The Rural Patriot

November 17, 2006

Medicare Part D News Items

Filed under: Bush Administration,Federal Government,Health Insurance,Medicare D — theruralpatriot @ 7:01 pm

Many Democratic campaign platforms included the promise to pass legislation that allows negotiation of Medicare Part D drug prices with pharmaceutical companies. Apparently, the Bush Administration still does not think that this is a good idea:

HHS Chief Opposes Negotiation of Medicare Drug Prices

“The idea of the government negotiating drug prices really isn’t about the government negotiating drug prices,” Health and Human Services Secretary Mike Leavitt said. “It’s a surrogate for a much larger issue, which is really government-run health care.”
(snip)
But Democratic lawmakers have promised a new approach when they take control of Congress in January. They would let the federal government use its massive purchasing power to negotiate the price of drugs used by Medicare beneficiaries. They say that such leverage would produce substantial savings that could then be used to improve the overall program.
(snip)
“Requiring the federal government to negotiate on behalf of seniors would generate significant savings, savings which could be used to close the gap in coverage — or ‘doughnut hole’ — that threatens millions of Medicare beneficiaries this year,” Pelosi said.

Negotiating drug prices is not a novel idea. Just ask the folks who administer the Veterans Administration. Closing the doughnut hole would also be beneficial to many seniors who fall into that time period where they are still paying their premiums, but receive no reimbursement/coverage on their perscription purchases.

Leavitt disagreed. He said the government could not develop a plan that would satisfy the needs of a broad range of consumers.

Could not, or would not? Sounds like they have already made up their minds. So I ask, are we looking at a presidential veto when Congress does come up with a workable plan? If so, I guess that big pharma really does come first. I also find the word “consumers” an odd choice, although I guess that you could argue for its usage here.

If you are a participant in Medicare Part D, be aware of the following:

Medicare officials say they expect insurers to offer 1,875 separate plans in 2007, nearly a third more than in 2006. Beneficiaries in most states have an average of roughly 40 plans to choose from.

The basic structure of most plans will remain roughly the same, officials say. But premiums for many plans are expected to rise, in some cases as much as 15 percent, while fewer plans will offer comprehensive coverage for brand-name and generic drugs.

Nearly eight in 10 beneficiaries are in plans with premiums that are expected to rise next year, according to an analysis release by the Henry J. Kaiser Family Foundation earlier this week. In many cases the rise will be less than $5 per month, the group says. Insurers are set to mail millions of letters alerting seniors to changes in prices or covered drug lists in their current plans.

Premiums will rise, and coverage for many will decrease. I don’t envy those who will find out that their current perscription coverage will change and will have to go through the exercise (again) of having to look for another plan that could be more beneficial for their needs.

Judith Stein, executive director of the Center for Medicare Advocacy, says fewer plans in 2007 will offer generics and branded drugs through the doughnut hole. That could affect seniors who take drugs for Alzheimer’s disease, cancer, and some heart conditions because many available drugs are relatively new and sold only in brand form.

She warned that seniors should eye potential plan changes carefully before choosing to stay with a plan.

“What we’re finding is that indeed some of the plans are quite different,” she says. “You need to look at a lot of things beyond the premium and make sure that if you’ve benefited from brand-name drugs being covered in 2006 that you don’t just assume that will be covered in 2007.”

I’m already feeling sorry for the seniors who won’t realize their coverage has changed and will find out “the hard way” when their pharmacist hands them the bill. (I also feel sorry for the pharmacists who will have to be the ones to deliver the bad news.)

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1 Comment »

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