PHARMA/POLICY: Yet more revisionism in Part D

It’s incredible how a couple of bullshit surveys, dishonestly conducted have changed the rhetoric a little on Part D. Now there’s a very odd article about Part D in The LA Times, which has been speaking truth to one power (Kaiser Permanente) all last week. Apparently it’s all going swimmingly well.

By the May 15 deadline, federal officials expect to have more than 20 million seniors enrolled in plans under Medicare Part D, as the benefit program is called. That would include at least 7 million who previously lacked insurance for outpatient prescriptions. Of the millions who have signed up, many are enjoying significant savings, sometimes $1,000 a year or more. That’s a considerable achievement for a government that has not tried to roll out such an ambitious entitlement program since the days of Lyndon B. Johnson. It’s especially so for President Bush, who is no fan of big government.

And read on because it quotes lots of dinisterested parties like everyone’s favorite lobbyist and truth-teller Karen Ignagni, and the flack from the AEI, before it gets to the real triumph of Medicare Part D. It’s cheap, much cheaper than we were told!

Mike Leavitt, HHS secretary was happy to point that out:

As proof that privatization is already working, Leavitt points to estimates that the program’s net cost to the federal government will be $678 billion over 10 years, instead of the $737 billion projected last year.

Funny that because this is what the PBS Newshour reported in March 2004

When the Medicare law was passed last November, Congress’s scorekeeping arm, the Congressional Budget Office, pegged the cost at $395 billion over ten years. Contrast that with the $534 billion estimate from HHS’ Centers for Medicare and Medicaid Services, or CMS. The Bush administration released that estimate last month as part of its 2005 federal budget request.

So we’re not yet hitting some of the wilder estimates of the program cost, and we’re only going to be (maybe) $280 billion over the original budget promised, or a mere $140 billion over the real estimate that was deemed so explosive that it was forcibly hidden from Congress by Tom Scully, the Bush flack then running CMS. That must mean that the whole thing is cheap and shows that the market is working!  And of course we can trust everything that these guys say, as in every other aspect of their performance.

Pity that if we just paid the prices the VA gets we could cover all seniors with no donut hole for less money, but at least we’re helping out with private enterprise and promoting choice! Because that’s such a great thing.

Martha Straub, 86, a retired secretary from Woodland Hills, gives her new drug benefit an A and the signup ordeal a D. That averages out to a C+. "It’s very hard for an individual to dial in the plan that’s going to be most beneficial to you," said Straub’s daughter, Lorna Bashara, who helped her mother. "It was like looking for a needle in a haystack."

(Cross posted over at TPMCafe, who’s blog on the subject is somewhat quietening down)

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4 replies »

  1. I agree that the donut hole is a ridiculous plan design. I think it could have easily been avoided and still fit within budget constraints if the initial deductible were set several hundred dollars higher. Everyone would then have had the peace of mind that comes from meaningful insurance protection against very high drug costs in exchange for less help in paying for more manageable costs of, say, less than $1,000 per year.
    However, politicians in their infinite wisdom thought they could buy more votes if the designed a plan that appeared to be a “good value” relative to premiums paid for as many Medicare beneficiaries as possible instead of something that would be more valuable to the comparatively small percentage of the population with well above average costs. Sound economics is trumped by politics, as usual.

  2. Republicans are supposed to be the party of small government and cost effective, efficient programs. Then we see how MedD works, if you can figure out how it works. Democrats are supposed to be the party of the small guy – HA. They are both the party of the lobbyist bribes and business kick backs. We won’t fix anything in this country until we reform Washington and the money machine that supports it. I won’t believe anything on MedD coming from the present regime, just more lies and coverup, no credibility at all. The losers are the taxpayers, the winners, some seniors needing drug cost relief, and overwhelmingly the drug companies and plan providers.

  3. Pat D, as I understand it, will save previously uncovered participants 50% of their out of pocket drug expenditures in spite of its shortcomings, yet it is reviled. The lesson to Republicans and their corporate constituency is that no good deed goes unpunished. Democrats and their constituency will regret this when they return to power, as they will have no support for further healthcare reform. Like it or not, the Democrats will find their opposition will always be with them, in numbers necessitating their votes to pass meaningful legislation. This is what happens when politicians put poliotics ahead of statesmanship, a sadly bipartisan vice.

  4. The government would have been better not even passing an Rx bill for Medicare. At Costco, many generic prescriptions will cost less than the many copays of regular health plans. The donut hole is the most foolish part of the whole bill. The idea of insurance is to protect against large out of pocket expenses. How does having $3000 in out of pocket expenses help seniors on fixed incomes? No one has offered any credible alternative plan that would give good comprehensive coverage and impose pricing discipline on the pharmaceutical companies as all of the other major industrialized countries in the world do.
    The US should explore Australia’s health care system. They also have Medicare, but Australian Medicare is a program that covers all citizens of all ages with medical care and Rx coverage. The government negotiates reasonable prices for medicines, and big Pharma is prohibited from doing direct to consumer advertising. Then there is a market for supplementary insurance that covers additional services such as accupuncture at a cost of $40-$50 Australian dollars per month.