OVERSHADOWED by SamuelAlito's nomination to the Supreme Court and continuing debate over the War in Iraq, few have been paying attention to one of the greatest expansions in government programs in recent history. This Tuesday marked the first day 42 million senior citizens nationwide could enroll for the Part D programs under the Medicare Act of 2003, following substantial reorganizing and a promise of $724 billion by the federal government over the next 10 years to fund Part D.
According to Medicare.org, the Part D reforms are based on the premise that increased competition among private health plans will keep costs low and increase the choices of health care plans provided to senior citizens. Due to its obscenely complicated programs and reliance on the private health sector to create the competition necessary to keep costs low, the reform will do little to advance the fundamental goals of the Medicare program: to increase the accessibility of health services and prescription drugs to the elderly.
With a rapidly aging population, the strains on Medicare are similar to those being felt by Social Security. According to the 2004 Census, the population over 65 is expected to almost double by 2030 -- to 71.5 million Americans, or about 20 percent of the total U.S. population.
In an effort to counter the effects of the expansion of benefits, the plan will increase the flexibility and choices available to senior citizens by relying on private sector competition, according to the New York Times. How this is actually going to be implemented is where it gets tricky: senior citizens can choose from over 40 different programs in most states.
Each program offers various benefits for different drugs in addition to substantially diverse ranges of coverage and costs. Each of the programs may or may not be accepted at beneficiaries' local pharmacies or include perks such as coverage for doctor's visits. To add to the headache of figuring out which program fits, beneficiaries who fail to enroll for Part D coverage by May 15, 2006 face an increase in premiums as penalty, according to the Washington Post.
While the Bush administration is unabashedly touting the future success of a program that is barely a few days old, no one can quite figure out exactly what the programs entail. A poll conducted by the Kaiser Family Foundation, cited in the New York Times, found that only 35 percent of citizens over 65 claimed to understand the new reform.
To counter the confusion, information sessions and workshops are being held nationwide and run as long as eight hours. As former president of the Kansas Pharmacists' Association Brian D. Caswell told the Times, "The program is so poorly designed and is creating so much confusion that it's having a negative effect on most beneficiaries."
To add to the cynicism, scam artists are having a field day conning confused senior citizens into illegitimate programs, according to an Oct. 15 Dallas Morning News article.
Supporters of the program argue that relying on private competition is the best solution for meeting the demands of a rapidly aging population. While offering senior citizens a wide degree of choice between dozens of programs sounds great when touted by President Bush as the "greatest advance in health care for seniors in 20 years," the Part D reforms are so difficult to implement that it is failing in its purpose of expanding accessibility to drug benefits and solving the crisis of increasing drug costs.
One solution to rising drug costs is to implement a uniform national drug prescription benefit program to increase the access to drug benefits without reliance on private insurers. While this would undoubtedly increase the costs of Medicare, repealing the $1.6 trillion tax cut enacted under the Bush administration, would offset much of the cost.
The purpose of a Medicare prescription drug program should be to allow senior citizens, under a comprehensive government umbrella program, cheaper access to prescription drugs. Offering senior citizens 40-plus choices of programs in which to enroll does not increase the comprehensiveness or accessibility of a program which for 40 years has served as a safety net for millions of Americans.
Sophia Brumby's column appears Thursdays in the Cavalier Daily. She can be reached at sbrumby@cavalierdaily.com.
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