That would be the Medicare prescription-drug coverage. Not that it’s been a non-issue entirely so far — lots of traditional economic conservatives are very unhappy with it because of the high costs — but I think the general tacit assumption has been that it’s going to be viewed as a bad initiative by the far left (for being insufficient in what it covers) who weren’t going to vote for him anyway, and by the beforementioned conservatives (but are they going to desert a Republican incumbent in droves?), but as a good initiative by lots of the center and especially the elderly who most directly benefit (good, someone’s done something about the high cost of Rx drugs for seniors!).
But I think such is not going to be the case. The logistics of it and its early reception by folks entitled to make early 1st-stage use of it, indicate that it’s a real turkey:
• Apparently you have to pick from an assortment of coverage-package plans. Some drugs are covered under one plan but not by another.
That makes it awkward already, because to make effective use of this scheme you’d have to know in advance what medications you’d need to have covered so you’d know which plan to select. Still, figure that many Medicare recipients are on maintenance doses so they aren’t clueless about what they’ll be on —it’s just any possible future prescriptions that are in the unknowable zone. But it gets worse:
• Not all plans are available in all areas, and not all pharmacies accept all plans.
• There’s insufficient information about what medications and what pharmacies are covered by what plans even on the web sites that seniors are directed to for up to date information. Skipping over the occasional ::ahem:: exception to the rule about how computer-savvy and web-confident our nation’s Medicare recipients are, and assuming the web sites get more informative with time, that only sounds temporarily awkward, but…
• The prescription meds that are covered by any given plan can change at any time whatsoever, as can the pharmacies that are participating.
• The price that one actually has to pay — the copayment — for any given med that is covered (for the moment) by any given plan can also change at any given time.
• Medicare recipients will be pressured to pick and plan and get going with it. If they wait until they actually need immediate coverage (e.g., develop a medical condition that requires an expensive name-brand medication), they will apparently be hit with a penalty fee for not having picked a plan as soon as they were eligible to do so.
• There is a greatly reduced premium and they’ll waive the deductible for participating in these plans if one’s income is below a certain level (I think it’s $12,000-and-change per year for individual), which sounds like a good deal until you learn that they are talking gross annual income. Most people poor enough to have incomes less than $12,000 gross per year would be eligible for Medicaid and would be able to get free meds anyhow, wouldn’t they?
•OK, gather around, here’s how it works: You join the plan and pay monthy premiums and you pay for all your prescription costs until you’ve met a $250 deductible, then the plan picks up 75% of up to $2000 in costs and you pay the remaining 25%, then after you shoot over the $2000 mark you pay for everything until you hit $4850 for the year, after which point the plan pays 95% of remaining costs your incur and you pay the remaining 5%. Got that? Ready for the pop quiz or do you want to review that again? Having fun in Excel doing your monthly budget estimates, are you?
• Some estimates of likely costs per year for various prescriptions consumed at commonly prescribed rates seem to indicate that it would usually be cheaper to buy prescription meds without the plan over the internet via services like “drugstore.com”. That’s assuming American-based internet Rx-drug services, btw, not getting your meds from Canada or other outside-the-US sources, which are even cheaper.
I think this issue has the potential for really blowing up in George’s face as (yet another) extremely expensive Federal initiative that only brings home rancid bacon that most voters can’t make use of, or at least that a good portion of the voters who would theoretically benefit from it would have to study every aspect with the intensity of a corporate attorney looking for a safe tax shelter for their clients in order to get any benefit from it.
And… WHAT WERE THEY THINKING? This thing just plain looks like one of those small-print gotcha clauses in shady insurance policies, you know, phrases like “clause must be invoked 3 days before the last Sunday preceding the interval no longer coinciding with prior coverage by a 3rd-party carrier deemed primary policy of policyholder as defined in Section A unless secondary insurance is in effect and not negated in the interim period or within 3 business days thereafter”. They couldn’t have had someone vet this for user-friendliness and clarity for purposes of political expediency? Did it not occur to them that the opposition party might have a field day if it looks like the admin spent zillions of dollars on something that Grandma and Uncle Rick have to deal with but which reads like the bloody tax code?
In addition to GWB: I suspect the AARP is going to suffer a political hangover from this mess too.