Thursday, April 27, 2006


Medicare Robbery, CEOs Join In

Been a while since I posted a two-fer. This is about the other government—yeah, I know, which other—fiasco: health care.

The percentage of Americans without health care keeps climbing: not just the numbers. If it was just the numbers, then it could be attributed to population growth; but it’s the actually percentage, the proportion of people who are uninsured. Oregon has one of the largest number of uninsured children in the country. As long as the Bush-Cheney Junta is running the nation, we’re not going to see health care improve. They only care about making it worse, except—

Except for the insurance companies. The HMO’s are making a killing. The pharmaceutical industry is making money like they’re printing it. I’m running along on Part D of Medicare, but I can see that drugs costing $10.00 apiece are going to yard me into out-of-pocket costs; Beth, my own true love, has nearly reached the place where she’s facing hundreds and hundreds of dollars a month in prescription costs.

In the first article, below, there’s an obvious lie: the government designed the Medicare prescription benefit to help the drug industry.

The second article is about how nicely the HMOs are doing under our current system of health semi-care. Every year the covered services become fewer, but the CEOs make more and more. I’m just boggled by the utter lack of concern, empathy, even sympathy by our rulers and the rich businessmen. I hope there is a Heaven, and a Hell, just so those fat-cats can go and shovel molten steel for eternity.

Disabled, seniors confront Medicare hole
4/27/2006, 12:07 a.m. PT
The Associated Press
WASHINGTON (AP) — Mildred Lindley is stuck in a hole, the doughnut hole — "right in the middle of it," she says — that comes with Medicare's new prescription drug benefit.

Just four months into the program, Lindley has hit the point in her coverage where she has to pick up, at least for a few months, the full cost of the medication she takes to keep her bone marrow cancer in remission. As a result, her two-month supply of Thalomid shot up from $40 to a whopping $1,300.

"If I can't get it, I guess I'm here until the Lord takes me out. That's all I can do, because there's no way I can afford it," said Lindley, an 80-year-old from Jonesboro, Ark.

"I'm in the hole all right."

Under the standard drug benefit, the government subsidizes the drug costs for seniors and the disabled. But after costs reach $2,250, the subsidy stops until a beneficiary has paid out $3,600 of his or her own money. Then, the government will start picking up 95 percent of each purchase.

Congress designed the drug benefit to give people some help with their initial drug costs, plus help those who have massive expenses. The doughnut hole was designed to reduce the overall cost of the program and still allow the federal government to meet those two goals.

About 6.9 million Medicare beneficiaries will have to deal with a gap in their drug coverage at some point this year, according to estimates from the Kaiser Family Foundation, a health policy research group.

Medicare officials point out that, even with the doughnut hole, millions of seniors are getting financial help that they never had before. They also stress that the poorest of beneficiaries will get extra help to cover their medications.

However, there are beneficiaries who are convinced they will be worse off, many of whom had relied on free medicine provided by the drug manufacturers. They were told by the manufacturers this year that the free supplies would stop now that they were eligible for Medicare coverage.

Victoria D'Angelo of Denver relied on the patient assistance programs for many of her prescription needs last year. She enrolled in a Medicare drug plan when told by one of those companies that such help would end Jan. 1.

Now, that she's hit the doughnut hole, she's charging some of her drugs to her credit card. She said she'll worry about the ramifications later since she cannot afford to skip taking her Seroquel, which is used to control bipolar disorder.

"Basically, I've been to hell and back on this," said D'Angelo, referring to her disease. "I'm just deathly afraid of getting sick again."

Shirley Rhodes of Gladwin, Mich., figures that while she and her husband, Samuel, are in the doughnut hole, they'll have about $49.67 a month to live on after covering their drug expenses.

For that reason, they will wait until the last possible day to enroll in a Medicare drug plan. In the meantime, she'll continue to ask the pharmaceutical companies to help her out, and she'll work with Social Security officials to figure out how the family might qualify for extra assistance through Medicare.

"If we don't qualify, we will be giving our house back to the mortgage company, and then we'll still owe for the second and third mortgage," Rhodes said.

Some beneficiaries pay higher monthly premiums to make the doughnut hole smaller or do away with it entirely. Also, the poorest beneficiaries don't have to worry about it at all.

Analysts say that most beneficiaries who hit the doughnut hole probably won't get there until the fall.

Mark McClellan, administrator of the Centers for Medicare & Medicaid Services, stresses that the beneficiaries may be able to avoid the doughnut hole entirely by switching to generic drugs or lower-cost brand names.

Consumers Union, publisher of Consumer Reports, says that senior citizens taking five commonly prescribed drugs _for high blood pressure, cholesterol, heart disease, arthritis pain and depression_ could save between $2,300 and $5,300 a year under various Part D plans by switching to lower-cost drugs.

Lawmakers are also pleading with drug manufacturers to continue with patient assistance programs that allowed many low-income people to get free medicine.

"We've got a situation where it looks like the May 15 date has become an excuse for dropping the assistance that many Medicare beneficiaries rely on, and that's not right," said Sen. Charles Grassley, R-Iowa.


On the Net:

Medicare site:

Consumers Union:

Centers for Medicare & Medicaid Services:

Copyright 2006 Associated Press. All rights reserved.
This material may not be published, broadcast, rewritten, or redistributed.


Dave Zweifel: 'Greed thrives in our health care system'
Date: Thursday, April 27 @ 10:03:22 EDT
Topic: Corporate America

Dave Zweifel, The Capital Times (Madison, WI)

Here's another one to remember when someone tells you that our "private" health care system works:

The Wall Street Journal ran a front-page story last week with the headline that said it all: "As Patients, Doctors Feel Pinch, Insurer's CEO Makes a Billion."

The story, datelined Minnetonka, Minn., was about William McGuire, a doctor who stopped practicing in 1986 to take a management job with UnitedHealth Group Inc., one of the largest HMOs in the country.

He's now the chief executive officer of the corporation, makes $8 million a year in salary plus bonus, has personal use of the company's private jet and has amassed what the Journal describes as "one of the largest stock options fortunes of all time."

According to the newspaper, those options total $1.6 billion.

"Even celebrated CEOs such as General Electric Co.'s Jack Welch or International Business Machines Corp.'s Louis Gerstner never were granted so much during their time at the top," the WSJ story said.

But the gist of the story is that while McGuire and other UnitedHealth execs are raking in millions, their company is putting the squeeze on everyone else.

"Dr. McGuire's story shows how an elite group of companies is getting rich from the nation's fraying health care system," the bible of the business world reported. "Many of them aren't discovering drugs or treating patients. They're middlemen who process the paperwork, fill the pill bottles and otherwise connect the pieces of a $2 trillion industry."

The newspaper's research shows that UnitedHealth has particularly benefited in recent years as health care inflation eased somewhat.

Insurers still raised premiums at double-digit rates. At UnitedHealth, for example, its stock price tripled from January of 2003 to January of this year and its net income rose to $3.3 billion. Hence, the nice board-of-director-approved windfall for McGuire. (Interestingly, former UW-Madison Chancellor Donna Shalala is a member of UnitedHealth's board.)

"In Minnesota, such riches have infuriated some people," the story continued. "Joel Albers, a Minneapolis pharmacist, regularly impersonates Dr. McGuire at state fairs, donning a tuxedo, holding up an enlarged picture of Dr. McGuire on a stick and handing out leaflets denouncing corporate greed."

Of course, this is just one more anecdote that serves to describe our broken health care system, which leaves more than 40 million Americans without coverage and an embarrassment of riches for those who know how to milk that system.

On one hand we have Medicare, which provides universal single-payer coverage to all Americans over age 65 at about a 2 percent administrative cost. On the other hand we have a hodge-podge of plans with layer after administrative layer that gobbles up close to 20 percent in overhead costs (Dr. McGuire's just a piece of that) and leaves millions out in the cold.

How hard can it be to choose in which direction we need to go?

Dave Zweifel is editor of The Capital Times. E-mail:

Copyright 2006 The Capital Times

Source: The Capital Times (Madison, WI)

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