Democrats Fire a Shot on Medicare Prescription Drug Coverage Reform

[WhiskeyGirl]

Democrats Fire a Shot on Medicare Prescription Drug Coverage Reform

Are seniors about to get a new deal on prescription drugs from Washington?

Medicare recipients have been able to purchase drug coverage since 2006 under Medicare Part D, which provides for federal subsidy of prescriptions. The coverage is provided through hundreds of private insurance plans and they have become popular, with nearly 27 million beneficiaries enrolled and paying premiums deducted from Social Security checks.

But costs have been rising sharply; average premiums for the 10 most popular plans jumped 30 percent for the re-enrollment cycle for 2009. And some critics point to needless complexity facing consumers, who must choose among dozens of varying plan offerings -- many of which are revised annually.

I think this is a good idea.  Drugs that seniors may have been purchased last year for just a small copay or perhaps received free, may jump hundreds of dollars.  For some seniors (many do not have access to the internet) changes are hard to determine and cause their out of pocket expenses to increase rapidly, overnight.  Drugs that may have cost $25 in December 2008, now cost hundreds of dollars in January 2009.

Democrats are introducing legislation that would create a Medicare-administered prescription drug plan that would compete with the hundreds of private plans. More important, the bill would require the Secretary of Health and Human Services to negotiate with pharmaceutical companies on the price of drugs offered in the government-run plan.

The bill -- called the Medicare Prescription Drug Savings and Choice Act of 2009 -- most likely will be considered by Congress as part of whatever broader healthcare reform legislation advanced by the Obama Administration.

If the proposed changes become law, a new government-administered drug plan could be offered as early as 2011. Proponents argue that it could produce a less expensive, easier-to-understand plan for consumers.

The price reductions would come from the elimination of plan marketing expenses, price negotiations with drug makers, and greater reliance on generic brands. A 2007 study by the health care advocacy group Families USA found that the Department of Veterans Affairs -- which runs its own program and negotiates with drugmakers -- paid a whopping 58 percent less, on average, than the prices paid by Medicare Part D programs (download a PDF of the study here). Some experts dispute the validity of comparing the VA and Medicare programs, but other studies have pointed to similar large potential savings.

The overall savings to Medicare and beneficiaries could be huge. Research by the Center for Economic and Policy Research pointed to $600 billion in potential savings over a seven-year period.

The bill's sponsors say some of those savings could be used to close the so-called "doughnut hole in Part D coverage -- the current gap in coverage that starts when beneficiaries exceed $2,510 in coverage for a given year. At that point, the beneficiary pays 100 percent of costs up to $4,500, when so-called "catastrophic coverage" kicks in.

http://www.huffingtonpost.com/mark-miller/democrats-fire-a-shot-on_b_161478.html

I would hope there would be some tough negotiators.  A price that is in line with what other buyers pay, other nations, and other insurance/healthcare providers - a fair price for seniors and taxpayers.  imho

[GreatOwl]

I am not sure of the complete accuracy of that article.  I do not receive any subsidy under Part D.  I manage to make company changes every year to try to keep my costs down.  A person never knows which company will be the most economical from one year to the next.  They seem to take turns.  It is not a matter of choosing from a couple of dozen.  There are literally hundreds of different plans a person has to evaluate each year.   

All you can really count on is that when you do find a plan for one year, it is assured that the premium will jumps 30% to 60% the next year.  This is not an exaggeration.  It is how companies manage to "low ball" for one year to build up there consumer base.  There are so many that just do not know how to work the system that they get caught in the increase the following years.  I have yet to keep the same insurance company two years in a row.  I reapply each year for a different plan and company.

It is a matter of looking at three factors.  The co pays for each of the three tiers, the premium and the deductible.  Most companies will rate drugs about the same as far as the tier levels go.  However, it is not always a guarantee, so it is necessary to run all of your personal medications that you take against each plan to find out what you will pay.

You just hope and pray that once you have made the commitment to an insurance company for the upcoming year that your physicians do not make any changes in your medications.  It takes due diligence to work together with medication changes with the doctor to stay on top of the costs.