The Public Square

Katie Coombes on the Failures of Medicare Part D


Katie Coombes is the lead organizer of the Medicare Task Force. The Champaign County Health Care Consumers' Medicare Task Force is comprised of affected consumers, senior advocates, and concerned citizens working to support legislative improvements to Part D.

Medicare Part D is the new prescription drug coverage option for Medicare beneficiaries. The Part D program is markedly different from traditional Medicare. Part D lacks the central principle of Medicare, described by Winston Churchill as, "bringing the magic of averages to the rescue of millions."

The only way for people to participate in Part D is to purchase a private insurance plan. This design divides the total risk pool of forty three million Americans with Medicare into small sub-groups. There are nearly 80 companies offering over 1,400 Part D plans each charging different monthly premiums and covering different medications, and each taking their own cut in profits and administrative costs.

The Part D program's design is not only inefficient and wasteful, it is also harmful to those it is intended to benefit. The most harmful failing of the Part D program is the coverage gap known as the Donut Hole. During this gap, Medicare beneficiaries pay one hundred percent of their prescription drug costs and continue to pay their monthly insurance premiums. For many, this is simply more than they can afford forcing them to go without their medication. The Donut Hole does not reign in costs as proponents argue, it merely shifts costs to Medicare beneficiaries and often results in poor health and increased trips to the emergency room, the costs of which are covered under traditional Medicare.

Medicare beneficiaries live on fixed incomes and have changing prescription drug needs. Insurance is supposed to provide protection from debt and guarantee access; Part D does neither. The unpredictable out of pocket costs and absence of guaranteed coverage for needed medicines make it clear Part D is not a real benefit for Medicare beneficiaries.

However, the insurance and pharmaceutical companies have benefited from Part D. As Part D is only available through private insurance plans, the insurance industry has seen an increase in business. The Part D legislation forbids Medicare from negotiating discounted drug prices allowing the pharmaceutical companies to continue charging the highest prescription drug prices in the world.

Part D must be redesigned so that it benefits the people with Medicare rather than the powerful interests of the insurance and pharmaceutical industries. A real Medicare prescription drug benefit would be administered by Medicare with the authority to negotiate discounts and without a Donut Hole.

Congress passed the Part D program legislation, so only Congress can fix it. It should be a non-partisan priority to improve the Part D program and make it the most efficient and cost-effective way to deliver affordable medicines to people with Medicare. I urge everyone to contact their Congressional Representative and ask them to make improving Part D a legislative priority.

People who are interested in learning more about Medicare Part D and how they can take action to support legislation that would fix Part D can attend a community meeting next Thursday, September twenty first from ten to noon at the Urbana Civic Center. An educational video narrated by Walter Cronkite will be shown and speakers will include Dean Baker from the Center for Economic Policy Research as well as William McNary from Citizen Action Illinois. For more information call 352-6533.