Even the person who came to explain it to us didn't understand it.

[Guest guest]

If a program was designed to confuse, misrepresent, and appear to help when it

doesn't, then with results like this, the program would have to be qualified as

a success....

 

-------------------------

 

QUOTATION OF THE DAY

 

" Even the person who came to explain it to us didn't understand it. "

MARY SHEN, 77, on the government's new drug discount program.

 

 

________________

 

http://www.nytimes.com/2004/05/12/national/12medicare.html?th

May 12, 200473 Options for Medicare Plan Fuel Chaos, Not Prescriptions

By JOHN LELAND

 

 

When Mildred Fruhling and her husband lost their prescription drug coverage in

2001, they suddenly faced drug bills of $7,000 a year. Mrs. Fruhling, now 76,

began scrambling to find discounts on the Internet, by mail order, from Canada

and through free samples from her doctors.

 

" It's the only way I can continue to have some ease in my retirement, " she said.

 

Last week, when the federal government rolled out a new discount drug program,

Mrs. Fruhling studied her options with the same thoroughness. What she found,

she said, was confusion: 73 competing drug discount cards, each providing

different savings on different medications, and all subject to change.

 

" I personally feel I can do better on my own, " she said. But she added, " At this

point, I don't think anyone can make an evaluation. "

 

Even before they go into effect on June 1, the cards — which are approved by

Medicare but offered by various companies and organizations — have been the

subject of heated political debate, an AARP advertising campaign about how

confusing they are and anxious speculation from those they are supposed to help.

Among retirees of different income groups interviewed last week, the initial

reaction was incomprehension.

 

" Even the person who came to explain it to us didn't understand it, " said Mary

Shen, 77, at the Whittaker Senior Center on Manhattan's Lower East Side. " It's

not fair to expect seniors, who have enough difficulties already, to have to

figure this out. "

 

Shirley Brauner, 75, pushed a metal walker through the center's lunchroom. " All

I've got to say is they confuse the elderly, including me, " she said. " I'm

furious. They're taking advantage of the seniors. How can the seniors understand

it? "

 

The prescription drug discount cards are a prelude to the Medicare Prescription

Drug, Improvement and Modernization Act, which will provide broad drug coverage

starting in 2006. The federal government projects that 7.3 million of Medicare's

41 million participants will sign up for the cards.

 

Those who wish to do so, however, face the daunting task of choosing the right

card.

 

" What it's like is a bunch of confusion, " said Katharine Roberts, 77, who said

she had not been to a movie in six years, in part because of her drug expenses.

" You might find you really need three cards, and you can only choose one. "

 

The cards are a 19-month stopgap measure to provide discounts of 10 percent to

25 percent for Medicare participants who have no other prescription drug

coverage. In addition, low-income participants are eligible for subsidies of

$600 a year.

 

The Department of Health and Human Services approved 28 companies or

organizations to issue cards; among them are AARP, insurance companies and

health maintenance organizations. Cards cost up to $30 a year. Each card

provides different discounts on different drugs, and is accepted by different

pharmacies. Participants can choose only one.

 

To help people sort through the options, Medicare and a company called

DestinationRx set up a database on its Web site, medicare.gov, that lists the

prices charged under various plans for whatever medications a user types in.

People can get similar help by telephone at 1-800-MEDICAR. But some providers

complained that the prices on the site were inaccurate, and some cards are not

listed at all.

 

For many retirees, it is too much.

 

" I'm 85, do I have to go through this nonsense? " asked Florence Daniels, a

retired engineer who said she received less than $1,000 a month from Social

Security, of which she paid $179 a month for supplemental medical insurance. She

gets drugs through a New York State program, which provides any prescription for

$20 or less. To make ends meet and afford her drugs, she said she bought used

clothing and put off buying new glasses. Some of her friends travel by bus to

Canada to buy drugs; others do without, she said.

 

Ms. Daniels did not use the government Web site to compare drug cards, in part

because she cannot afford a computer. " I'm trying to absorb all the information,

but it's ridiculous, " she said. " Not just ridiculous, it's scary. If there was a

single card and it was administered by Medicare, and it got the cost of drugs

down - wonderful, marvelous. But with these cards, the only thing we know is

that we'll have to pay money to other people to administer what we can get and

can't get. "

 

The discount program, which is financed largely by the cards' sponsors, reflects

the Bush administration's desire to open Medicare to market principles without

allowing participants to import drugs from other countries, which many Democrats

favored.

 

Mark B. McClellan, an administrator at the Center for Medicare and Medicaid

Services, said the complexity of the plan encouraged competition. " We're seeing

more plans offering better benefits, " he said, estimating that people will be

able to save 15 percent or more using the cards.

 

But the complexity of choices will keep many people away from the program, said

Marilyn Moon, director of health at the American Institutes for Research, a

nonprofit research organization in Washington.

 

Often, the discount provided by the cards is not as good as what people can get

from existing state programs, union plans or consumer groups, said Robert M.

Hayes, president of the Medicare Rights Center, a nonprofit organization that

helps individuals with Medicare problems.

 

Sydney Bild, 81, a retired doctor in Chicago, compared the discount cards with

the prices he paid ordering his drugs by mail from Canada. Dr. Bild pays $4,000

to $5,000 a year for five medications. When he checked the government Web site,

he said the best plans were about 50 percent to 60 percent higher than what he

was paying.

 

But Dr. Bild said his main objection to the new plans was that companies could

change prices on drugs, or change the drugs covered. Medicare requires plans to

cover only one drug in each of 209 common categories. Consumers can change cards

only once a year. Committing to a card is " like love - it's a sometime thing, "

Dr. Bild said. " What if I chose one? They could drop my drugs two weeks later. "

 

Companies began soliciting customers for their discount drug cards last week.

When the first pamphlets arrived at Beverly Lowy's home in New York City, Ms.

Lowy said, she looked at them carefully. She does not have drug coverage and

last year spent about $3,000 on prescription drugs. But the more brochures she

read, Ms. Lowy said, the less clear things became.

 

" You really have to be a rocket scientist, " Ms. Lowy, 71, said. " It takes time,

energy, and you don't even save money. I thought, 'This one is offering this,

this one is offering that.' Finally I decided this isn't for me. "

 

At the Leonard Covello Senior Center in East Harlem, the new cards seemed

opaque. Ramon Velez, 72, a retired taxi driver, said he had watched AARP

advertisements in which people read the dense language of the federal Medicare

bill.

 

" I was laughing at the people in the ads, but it's true, " Mr. Velez said.

" Everyone's confused. "

 

Mr. Velez receives $763 a month from Social Security, and often skips his

psoriasis medication because he cannot afford the $45 co-payment under his Blue

Cross/Blue Shield plan. He wondered if the new drug cards could save him money.

 

" But it's very confusing, " he said. " I'd go to the Social Security office to ask

about the cards, but I don't think they'd know. "

 

Alejandro Sierra, 67, a retired barber, paced around the center's pool table.

Mr. Sierra takes six medications for diabetes and complications from cataracts

and colon cancer, and sometimes skips a medication because he cannot afford it.

 

" I'm interested in the cards, " he said. " But I can't figure it out on the

computer, because I can't see. "

 

Carlos Lopez, the director of the center, said the cards had so far produced

little but anxiety. Mr. Lopez asked participants to bring any applications to

him before signing them, and warned them about people selling phony cards.

 

" They're not nervous, but concerned, " he said. " They feel, why now? Why do I

suddenly need a card for medications? "

 

 

 

Copyright 2004 The New York Times Company |

 

 

 

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