Monday, November 14, 2005

A Turkey Stuffed with Prescription Pills.

The President used his radio address this week to urge seniors to sign up for the new Medicare prescription drug benefit.

The problem is, that the plan, written by representatives of the pharmaceutical industry and delivered to Congress to put the finishing touches only on, and which is a sop to that industry, was written by people who seem to be used to writing a complex series of laws. Seniors in many states have to learn about multi-tier pricing, drug formularies, and then pick through the fine print of as many as thirty competing plans, all while being inundated with commercials, sales pitches and mail from people who want them to choose their particular plan (my mother is one such, and she at least is in full possession of her faculties and still has a sharp mind, which some seniors no longer have).

According to the Arizona Republic the day the President visited El Mirage to plug his plan (August 29, 2005, ironically the day the country was suffering the worst disaster within recent memory while he was at a country club in El Mirage, which he followed up the next day with a trip to a posh resort in San Diego, also to push the drug plan), he will be lucky if even half of eligible seniors even sign up for the plan (as opposed to the original assumption that nearly all would). The number one reason cited for people not signing up: the plan is too confusing.

If I was more conspiratorially minded, I would think that the confusion this is all causing was designed to obscure the fact from the seniors invovled that this is mostly a sop to the pharmaceutical companies, but in fact, I will give them the benefit of the doubt and assume that the people who wrote this were just writing it the same way as if they were writing it to an audience of industry specialists and corporate lawyers, like most of the stuff they write.

And the biggest irony: Some conservatives (notably Republic columnist Robert Robb) have touted the fact that the plan is now considered likely to come in under budget as a measure of its success. Sure. And if you cancelled it completely and no one at all signed up for it, just think of how much more under budget that would be. Only conservatives could take such a resounding failure and spin it into a success.

This bill was a turkey the day it was voted on (which is why Democrats opposed it), it is still a turkey today, and it will be a turkey once it is implemented.

There. Unlike the bill itself, I just described it in short, simple, concise language that leaves no room for confusion.


Anonymous said...

I agree with you on this one Eli. But, how would the Democrats solve the problem that seniors have with hyper-expensive medications?

Eli Blake said...

Easy, Mark.

The same way we have proposed solving it in the past.

1. Allow states and for that matter the Federal Government to negotiate prices with the pharmaceutical companies, the same as every other country in the world does. For that matter, if people want to buy from overseas sources, as long as the drug is legal and approved in the U.S., why can't they? The claim that they have been making that drugs are of questionable quality JUST because they are being sold from a Canadian pharmacy is laughable-- I have no problem if you want to limit foreign sources to pharmacies that you have confidence in, but then you have to make an honest effort to list them, not the blanket ban being pushed by the Bush administration.

And it isn't like the pharmaceutical companies aren't making a profit selling drugs in Canada or Europe or Japan, if they weren't, then they wouldn't sell them there.

Now, I understand that the higher price that Americans pay also help subsidize drugs in poorer parts of the world. And I have no problem with paying a little more to help subsidize the cost of drugs in Bangladesh of Zambia. But I do have a problem with paying more to effectively subsidize drug prices in places like the Netherlands and Saudi Arabia.

2. Make the prescription drug plan simple and directly benefit seniors. Why not just have Medicare cover a percentage, say, 50% of drug costs up to a maximum amount (say $10,000 per year), after which a trust fund could be set aside to pay the rest of the costs for the sickest of the sick. I suspect this would in total probably cost less than the price tag for the current bill, and is very simple and easy to understand (you could jimmy with the percentages but the concept is still there, and should be the same numbers for everyone).

3. Don't let companies pull the same stunt they did with Prilosec last year. When the patent expires on a drug, don't interfere with allowing generic manufacturers to quickly bring it to the market.

The fact that this administration not only allows, but by restricting re-importation of drugs, assists pharmaceutical companies in selectively gouging Americans, is shameful.

Liberals believe it is the purpose of Government to help people out, not help pharmaceutical companies or others who are trying to give them the shaft.

dorsano said...

We accept negotiated volume pricing agreements in the private sector all the time. Walmart pays it's wholesalers less than Target or K-Mart for the many of the same goods.

MN Governor Pawlenty (R) recently instructed the MN Department of Human Services to research Canadian pharmaceutical companies set up a web site which allows people in MN to purchase drugs directly from the Canadian providers.

Those who do purchase from Canadian suppliers are saving anywhere from 10% - 20% per monthly perscription. For anyone requiring sustained medication, this is a significant savings.

Pawlenty was threatened with retalitory action from the FDA and held his ground. But it's hard to say how much of that back and forth was political theatre.

MN is a progressive state. We still elect liberal Republicans and the libertarian policies in vogue in the GOP at the national level are a tough sell - so he have received special treatment from Washington.

dorsano said...

If seniors don't sign up for coverage, should they ever signup, they will need to pay one percent of the base beneficiary premium every month for the duration (the calculation of the penalty is actually is much more complicated but that's a good figure for the point I want to make)

The penalty is in place because the program can't succeed with only high cost drug users subscribing.

The program needs low cost drug users to help fund the high cost drug users - thus the penalty.

This brood of GOP leadership is anti-collectivist - they view collectivist programs like medicare and social security as socialistic or big government.

Yet collectivism works - and the insurance industry is proof - and they need collectivism to make this program work as designed - as poor a solution as it is.