Saturday, January 14, 2006

"President Bush's signature domestic achievement..."

From today's WaPo, Bush's "Drug Benefit" is Katrina all over again:

Two weeks into the new Medicare prescription drug program, many of the nation's sickest and poorest elderly and disabled people are being turned away or overcharged at pharmacies, prompting more than a dozen states to declare health emergencies and pay for their life-saving medicines.

Computer glitches, overloaded telephone lines and poorly trained pharmacists are being blamed for mix-ups that have resulted in the worst of unintended consequences: As many as 6.4 million low-income seniors, who until Dec. 31 received their medications free, suddenly find themselves navigating an insurance maze of large deductibles, co-payments and outright denial of coverage...

"This new prescription drug plan was supposed to be a voluntary program to help people who didn't have coverage," said Jeanne Finberg, a lawyer for the National Senior Citizens Law Center. "All this is doing is harming the people who had coverage -- America's most vulnerable citizens."

Hailed as President Bush's signature domestic achievement, the program, which began Jan. 1, offers drug coverage for the first time to 43 million elderly and disabled Americans eligible for Medicare. At the same time, 6.4 million low-income beneficiaries who were receiving their medications through state Medicaid plans were switched into Medicare for their drug benefits and told they would not be charged the standard $250 deductible or co-payments.

But interviews with two dozen people -- state officials, pharmacists, advocates for seniors, and Medicare clients -- revealed a host of problems. Many poor seniors were never enrolled or were enrolled in plans that do not cover their medications. Others received multiple insurance cards, creating confusion at the pharmacies. Some were charged the deductible and unaffordable co-payments. And some, such as Laurine League, left empty-handed.

"For years I've had no problems, going to the same pharmacy," said League, 49, a Queens, N.Y., woman with severe mental illness. "The pharmacist told me one drug was going to cost $198. I don't have that kind of money."

He's doing a heckuva job.

But gods, the man has so many "signature achievements": the fiasco with China invading their airspace, the lack of inaction in reponse to the Aug. 6 2001 PDB, "My Pet Goat," Iraq, Katrina, Plamegate...

But I am truly not telling you the scope of this, so when this thing's published right, this should stand out a bit:

Politicians in both parties were quick to rise to the defense of a particularly vulnerable population. As a group, dual-eligibles have incomes below the poverty rate of $9,570 a year and take an average of 15 medications a day. More than half are women, 40 percent have cognitive impairments such as Alzheimer's and 20 percent do not speak English, according to Finberg.

"The dual-eligibles should have been the last group enrolled because they are the hardest to get going," said Thanh Lu, who focuses on Medicare issues at the Progress Center for Independent Living in Illinois. Clients who are in nursing homes, who have schizophrenia, or who are deaf or blind are ill equipped to tackle the complex new system. Medicare compounded the problem by sending out a handbook that incorrectly told low-income seniors they could enroll in any plan at virtually no cost, he said...

"We had dialysis patients who were not getting medicines, pharmacies on hold for 60-plus minutes, some plans closed for the holiday," she said, describing some of the frantic calls. "One man called me -- he and his wife were on 15 medications. They had no co-payments on Medicaid. He went in for 15, and he left with one" medicine because of the cost, she said.

Yesterday the hotline uncovered a new problem, she said. Some beneficiaries have received letters from private health plans warning that the monthly premiums for their drug coverage will be deducted from their Social Security checks, even though they are poor enough to qualify for free coverage...

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