Booman Tribune

Medicare D: Today's Responses and Reality

by Street Kid
Tue Jan 24th, 2006 at 09:29:24 PM EST

Both Sentors Dick  Dubrin and Carl Levin now offer "solutions" to the Medicare D(isaster).

From Senator Dick Durbin:

The Medicare bill was drafted with the most powerful Republican donors in mind: pharmaceutical and insurance companies...Republicans followed an ideological belief...by forbidding Medicare from negotiating with pharmaceutical companies and handing the program over to private companies offering hundreds of plans...Americans expect us to put their interests ahead of special interests. Republicans should join Democrats in their plan to extend the enrollment period and in efforts to allow Medicare to offer drug coverage directly and to negotiate prices much as the Department of Veterans Affairs does

continued

Senator Carl Levin intends to ask Congress to:

  •  Prohibit the clause that allows Medicare drug plans to change the list of prescription drugs they will pay for during a calendar year.

  •  ...propose that insurance companies be allowed to change their list of covered drugs, called formularies, only once each year during the patient open-enrollment period.

  •  Eliminate prescription-drug co-pays for patients who used to receive their prescription drugs for free through Medicaid.

  •  Offer relief to those seniors who used to pay a fraction of their drug costs through pharmaceutical company plans designed to help low-income Americans. Many seniors and disabled people who qualified for that help now aren't eligible for low-income assistance...and must pay more for their medications.

  •  Eliminate the segment of Medicare drug coverage called the doughnut hole...for most Medicare beneficiaries it begins when their total drug costs reach $2,500 -- during which beneficiaries must continue paying a monthly premium for their Medicare prescription drug plans, but they receive no help with their drug costs.

And here is what some rx-makers are doing:

...ending programs that provided free or discounted prescriptions to elderly Americans now that pharmaceutical benefits are widely available under the Medicare program--saying government rules are forcing them to back away...companies say certain of their assistance programs could be interpreted as a kickback to win loyalty to their prescriptions.

Reality is that there are many people in life-threatening situations as they are not able to afford their rx's under Medicare D.  An example of this is Crystal Bell, who received a kidney transplant in 2003.  Her rx costs were supposed to paid by Medicare D, however, the cost  s have now doubled, as Medicare D, doesn't pay 50-percent for the drugs she's taken after her kidney transplant.

According to Ms. Bell

"...its either rent or medicine...and I choose medicine...I could have been the person next door to you, or your daughter's friend in high school, and now look at me, I'm just trying to get by...I'm not going to give up, you can't kill me."

After calling Medicare, Ms. Bell was told that the problem should be fixed in 30-60 days.  Her response?

"I don't have thirty to sixty days."



Display:
x-posted at dkos and mlw

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi
by Street Kid on Tue Jan 24th, 2006 at 09:41:04 PM EST
You're doing a superb job tracking this. ....

if our stupid local newspaper didn't have this lame rule about not posting its news stories, I could point you to an incredible story of a Port Angeles man who's had a brain tumor for 13 yerars but, because of expensive medications, he's been able to keep going and to have a reasonably decent life.

He did everything right.  He signed up properly, etc.  But when he went to RiteAid, they said his drugs weren't included in the plan.  And, the company is in California, beyond the reach of the Washington state attorney general and insurance commissioner's offices.

His cancer specialist here called and called the new insurance company that he got through Medicare -- This WONDERFUL doctor sat on hold for 2 hours at one point, trying to get those drugs for his patient.

In the meantime, a local pharmacy has pitched in with the $3,000 in drugs he needs ... but that's only good for a month.

The article explains all this better than I, but that's the gist of it.

Hickok: "You know the sound of thunder. Can you imagine that sound if I ask you to? Ma'am, listen to the thunder."

by susanhu (susanhuatearthlinkdotnet) on Tue Jan 24th, 2006 at 11:31:12 PM EST
[ Parent ]

I know they are not the only ones, who are doing whatever they can to save the lives and health of people.

And I wonder, what would happen if the evil drug companies themselves were contacted by these patients or their advocates, with the advance knowledge of local media like your hometown paper?

Might some of them be shamed, or ok, shame not possible, but embarrassed or motivated by a desire for better public relations to help out some people?

I know it would be a drop in the bucket, throwing crabs back into the sea, but to each crab thrown back, it is is a big deal...

one man's conspiracy is another man's business plan
Blog updated as needed

by DuctapeFatwa (DuctapeFatwa@yahoo.com) on Tue Jan 24th, 2006 at 11:48:57 PM EST
[ Parent ]
And I wonder, what would happen if the evil drug companies themselves were contacted by these patients or their advocates, with the advance knowledge of local media like your hometown paper?

It would be a damn good idea, especially if the amounts that an rx company and insurance carriers "donated" to those who voted for this crap also made the papers!!!

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

by Street Kid on Tue Jan 24th, 2006 at 11:55:27 PM EST
[ Parent ]
This whole thing is just beyond belief.  People not getting their rx's...even though it is happenning, it seems incomprehensible to me that the legislation for Medicare D(isaster) was actually passed, let alone intorduced and voted on.  

And, the example you gave was just another...in addition to the one that I found.  

Suggestions:  One thing that might work to help the Port Angeles man get his rx's is for him (or a family member) to call his congresscritters and Senators, and remind them on how he voted.  And then, if he doesn't get his rx's really raise hell.

Another thing:  contact the Medicare Rights Center

Phone: 202-589-1316  DC

Phone: 212-869-3850  NY

But, they may say something to the effect that he may have to appeal, but there is a provision that a person can get their rx's if they are considered to be life-saving.  (If I am understanding all of this correctly.)

website:  http://www.medicarerights.org/


"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

by Street Kid on Tue Jan 24th, 2006 at 11:50:51 PM EST
[ Parent ]


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