The medicare drug benefit is a huge help for millions of seniors. There are the critics of the program, but prior to 1/1/2006 seniors paid for drug cost 100% out of pocket unless they were on medicaid in addition to medicare.
The biggest complaint of Medicare part D has been the coverage gap. This year each medicare beneficiary enrolled in part D has $2830 in drug coverage before they hit the gap. Then they have to pay 100% of the drug cost until they have $4550 out-of-pocket. For most seniors hitting the donut hole this out-of-pocket limit is rarely reached before the whole process is started over Jan. 1 of each year.
One big selling point of the bill passed Sunday touted elimination or reduction of the gap that hurts seniors. Well they delivered.... $250 for seniors reaching the gap. $250 thrown at a $4550 problem... that's nice. That equals about a 5.5% reduction in the out of pocket portion of the GAP... big deal. For seniors reaching the gap that won't be realized as much help when some of the more expensive medications can cost $250 for one month's supply.
What would have helped more? Drug price control. Medicare has fixed prices for everything a medicare beneficiary gets medically... except drugs. The market is free to charge what they will. I blame the last administration as well as this one for being chickens when they needed to control big pharma. One simple regulation setting the price of every drug prescribed to a medicare beneficiary to the price they are sold at in Cananda would have saved seniors more than $250 this year and saved Medicare billions. There is no reason a drug can be sold for $220 here and you can order the same drug from Canada for $85 and it is made in the USA.
The biggest complaint of Medicare part D has been the coverage gap. This year each medicare beneficiary enrolled in part D has $2830 in drug coverage before they hit the gap. Then they have to pay 100% of the drug cost until they have $4550 out-of-pocket. For most seniors hitting the donut hole this out-of-pocket limit is rarely reached before the whole process is started over Jan. 1 of each year.
One big selling point of the bill passed Sunday touted elimination or reduction of the gap that hurts seniors. Well they delivered.... $250 for seniors reaching the gap. $250 thrown at a $4550 problem... that's nice. That equals about a 5.5% reduction in the out of pocket portion of the GAP... big deal. For seniors reaching the gap that won't be realized as much help when some of the more expensive medications can cost $250 for one month's supply.
What would have helped more? Drug price control. Medicare has fixed prices for everything a medicare beneficiary gets medically... except drugs. The market is free to charge what they will. I blame the last administration as well as this one for being chickens when they needed to control big pharma. One simple regulation setting the price of every drug prescribed to a medicare beneficiary to the price they are sold at in Cananda would have saved seniors more than $250 this year and saved Medicare billions. There is no reason a drug can be sold for $220 here and you can order the same drug from Canada for $85 and it is made in the USA.
