Medicare Part D: Still Broken or A-Okay?

Depending on who you listen to, Medicare Part D is either a seriously flawed program that primarily benefits the pharma industry, or a program that is satisfying customers, dropping prices, and showing that the magic invisible hand of the free market can work wonders. This editorial in US News and World Report is all praise, for example, while this article in The New York Times, this post on Daily Kos, and these reports from Families USA, paint a picture of the program’s ongoing confusion, expense, and rip-off of seniors for the sake of padding the wallets of corporate America.

It’s very hard to get past the spin on this one. Reportedly, 80% of seniors enrolled in Medicare Part D are expressing satisfaction with the program. That is indeed good news. One of the unanswered questions, though, is why more seniors have not enrolled in the program. The cost of the program was less than expected the first year. One reason appears to be because so few people signed up, particularly low-income seniors. So it may be that many of the 80% who are satisfied are not low-income seniors. They are people who were paying for much of their healthcare out of pocket, and who had the means to do so. Hence, they don’t end up crying when they don’t have money to cover the costs of their drugs in the doughnut hole. It may be that this statistic would look different if the program was serving the large number of low income seniors who are currently not enrolled.

Another point where it is unclear who is spinning and who is telling the truth is regarding whether costs of the program for consumers will go up in 2007. The US News article quotes an analyst saying that the cost of programs is dropping in 2007, while data from Families USA says just the opposite — that the cost of premiums and copayments for 10 out of 13 programs they examined are going up in 2007.

So it will be interesting to see what the Dems do when they get to Washington and attempt to fulfill their legislative agenda for the first 100 hours, including seeking the ability to negotiate prices on drugs with the pharmaceutical industry, and doing something about the doughnut hole that catches low-income seniors off-guard with giant prescription bills.