Many of the sickest and poorest beneficiaries nationwide are going without life-sustaining medication because of program failures, misinformation and confusion. The federal government has botched the roll-out of one of the most-expensive entitlement programs ever, and the frail elderly are paying the price in pain, aggravation and tears. Congress should rethink the program and fix flaws inherent in the overly complicated program.
The situation has grown so critical that, last weekend, the Bush administration ordered private Medicare drug-plan insurers to cover an emergency 30-day refill of prescriptions and cap co-pays for low-income seniors at $5. It isn't known if this will work. Earlier, CMS had directed pharmacies to provide the refills and bill Medicare. Yet many pharmacies refused because they either didn't get the notice or didn't trust that they would be paid.
Why, beacuse this all goes through private insurance companies. Medicare pays a subsidy to them to then pass on to the local pharmacist. If this was done directly from Medicare to the pharmacist, we would save billions and have a functional system.
How bad is it? Consider that 20 states have intervened to subsidize drugs for low-income beneficiaries who can't get their prescriptions covered under the new program. Florida should join the effort. Otherwise, poor seniors will be left out on a limb by the Medicare program until the crisis is resolved.
Wisconsin was one of those states (thank you Gov. Doyle).
Since the benefit began on Jan. 1, countless needy beneficiaries have been charged excessive fees or denied coverage altogether. Others who enrolled in plans based on formulary information from Medicare's website or pamphlets have discovered the plans do not cover their medicines. Jammed phone lines have prevented pharmacists from verifying enrollment and seniors from resolving issues. One Broward pharmacist who serves transplant and dialysis patients estimates that up to 40 percent of his low-income clients haven't been able to get their medicines through Medicare. The snafus have created a national medical emergency.
Florida's Agency for Healthcare Administration does not see a crisis. Those who can't get their medicines would disagree. The problem is urgent. A national remedy is needed -- now. Gov. Jeb Bush should ensure beneficiaries get drug coverage now, and bill the federal government later.
Aren't you glad you have a Democrat in the state house? If only Petri or Green hadn't voted for this - it passed by one vote.
And don't forget, Petri said in December 2003:
Without question the most significant domestic legislative accomplishment in 2003 was congressional passage of Medicare drug reform.
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