HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Tuesday, November 23, 2004

Medicare Prescription Drug Plan - More Costly for Some

The Associated Press reports on a new independent analysis by the Kaiser Family Foundation that shows that the  Medicare Prescription Drug plan isn't saving everyone money.   Although approximately 19 million people will benetif from the new Medicare drug benefit, 10 million others will pay the same or more for their medications.

"The biggest winners are low-income Americans who will receive government assistance that is projected to reduce their drug spending by 83 percent when the drug insurance program begins in 2006, said the Kaiser Family Foundation. The poorest of these people would spend an average of $90 for medicines, said the study by Kaiser, a health care think tank.

The signature component of last year’s Medicare law, the prescription drug benefit will vary widely in its impact on the 29 million older and disabled Americans that the Congressional Budget Office projects will enroll, the study said. The CBO said the average savings will be 37 percent in 2006."

In response, the federal Centers for Medicare and Medicaid Services sent a four-page rebuttal of the report, claiming that it is flawed and tends to "understate savings and exaggerate the number of people who would pay more."

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I saved almost 80% on my prescriptions. The prescription plan really works. Best of all, actually lists member prices on its website No surprises. I found out before joining how much I was going to save. Their website is This is the best Prescription drug card I have ever found. Their literature claims that members saved an average of $24.81 per prescription in 2004 and that the average discount was 68% for generics and between 14.5% and 19.6% for brands. I saved more than this on my prescriptions. If you want prescription savings this is the card to have. You can save more on Drugs than in Canada or the Canadian pharmacies on most medications.

Posted by: Lily | Dec 2, 2004 12:28:19 PM

I am one of about 125,000 transplant patients in this country who must take very expensive anti-rejection drugs.

Consumer Reports said the cost of these meds will nearly double in the next 18 months. Incredible!

My company, which currently provides me with a prescription plan, plans to drop it when Part D takes effect.

I currently pay about $5,000 a year in copays.

The National Kidney Foundation says transplant patients can expect to pay for half the cost of their meds when Medicare's prescription plan takes effect in January 2006.

Taking inflation into effect, I will have to pay $34,000 annually under Part D in 2006. My position is pretty typical.

There is no way most transplant recipients can do this.

I am a disabled journalist and I called all the right people to get my information.

I find it hard to believe the Bush administration would leave so many people in so drastic a position.

I think when this new plan takes effect it will become apparent that many people have fallen through the cracks and are in a devastating position.

Posted by: Bernard Cullen | Dec 17, 2004 11:17:28 AM

An addendum...

I get my prescriptions covered by my employer. So do 93 percent of Americans working for modest-sized to major companies.
An estimated 64 percent of retirees and disabled at those corporations are expected to have their superior prescription coverage canceled and be placed on Medicare's paltry system.
Until this year it was the law that you either offer prescription coverage to all employees or to none.
You couldn't give prescription coverage to your employees when they are healthy but cancel it once they become ill and actually started to use it.
So it seems most seniors and disabled lose and the corporations win - they get to dump their most costly employees on the government's door.
If the Bush administration were following conservative principles it would want workers' insurance covered by the private sector - which had been the practice until now.
Why enlarge Medicare when you have been philosophically opposed to it in the first place? Why begin another government give-away program?
OK, be compassionate and give seniors without insurance Plan D.
But unless the expansion of Medicare was nothing more than a giveaway to large corporations and a political ploy to the electorate, why make it legal for them to drop coverage they already had been giving their sick and elderly?
Its been said you should work for what you get and not burden Uncle Sam.
But what about getting what you worked for? What about the workers who suffered employee deductions for decades and are now left out in the cold?
A lot of transplant patients with new hearts, livers and lungs feel the government has just pulled the plug on them.

Posted by: | Dec 17, 2004 4:41:50 PM

Forgive me for making another addendum.

There are many middle class people who played by all the rules, worked hard, paid taxes, suffered employee deductions and then were struck with a catastrophic illness.

They followed the rules with the expectation that the system they paid to support - private and public - would be there for them if tragedy struck.

Many of these people are young and raising families. Thus far they have been receiving the costly medications they need to stave off death without having to pay a dreadful penalty.

But now society has become cruel and is requiring 5.7 million families (Associaed Press)to decide whether to surrender everything they own if they want the medication they so badly need.

Many are young and have families. The kids will suffer the most as the the family descends into poverty. If my company drops my prescription plan I will end a very successful 30-year career not with a reward, bur rather with abject poverty and destitution.

Many Americans are not aware of this aspect of the Medicare changes. We thought that if we paid our dues, everything would be all right.

The government is very choosey about what drug purchases qualify to help toward filling the "doughnut hole," and patients may have to pay considerably more than $2,000 before they qualify for catastrophic coverage.

But even if Medicare makes these medications affordable to the newly destitute families, people who are already terribly ill will be hit with a new challenge - survival, and their spouses and the childrem will be punished for something they have not done.

Those who are hit with a catastrophic illness and lose their employer's prescription plan may not be able to afford the huge cost of their medications under Medicare's Plan D. They will be faced with the biggest decision in their lives - do they make their families poor and fighting for survival so the spouse can get his lifesaving medications, or does the ailing partner decide to take the more noble route and stop taking these costly medications so his family will at least have a roof over their heads and not be peniless when the spouse is gone.

We are changing as a nation. We are becoming cruel and selfish. And compassion has disappeared in a nation that was once a model for the world.

Posted by: Bernard Cullen | Dec 18, 2004 3:10:06 PM

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