Have you taken a look at the Medicare prescription drug benefit, aka Medicare D?
If you’re on Medicare, your premiums shoot up to cover the benefit — different amounts depending on the plan you go for.
You pick a plan (presumably) on the basis of which meds the plan covers, and that opts you in for the Medicare D generically and binds you to that plan for a minimum of one year.
• This means you’d have to know in advance what kind of pills you’re going to need (*do * try not to develop any new or unexpected ailments, dearie)
• But the plans can stop covering any given medication for no reason, giving participants a mere one month’s notice. Not that participants can do anything about it untl the end of their one-year signup period. (Sorry, your plan doesn’t cover your heart pills any more, dearie, maybe your doctor could pick a different pill for you?)
• Online information gives Medicare recipients a breakdown of which plans cover which medications, but as plans drop medications the sites aren’t necessarily updated, so the info may be out of date.
• Online info also gives Medicare recipients info on which of their local pharmacies participate in which plans. You can’t just pick a plan, you have to pick a plan that some pharmacy in your area participates in. Oh, but pharmacies can drop plans the same way plans can drop medications. But you, the Medicare recipient, are stuck with the plan you picked until next year. (I don’t think any drugstores in town still belong to that plan, ma’am, but there might be one in Chicago that does)
• The plans don’t cover some X% of your medication cost and then you pay the rest. No, that would be too simple. The plans cover some X% of your medication cost after you’ve paid a fairly substantial deductible out of pocket this year — on drugs covered by your plans, the money you pay on non-covered meds doesn’t count — and then it covers meds up until a certain level for that year is reached and then stops, and you pay full cost out-of-pocket until the end of the year (while paying your Medicare D premiums, they don’t stop) until you exceed another specified level (and once again only the money you shell out for meds covered by your plan count towards this total), and then the plan kicks in again and this time it covers nearly 100% of your medication costs until the end of the year. Got that?
• But since we all know how astute Medicare recipients are at using online web-based resources to compare and contrast 30 or 40 or 50 different competing plans, there’s not much risk of folks signing up for expensive plans that still don’t cover what they need, right? Right? (Oh look, Henry, another 3 fliers in the mail telling us to sign up for their medication plan!)
• Eligible people can opt out but only at a surcharge that ratchets up the cost of premiums for every year that they don’t opt in. So if you don’t find a plan that covers what you need this year, or you happen to be in good health for a person your age and aren’t taking many meds (yet), and you decide not to sign up for Medicare D, then next year the cost of your premiums is automatically increased by some Y% above current standard costs for the plan. If you wait five years to sign up, your premiums will be 5 x Y% additional above and beyond the standard costs for the plan. And if the plan itself gets price hikes over the next five years, that’s 5 x Y% of the cost of the plan as it is priced five years from now.
This is the “irresponsible big-government spending” of the Bush administration that the fiscal conservatives in the Republican party are unhappy about.
But surely such a well-designed efficiently-planned social program would only elicit praise from groups of senior citizens, right? Right?
If i had my name associated with this klunker I’d hide, too.
Note the speech he gave yesterday at the World Affairs Council* where he was asked about the Iraqi death toll. Emphasis added: