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Wrong, Wrong, Wrong
October 19, 2006 • Volume 6, Issue 42The Part D prescription drug benefit was at the center of a recent exchange between Senator Jim Talent, Republican of Missouri, and his challenger in the November election, State Auditor Claire McCaskill, a Democrat. The Missouri Senate race is one of a handful of close contests across the country that will determine control of the Senate and what types of reforms, if any, are enacted to fix the deeply flawed Part D benefit.
McCaskill took aim at the central flaw in the Part D benefit—the legal prohibition against using Medicare’s purchasing power to negotiate lower prescription drug prices for people with Medicare. Her position is consistent with the stance she took when answering the Medicare Rights Center’s candidate questionnaire on six crucial legislative reforms that would improve Medicare. On Part D, McCaskill committed to cosponsor legislation requiring Medicare to negotiate lower drug prices, giving older adults and people with disabilities the choice of a drug benefit administered directly through Medicare.
Senator Talent, on the other hand, refused to answer the questionnaire, despite repeated reminders to his campaign staff. His position on Part D is not exactly a mystery, however. Last March, Senator Talent voted against legislation that would allow Medicare to negotiate lower prices as well as an amendment that would enact a prescription drug benefit option directly through Medicare. Both those reforms, which are overwhelmingly supported by people with Medicare, went down to defeat by slim margins. The senator did not bother to explain those votes in his recent defense of Part D, instead making a series of claims that indicate the senator doesn’t understand the program, or he has a talent for stretching the truth.
First, Senator Talent claims the legislation enacting Part D “forces prescription drug companies to discount prices.” The law does no such thing. It allows the insurance companies offering Part D to ask the drug companies for discounts, but no manufacturer is required to actually lower prices. In fact, a number of recent studies show that the prices charged by Part D plans are well above what the Medicaid program pays, what the Department of Veterans Affairs is able to negotiate, and even what some pharmacies are able to provide in the way of discounts. Incredibly, Talent believes that a program that overcharges both taxpayers and people with Medicare is a “sound, affordable drug plan.”
Second, Senator Talent makes the completely false claim that there is no “doughnut hole,” or coverage gap, in the Part D benefit for Missourians because there are seven plans that offer coverage in the gap. Six of those plans only cover generics in the gap, excluding brand-name drugs with no generic equivalents that cancer sufferers and transplant recipients rely on to stay alive. The one plan that covered those high priced drugs in the gap in 2006 is dropping coverage in 2007. The one plan offering such comprehensive coverage in 2007 charges nearly twice as much, over $100 per month. Finally, enrollment in plans with gap coverage is far below the need for comprehensive coverage among people with Medicare, largely because companies failed to inform their prospective customers that they were buying plans with a built-in coverage gap and because many people with Medicare cannot afford to pay the high monthly premiums.
Finally, people with Medicare could still have changed to a drug plan that covered the doughnut hole when they needed to if Congress had enacted legislation that would have extended the enrollment deadline and prevented “lock-in.” Senator Talent voted against that legislation, which would also have lifted the late penalty for people who missed the deadline. Now, Talent says Congress should lift the late penalty. He’s a little late himself.
The Missouri Senate race is not the only election where voters can choose a candidate ready to stand up to the pharmaceutical industry and allow people with Medicare to choose a Medicare-administered drug benefit, with affordable prices negotiated by Medicare, as an alternative to the confusing array of private Part D plans. Candidates in several tightly contested Senate and House races have made that pledge to the Medicare Rights Center and taken the time to address a range of other issues that are important to their constituents who count on Medicare for their health care. (Survey results) For the most part, their opponents have dodged the questions posed by the Medicare Rights Center, denying voters an honest answer.
People with Medicare deserve better. On Election Day, they can get it.
Medical Record
“When the new Medicare prescription drug benefit took effect this year, Republicans praised the program for helping millions of elderly Americans cope with rising drug prices. Many Democrats disparaged the plan for being too complex and failing to let the government negotiate prices with pharmaceutical companies to bring drug costs down. More recently, millions of beneficiaries have complained about facing a temporary break in their Medicare drug coverage, commonly known as the ‘doughnut hole.’ The conflict is playing out in Missouri’s Senate race, where incumbent Republican Sen. Jim Talent says most voters are benefiting from the new drug program and his opponent, State Auditor Claire McCaskill, says the plan is too generous to drug companies at the expense of seniors who need help” (“Candidates for U.S. Senate Square Off on Health Care,” Associated Press, October 17, 2006).
“A recent survey on the Part D prescription drug benefit found that 77 percent of Americans age 65 and older feel that it would have been better to provide drug insurance automatically as part of Medicare, instead of through an optional program with multiple providers. Only 30 percent think that Part D was well designed. Administering Part D through Medicare, instead of private insurance companies, would give older adults and people with severe disabilities drug coverage that is reliable and affordable. Instead of gambling that the Part D plan they picked will cover the medicines they need, individuals could simply present their Medicare card at any pharmacy in the country to get the medicines they need” (Background Information for 2006 Congressional Survey, Medicare Rights Center).
An amendment that would have extended enrollment and waived the late penalty was rejected by the Senate on March 15, 2006. Forty-nine senators voted for it and 49, including Senator Talent, voted against it (Vote summary of Nelson Amdt. No. 3009). Senator Talent also voted against an amendment to authorize Medicare to negotiate drug prices (Vote summary of Snowe Amdt. 3004) and another to provide a drug benefit directly through Medicare (Vote summary of Stabenow Amdt. No. 3164) (From “U.S. Senate Roll Call Votes 109th Congress—2nd Session, 2006”).
“The prices offered by the ten [leading] Medicare drug plans are higher than the prices currently available to consumers in the United States through the popular [website] Drugstore.com. For the ten Medicare drug plans, the average price for a one-month supply of each of the ten [highest selling drugs in 2004] is $1,158. At Drugstore.com, these ten drugs can be purchased for just $1,119. The average prices negotiated by the Medicare drug plans are over 3.5% higher than the Drugstore.com prices…At [Costco stores], these ten drugs can be purchased for just $1,126. The average prices negotiated by the Medicare drug plans are 2.9% higher than the Costco prices” (“New Medicare Drug Plans Fail to Provide Meaningful Drug Price Discounts,” U.S. House of Representatives Committee on Government Reform, November 2005).
***** The Medicare Rights Center (MRC) needs to hear about all the problems with the Medicare Part D benefit, whether they happen to you or someone in your community. With this information, we will be armed with the needed evidence to push for a Medicare-administered drug benefit.
Fast Relief: Part D Monitoring Project
Submit your story at www.medicarerights.org/partdstories.html
*****
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