'Part D' stands for dysfunctional The Medicare drug program suffers from a lack of common sense
It's hard to imagine how the new Medicare prescription drug program could have been botched any more thoroughly. Reports are flooding in from across the country of seniors who have been put through the bureaucratic wringer, denied vital drugs or asked to pay full price to get drugs they have depended on for years.
Just when it seems this program has to get better, we get the news that local mental health clients are among those who can't get their prescriptions ' drugs they depend on to function in society.
Here are a few of the unintended consequences of the Medicare Part D drug plan, which went into effect Jan. — and was intended to assist seniors and Medicaid recipients in paying for prescriptions:
Reports have flooded in from across the country of people struggling to get their benefits. Computer systems are bogged down, the complex process has confused users, insurance companies have been slow to finish paperwork or have done it incorrectly and pharmacists have been unable to verify beneficiaries' enrollment.
State after state, including Oregon, has had to step in to pay for temporary drug coverage. The federal government has promised to reimburse the states, but the mind boggles at the thought of the paperwork involved with that.
Medicare's administrative costs associated with the program have been reported at 5.2 percent of its claims costs, compared to typical costs for the agency of 2 percent. Costs for private insurers are 20 percent higher than normal. Guess who will end up paying for that?
Several pharmaceutical companies are ending assistance programs that provided free or reduced-cost drugs to low-income people. The companies say they are dropping the programs because new rules associated with the Medicare program prohibit any inducements to patients who receive government assistance to help pay for medications.
The prescription program allows coverage of intravenous drugs but unlike private coverage does not pay for the medical supplies and nursing staff needed to give in-home transfusions. That means some patients must now go to a hospital for the treatment, greatly increasing the cost.
The program was flawed to begin with, as Congress caved in to the demands of the pharmaceutical industry. Sen. John McCain called it the Leave-No-Lobbyist-Behind Bill. Chief among those flaws was a clause prohibiting the federal government from negotiating lower prices for bulk purchases from the drug companies.
A Consumers Union analysis said the plan's problems were compounded by the federal government's breathtaking arrogance in rushing the program out without adequate measures taken to ensure that the system could handle the demand. The report said that transferring large numbers of patient files from one insurer to another can take an average of six months. Sign-ups for the Part D drug plan didn't even begin until Nov. 15 for most beneficiaries, so it was no surprise that so many people found out in January they had no access to their benefits.
No one, least of all the embattled Bush administration, wanted this program to fail. But a lack of basic common sense doomed it to a rocky start.
Every day that the chaos continues, more potential users decide against signing up. That puts the entire program ' and millions of potential beneficiaries ' at risk. Medicare now must regroup and find a way to quickly put the program back on track.