Wednesday, November 16, 2005

As the insurance companies, the medical professions and the drug manufacturers continue to fight against national health care—although “bribe” is more descriptive than “fight”—the Medicare and Medicaid mess gets worse and worse. Forty to fifty million Americans without health insurance; citizens on fixed incomes forced to choose between food and prescription drugs; government plans to shrink what medical care is available... It’s disgraceful, sure. Our politicians are disgraceful for listening to their big donors rather than attempting to really find out what people really need and want.

I’m one of the lucky folks: the HMO I’m enrolled in offers their own prescription plan and if I want another one, I have to disenroll from the HMO. Hot doggies! The choice isn’t mine to make! For another twenty dollars a month on top of my HMO, I can get drugs at somewhat of a discount—after the initial $250 out of my own pocket. Then, when I reach about $2500 dollars, I can pay full price again. I don’t know how to celebrate.

There are a lot of people getting screwed by this plan. Millions find the competing plans confusing; millions of other people just can’t figure things out because the intricacies are beyond their capabilities. It’s hard to know if the the new Medicare regulations were deliberately written in order to do that. My senators voted for this new system, but I can’t get them to explain it to me.

People are standing up and fighting back. We’ll see how effective that is.

Tuesday, November 15, 2005 - 12:00 AM

Groups sue over Medicare drug benefit

The Associated Press

WASHINGTON — Eight advocacy groups asked a federal judge Monday to ensure that no elderly or disabled Americans lose access to their prescription drugs as they enroll in the new Medicare drug plan.

The groups filed a lawsuit on behalf of about 6.4 million people who qualify for Medicare as well as Medicaid because of their incomes. Their earnings are usually well below the poverty level. Nearly 40 percent have dementia or other impairments.

Medicaid, a state-federal partnership, now covers most of their prescription-drug costs. But beginning Jan. 1, Medicare will undertake that role.

The advocacy groups are concerned that some of the "dual eligibles" no longer will be able to obtain drugs, either because they weren't enrolled in a drug plan or could not understand communications about their new coverage. Even temporary glitches could be fatal for the beneficiaries, the groups contended in a lawsuit filed in the U.S. District Court for the Southern District of New York.

"If the government transitions 99 percent of these men and women flawlessly, there will still be 64,000 people without their medicine come January," said Robert Hayes, president of the Medicare Rights Centers, which is based in New York.

The suit, which names Health and Human Services Secretary Mike Leavitt as the defendant, seeks a system under which existing coverage would be continued until these beneficiaries are enrolled in a plan that meets all their prescription needs.

Under the current program, these people can choose any drug plan they believe meets their needs. If they don't choose a plan, they will be automatically enrolled Jan. 1. Last month, Medicare sent letters to dual eligibles letting them know what plan they would be in if they didn't join one before Dec. 31.

Copyright © 2005 The Seattle Times Company

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