seniors are pretty
wise, however – regardless of HHS’ multimillion-dollar advertising
campaign. Seniors already see these discount cards as election-year
propaganda designed to counter the mounting criticism of the
administration for its handling of the Medicare prescription drug
benefit law. They are upset that it essentially traded away Medicare’s
guarantee of seniors’ health care for a flimsy drug benefit that will
only get flimsier and more burdensome when the “full” benefit kicks
in two years. If the administration were serious about doing something
to reduce the price of prescription drugs, it would allow the use of
safe, FDA-approved, affordable drugs from countries such as Canada, and
it would have allowed HHS to negotiate lower prices with the drug
companies.
But, of course, it
didn’t. So when it comes to these drug cards, seniors should read the
fine print.
