Friday, January 20, 2006

One Good Thing About The Medicare Part D 'Donut Hole'

by Tom Bozzo

A couple months ago, I'd had a brief blog debate with my good friend Jeremy Freese over the degree of pathology of the 'donut hole' where the new Medicare prescription drug benefit provides no coverage for a range of out-of-pocket expenses; I'd argued that it was worse than Jeremy had made it out.

That was, of course, before the massive clusterf*ck that's accompanied the rollout of the benefit. (Among other things, it serves as a reminder of the power of DeLong's Paradox: The Bush administration is always worse than you think, even after accounting for the fact that it's worse than you think.) The particular timing of the rollout is such that there should be legions of pissed-off senior voters either in, or with fresh memories of, the 'donut hole' — among other pathologies of the program structure — just in time for the midterm elections.

Of course, Democrats must both successfully remind voters whose brilliant idea the whole thing was, and offer a coherent alternative. In this regard, we have to give snaps to Jamie Wall up in the WI-8 for having issued a press release noting the impending disaster and offering a substantive Medicare Part D reform platform last December 12. Way to get ahead of the issue! Wall usefully focuses on using Medicare's purchasing power to reduce prices, though he's arguably a bit under-focused on the inefficiencies associated with private administration of the benefit — a theme of this morning's Krugman column (Times Select subscribers), excerpted at Economist's View for non-Times Selecters.
Comments:
The Democrats have had plenty of opportunity to take advantage of the missteps of this particular administration. The fact of the matter is that they won't. It's cynical of me for thinking this, but ...

Response to Katrina? Vehement at first, then nothing.
Response to War Missteps? Eh. Hillary isn't saying anything; it must be all right.
Response to Domestic Spying? Hello? Anyone home? Well, except for this...Progressive Patriots...I love Russ Feingold.
And now Medicare...

you'd think with all of these states stepping forward and saying "Look the Federal goverment has F&(#ed you all over but we can bail you out of this current clusterf*%k, until they get their heads out of their a$$es" would spur the Dem Party to action. I bet we see a lot more of this isue when it comes to election time ...especially from Dem Governors who are looking for reelection and looking to pad their state houses with the like minded...instead of having to swim upstream to get anything passed.
 
Sara, you're definitely preaching to the choir here. The Dems' toothlessness is most perplexing. Either they haven't gotten the message on what they're dealing with, despite Krugman shouting it at 11 on the Times op-ed page (darn Times Select), or the whole lot of their strategists need to be sent to work at fast-food restaurants until they acquire a clue, or perhaps both.

Russ is looking strong these days, though.
 
Sorry for being late to this. It's a marvel how screwed up the rollout has been. I've been curious to look back at the origins of Medicare itself to look over the stories surrounding that rollout.

I also liked your more recent post about the web tool. I have no idea what to think of that.
 
Medicare D worked great until I reached the "Donut Hole". My Wonder medicine for Luekemia, "Gleevec" costs $2,700 a month, which was covered by Kaiser Senior Advantage, with a $30 co-payment until we reached the cost where I pay the full amount. Now for $2,700 I will pay full price for about two months. That's approximately $5,400 for the two months, then they will charge me about $5 or$10 co-pay. I could sell my wifes car and pay for most of that. I need one car to go to work because I can't live on my $1,350 retirement check. Do you know anyone who can?

That Donut Hole doesn't make any sense. Every year I will have to come up with over $5,000 to cover the Donut Hole. "Disappointed"
rburkhart2300@yahoo.com
 
Richard: Sorry to hear about your situation. You're right, the donut hole doesn't make sense; you'd have paid less, on average, without it. (See here.)

If it's available (I'm not sure what the story is with changing plans at this point), you could be better off with one of the higher-premium plan that offers coverage in the hole, assuming Gleevec is in the formulary -- those work best for people who require expensive drugs. You can get some indication of the least expensive plan by entering your specific medications in the Medicare web site's plan finder.
 
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