Asclepios
Get Asclepios free by e-mail every week! Click here to subscribe.
Give It a Chance?
January 18, 2007 • Volume 7, Issue 3In recent weeks, the Pharmaceutical Research and Manufacturers of America (PhRMA), the drug industry’s lobbying group, spent over $1 million on full-page newspaper and television ads praising Part D and urging the public to oppose efforts to improve the benefit. The ads depict happy, beaming people who are obviously quite thrilled with their Part D plan. They tell the TV cameras, “Give it a chance. It’s working.”
PhRMA calls Part D a “clear success” by pointing to poll findings that indicate the majority of people enrolled in Part D are satisfied with their plan. But they conveniently ignore other findings that show most people with Medicare think the current benefit should be improved and support key changes, including allowing the government to negotiate lower drug prices and providing a drug benefit directly through Medicare.
“Satisfaction” rates also mask the many problems people with Medicare, including those who tell pollsters they are satisfied, have experienced with their Part D plans. Polls of people with Medicare, doctors and pharmacists, as well as the day-to-day experiences of volunteers who counsel older adults and people with disabilities, reveal a wide range of problems, including high drug costs during the gap in the Part D benefit, denials of coverage and high-pressure, deceptive marketing.
One older adult from Atlanta, Texas, wrote to MRC’s Part D Monitoring Project: “Other than reaching the gap quickly, and the difficulty paying the $291 monthly cost for drugs when in the gap, I really have not been unhappy with [my Part D plan]. Without this coverage, it would be extremely difficult to pay for my heart medications.” Is Part D really working for older adults and people with disabilities when people with Medicare still have trouble paying their monthly drug bills?
It’s certainly working for PhRMA. The pharmaceutical industry’s profits are up thanks to Part D. People with Medicare and taxpayers, however, are not doing quite as well. Prices for medications have increased under Part D. In addition, 31 percent of people enrolled in Part D plans are paying about the same amount as before and 14 percent are paying more. Shouldn’t we be doing more with the approximately $1 trillion this benefit is costing American taxpayers and people with Medicare than just giving higher profits to drug companies?
The drug lobby’s reassuring ads, of course, also leave out the fact that premiums for drug coverage this year have increased across the board while options for comprehensive coverage in the gap have shrunk. The only widely available plan offering doughnut hole coverage for both brand-name and generic drugs last year is now only covering generics during the coverage gap, even though it raised its premiums by 43 percent. In 11 states, people with Medicare have no access to stand-alone drug plans with gap coverage for brand-name medicines. Is Part D really working for those who will have to cover the full cost of their medicines while continuing to pay premiums?
It is clear who Part D is definitely working for: the pharmaceutical industry. Drug companies raked in windfall profits from the benefit last year and want to ensure 2007 is another “clear success.” So PhRMA launched its ad campaign ahead of last Friday’s vote in the House of Representatives on a bill requiring Medicare to negotiate with drug manufacturers for lower prices for people with Medicare. The House passed the bill, leaving the Senate to now decide on the issue.
“Give it a chance. It’s working,” says the drug industry. People with Medicare have given Part D a chance, and for too many, it’s not working. It is time for change. Removing the impediment for Medicare to negotiate lower drug prices is an important first step toward implementing the change people with Medicare really want: a drug coverage option under the Original Medicare program.
Myth #2: Part D is working well and there is no need to change it
Tell your senators to support legislation giving Medicare the power to negotiate lower drug prices.
Medical Record
“Seniors are satisfied with their new coverage and are experiencing significant savings…However, despite the clear success of the program and the nominal public support for legislative intervention, the Kaiser Family Foundation dedicated a significant portion of its survey to proposed changes to Part D—particularly in support of government ‘negotiation’ of drug prices” (“PhRMA Statement on Kaiser Family Foundation Survey,” PhRMA press release, December 8, 2006).
“Humana PDP Complete, which had the highest enrollment among plans offering full gap coverage in 2006, will cover only generics in the gap in 2007. It will be important to assess the extent to which these plans alleviate financial burden for those who reach the gap” (“Status Report on Medicare Part D Enrollment in 2006: Analysis of Plan-Specific Market Share and Coverage,” Health Affairs, November 21, 2006).
“In 2007…Most PDPs [stand-alone prescription drug plans] have a coverage gap; less than 2% of PDPs nationwide cover both brand-name and generic drugs in the gap. In 11 states, there are no PDPs available that offer gap coverage for brand-name drugs” (“Medicare Prescription Drug Benefit Fact Sheet,” Kaiser Family Foundation, November 2006).
“The pharmaceutical industry is beginning to reap a windfall from a surprisingly lucrative niche market: drugs for poor people…The windfall, which by some estimates could be $2 billion or more this year, is a result of the transfer of millions of low-income people into the new Medicare Part D drug program that went into effect in January. Under that program, as it turns out, the prices paid by insurers, and eventually the taxpayer, for the medications given to those transferred are likely to be higher than what was paid under the federal-state Medicaid programs for the poor” (“A Windfall from Shifts to Medicare,” New York Times, July 18, 2006).
***** 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
*****
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 e-newsletter 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.
Please send all replies and subscription requests to mrcadvocacyupdate@medicarerights.org.
Get Asclepios free by e-mail every week! Click here to subscribe.