Medicare_Part_D

Medicare Part D | How did it get passed Homeland Security' | | Professor Lee, HA540, Kaplan University | | Anna-Marie | 5/17/2011 | | * * (Credit: Wikimedia Commons) * Medicare Prescription Drug Improvement and Modernization Act of 2003, (MMA) became law through an extremely long list of inequities, illegal charades, political-back-scratching, manipulative, high-stakes-lobbying. The long list of staffers, responsible for the details of the bill, turned lobbyists for the drug companies, with billions at stake. It is hard to imagine how drug companies have been handed the reins, so-to-speak, when we examine how the self-centered industry’s interests prevailed when Part D was created in 2003. As details of the prescription drug benefit were being debated, different proposals were introduced that would have allowed the government to negotiate for lower drug prices, just like it does for the drugs it buys for Medicaid and for the Department of Veterans Affairs. After lobbying by pharmaceutical companies, and aggressive tactics by House leaders, the final bill specifically prevented the government from negotiating for lower drug prices. It also banned importation of cheaper drugs from Canada and gave drug companies stronger protections against their generic competitors. Congressional leaders made sure the bill passed. In violation of House rules, members were given less than 24 hours to read the 850-page document, and the final vote was called about 3 a.m. Instead of closing the vote 15 minutes after voting began, as required by House rules, leaders kept the vote open for almost three hours, the longest roll call vote in the history of the House of Representatives, while they worked the floor. In 2006, Rep. Louise Slaughter, D-N.Y., called that night “the worst abuse of the legislative process I have seen during my 20 years in Congress.” Indiana Republican Rep. Dan Burton also recalls the night as being ugly. “The votes were there to defeat the bill for two hours and 45 minutes and we had leaders going around and gathering around individuals, trying to twist their arms to get them to change their votes,” Burton told CBS’s 60 Minutes in 2007. Today, the prices the government pays for drugs through Part D are about 30 percent higher on average than the prices it pays for drugs for Medicaid recipients, according to a 2008 report by the House Committee on Oversight. Save, save, save. Save your money invest it, shop bargains, clip coupons, get stuff for free, eat healthy, exercise daily, and drink more water, because we are going to live longer than our parents. If and when we do get sick, there will be much technology available, but you won't be able to afford it. Because you spent all your money on Medicare Part D ~$58.00 by 2013, plus the annual deductible $250.00, but wait there's more... The Plan will only cover 75% of the cost of medications, between $251 and $2,250; we the consumers will be responsible for the remaining 25%. Wait there's more, so you have met your deductible, paid the first $2,250, think you're in for a break, no, you get to pay the next $2,850. The 100% of the cost of the medications, until you reach the $3,600 is your out-of-pocket expense. Let me reiterate: $250 deductible + $500 total co-payments for drug costs up to the initial $2,250 initial coverage limit + $2,850, = "the donut hole". Out-of-pocket costs will be covered by the plan only once you've spent $3,600. Until the MMA in 2003 Medicare beneficiaries would be eligible for assistance with their outpatient drug costs, through the prescription drug discount card. In the two year period prior to Part D taking effect, the Discount Card Program gave access to negotiated discounted prices for prescription drugs. In addition to discounts through the Discount Card Program, the Bush administration maintained that Part D would provide Medicare beneficiaries maximum flexibility by allowing them to choose their optimal plan. President George W. Bush stated, Every senior needs to know if you don’t want to change your current coverage, you don’t have to change. You’re the one in charge. If you keep your Medicare the way it is, along with the new prescription benefit that is your right… …For the seniors of America, more choices and more control will mean better health care. The process of bill passage usually follows a strict course of action. The details are shown in this figure borrowed from Wikipedia: * With Medicare Part D anyone eligible for Medicare, in order to receive this benefit had to enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). Although these plans were approved and regulated by the Medicare program, they were managed by private health insurance companies. Medicare (Part A and B), not D is standardized. These companies dictate which drugs (or classes of drugs they choose to cover, and at what tier, some drugs they completely exclude from the list altogether. Medicare specifically excludes from coverage, including but not limited to benzodiazepines, cough suppressants, and barbiturates. Those plans that exclude drugs are restricted from passing those costs to Medicare. Some patients are eligible for both Medicare, and Medicaid, and Medicaid may pay for those drugs not covered by part D of Medicare, such as benzodiazepines, and other restricted controlled substances. Out-of-pocket expenses not paid for by neither Medicare Part A nor Part B, such as premiums, deductibles and coinsurance, are the person’s responsibility. Some may qualify for to have other governmental programs like Medicaid pay premiums and a portion of the cost associated with Medicare. Funding of these programs is through Federal Insurance Contributions Act taxes, “FICA” on your pay check, pays for Medicare Part A as long as the person or their spouse worked 40 or more 3-month quarters in which this deduction was taken from their pay.$248.00 per month in 2011 for those with 30-39 quarters of Medicare-covered employment, or $450.00 per month in 2011 for those who had less than 30 quarters of Medicare-covered employment, and are not eligible for premium-free Part A coverage. Medicare Part B premiums are deducted automatically from beneficiaries’ monthly Social Security checks. Part C, and Part D may or may not charge premiums, at the programs discretion. Part C plans may also choose to rebate a portion of the Part B premium to the member. To gain support for the bill, the Bush administration misled Congress and the public about the program’s true cost, intimidating public officials and using taxpayer funds to distribute propaganda. Congress passed the Medicare drug legislation by a slim margin—and several lawmakers likely would not have voted for the bill had they been told the true cost. While the Bush administration claimed the legislation would cost $400 million over 10 years, in February 2004 Congress learned that Medicare’s chief actuary had estimated the true cost of the program at $534 billion. In fact, the government’s chief analyst of Medicare costs said he was threatened with firing if he revealed the full cost of the legislation, and the inspector general of the U.S. Department of Health and Human Services confirmed his claim. Using taxpayer money, the Bush administration distributed video “press releases” praising the drug program to TV stations around the country—actions the U.S. Government Accountability Office in Mary 2004 ruled constituted illegal covert propaganda. Logo of the Pharmaceutical Research and Manufacturers of America. Mission On its website, PhRMA states its "mission is winning advocacy for public policies that encourage the discovery of life-saving and life-enhancing new medicines for patients by pharmaceutical / biotechnology research companies. To accomplish this mission, PhRMA is dedicated to achieving in Washington, D.C., the states and the world: * "Broad patient access to safe and effective medicines through a free market, without price controls, * "Strong intellectual property incentives, and * "Transparent, efficient, regulation and a free flow of information to patients." This is the corporation that would gain the most with the passage of the bill. With all of its lobbyists and their lack of ethics related to being staffers and then guided by greed, jumping-ship to profit-laden pharmaceutical companies. References http://en.wikipedia.org/w/index.php'title=Medicare_(United_Satest)&printable=yes. Retrieved 5/17/2011. http://en.wikipedia.org/wiki/Pharmaceutical_Research_and_Manufacturers_of_America#Mission. Retrieved 5/17/2011 http://www.thefreelibrary.com/-/print/PrintArticle.aspx'id=147216154. Retrieved 5/17/2011. http://www.propublica.org/article/medicare-drug-planners-now-lobbyists-with-billions-at-stake-1020. Retrieved 5/17/2011. -------------------------------------------- [ 1 ]. http://www.propublica.org/article/medicare-drug-planners-now-lobbyists-with-billions-at-stake-1020.Retrieved 5/17/2011 [ 2 ]. http://www.propublica.org/article/medicare-drug-planners-now-lobbyists-with-billions-at-stake-1020. Retrieved 5/17/2011. [ 3 ]. http://www.propublica.org/article/medicare-drug-planners-now-lobbyists-with-billions-at-stake-1020. Retrieved 5/17/2011. [ 4 ]. http://www.thefreelibrary.com/-/print/PrintArticle.aspx'id=147216154. Retrieved 5/17/2011 [ 5 ]. http://en.wikipedia.org/w/index.php'title=Medicare_(United_Satest)&printable=yes. Retrieved 5/17/2011. [ 6 ]. http://en.wikipedia.org/w/index.php'title=Medicare_(United_Satest)&printable=yes. Retrieved 5/17/2011 [ 7 ]. http://en.wikipedia.org/w/index.php'title=Medicare_(United_Satest)&printable=yes. Retrieved 5/17/2011. [ 8 ]. http://en.wikipedia.org/w/index.php'title=Medicare_(United_Satest)&printable=yes. Retrieved 5/17/2011. [ 9 ]. http://en.wikipedia.org/wiki/Pharmaceutical_Research_and_Manufacturers_of_America#Mission. Retrieved 5/17/2011