Bush Admits Drug Plan Can Be Daunting
With the Medicare prescription benefit scheduled to take effect in less than three weeks, President Bush acknowledged Tuesday that navigating the complex program could be a challenge -- a complaint often voiced by its detractors.
At the same time, a leading consumer group released a report Tuesday that told seniors how they could save money on the prescription benefit without sacrificing quality.
For the record:
12:00 a.m. Dec. 15, 2005 For The Record
Los Angeles Times Thursday December 15, 2005 Home Edition Main News Part A Page 2 National Desk 2 inches; 65 words Type of Material: Correction
Medicare benefits -- An article in Wednesday’s Section A about the new Medicare prescription benefit said Medicare’s annual coverage of drugs would halt after a person spent $2,250 on medication and would resume after spending on drugs reached $3,600. This coverage gap, known as the “doughnut hole,” actually ends after an individual has spent $5,100. After that, Medicare pays 95% of the cost of prescriptions.
“We fully recognize that for some seniors this is a daunting task,” Bush said after meeting with residents at the Greenspring Village Retirement Community in suburban Virginia. “When you give people choice and options, it can be a situation where people say, ‘This is something I may not want to do.’ ”
White House spokesman Trent Duffy said the president did not intend to criticize the drug benefit -- one of the main achievements of his administration -- but was merely relaying concerns from a retiree he had just talked to at Greenspring. The campus-like facility is home to many middle-class seniors, including a sizable contingent of federal retirees.
Bush urged Medicare beneficiaries to enroll in the prescription program, saying it was “a good deal for our seniors.”
Meanwhile, Consumers Union, publisher of Consumer Reports magazine, said seniors who signed up for the benefit could save thousands of dollars by switching from costly brand-name drugs to more affordable medicines that independent researchers had identified as equally effective.
The organization has posted a selection of such drugs at CRBestBuyDrugs.org. It covers 10 broad classes of medications, including drugs for high blood pressure and high cholesterol, pain and arthritis, and antidepressants. More types of drugs are gradually being added.
Consumers Union said that Medicare beneficiaries who followed its best-buy recommendations could avoid or lessen their exposure to the “doughnut hole.” That’s the name given to a coverage gap in the middle of the Medicare benefit, put there because of federal budget constraints.
The gap is seen as one of the biggest concerns for seniors weighing whether to sign up for the prescription benefit. Under the standard plan, after a person’s total drug costs reach $2,250 for the year, Medicare will not provide any more coverage until total costs hit $3,600. After that point, Medicare covers 95% of drug costs.
The Consumers Union report estimated drug costs for three hypothetical Medicare beneficiaries living in Sacramento, Atlanta and Minneapolis and enrolled in the prescription program. The organization used Medicare’s online Plan Finder to conduct its research.
In each case, the beneficiary was taking the same combination of prescriptions, including anticholesterol and blood pressure drugs and a painkiller.
The analysis found that the hypothetical seniors switching from brand-name to best-buy drugs could save from $2,300 to $5,300 a year.
The best-buy drugs, usually generics, are picked based on an independent review of scientific literature by researchers at the Oregon Health & Science University.
In the analysis, all three seniors were able to avoid the doughnut hole by switching to the lower-cost medications recommended by Consumers Union.
Some private plans providing the drug benefit will offer gap coverage for higher monthly premiums.
Gail Shearer, a Consumers Union health policy analyst, said opting for lower-cost, equally effective medications could allow a senior to pick a less-costly plan and also avoid the gap.
Because of the many choices -- more than 40 plans are being offered in California -- the president urged family members, health professionals and volunteers to help seniors decide.
“Ask your son or daughter, ask people in your church, ask people in AARP, ask people in your community center to help you look at what’s available for you,” Bush said.
“I urge our fellow citizens to help our seniors realize what’s available in this wonderful program,” he said.
Sen. Edward M. Kennedy (D-Mass.) said he was hearing complaints that many volunteers, and even telephone counselors employed by Medicare, were confused.
“Seniors are given information that contradicts itself, and volunteers who are supposed to help navigate the maze of plans and options are overworked to the point of exhaustion,” Kennedy said in a statement. “Americans deserve a prescription drug plan that gives them more than a headache.”
Some lawmakers are calling for an extension of the May 15, 2006, enrollment deadline to give seniors more time to decide. Others want to redesign the program to create a simpler, standard benefit administered by the government.
