Posted on 09/20/2004 8:49:32 AM PDT by cowboyway
When I'm down here in Palm Beach County on Sunday morning, I usually pick up a copy of a local newspaper called the Hometown News. They have a section called Rants & Raves. The following was in yesterdays edition:
Medicare prescription drug benefit is a big asset.
"I see lots of TV ads about the Medicare prescription drug benefits and how bad it it, but it works for me.
My monthly drug bill has dropped from over $450 to less that $20 a month. I am so grateful for this benefit. Of course, I had to apply for it. That's what's the problem. Perhaps people just haven't applied for it. It takes a little effort, but it's certainly worth it."
1) The misinformation campaign by the left is starting to erode.
2) Seniors are using the benefit and saving a lot of money. $430 a month savings is a chunk of change.
3) The last sentance; it takes a little effort.
It takes a little effort.
As a pilot program, have a town of about 20,000 purchase the hospitals in the area. Usually there would be just one or two. Have an effort to employ the physicians who would like admitting priv's to consolodate their offices into clinics which would be staffed 24/7. Perhaps three or four non critical/emergency care or simple outpatient procedures. Doctors who won't sign on will wither on the vine. Now offer free healthcare to all residents of the town. Corporations will flock there in order to escape high insurance costs killing them now. Make the healthcare operating costs a portion of the local realestate tax bills or payroll tax. Tag it onto each bill or payroll as a certain millage. Do not cover prescription drugs. This will make the physicians prescribe the least costly, yet effective drugs based on need and not on convenience or pharmecutical sales trips to Cancun.
It would be a great micro-study of socialized medicine which would differ greatly from the Canadian system.
Just a thought. Maybe too many tractor fumes and dust?
If the Socialist Democrat Party had passed this plan, the media would be pounding the masses with how great the plan is. Catch 22 as always.
The prescription drug plan does not begin until '06 so I wonder just what this person is talking about?
It is in effect now. My mother is using it.
Hm. It's running now, unless my pharmacist is just being nice to me. I got a letter notifying me of the program a few months ago, sent back my application and now when my pharmacist processes my prescriptions, they have a very, very big discount. One prescription alone used to be almost $60, now it's just under $8.
The REAL plan starts after the election.
You will have to pay a few hundred out of pocket first and then you will have to pay 25% ( of the regular cost) on meds, up to $3500 at which point you go back to paying 100% , that is on top of your mandatory monthly fee for the "insurance "
It is a nasty plan that I have heard denies any other prescription plan , so all those businesses that now pay prescription insurance will be off the hook , and the seniors will get to pay many many more than they do now .
It is a give away to big business and Pharmaceutical companies BY THE TAXPAYERS (exempting all those big corps )
People need to read the plan and not trust the GOP rhetoric on this.
In 2015, for example, 44 percent of the typical 65-year-old's benefit check would be devoted to Medicare premiums, deductibles and co-payments, according to the actuaries' projections. By 2020, it would be half. The typical 85-year-old would lose 50 percent of his or her Social Security check to Medicare in 2015 and 58 percent in 2020.
http://seattletimes.nwsource.com/html/nationworld/2002040767_medicare20.html
UNDERSTANDING THE NEW MEDICARE PRESCRIPTION DRUG BENEFIT
When does the program begin?
The new drug benefit will begin in 2006.
How much does it cost?
Premiums are estimated to be $35 a month ($420 a year) in 2006.
What will I get?
After you pay the premium and a $250 annual deductible, the plan will pay 75 percent of your drug costs (you pay 25 percent) until your total drug expenses reach $2,250. After you reach $2,250 in drug expenses in a year, your coverage stops and you have to pay for the next $2,850 in drug expenses entirely by yourself. This is called the “doughnut hole.” Insurance coverage doesn’t start again until your drug expenses reach $5,100. At that point you’ve spent $3,600 of your own money for prescription drugs plus the $420 premium, and you now qualify for catastrophic coverage. For the rest of the year, you pay either a flat copayment of $2 for every generic drug prescription and $5 for every brand-name drug prescription, or 5 percent, whichever is greater.
What will I have to pay?
What you’ll have to pay—your out-of-pocket spending—will depend on your drug expenses. Here’s a table summarizing the benefit for different levels of drug expenses, with the last column being your aggregate out-of-pocket cost (not including the premium):
In addition to the annual premium of $420 a yearÂ…
HereÂ’s a table summarizing the benefit for different levels of drug expenses, with the last column being your aggregate out-of-pocket cost (not including the premium):
|
In addition to the annual premium of $420 a yearÂ… |
|||
|
If your drug costs areÂ… |
You payÂ… |
Up toÂ… |
Cumulative total amount out of your pocketÂ… |
|
$0 – $250 |
100% |
$250 |
$250 |
|
$251 – $2,250 |
25% |
$500 |
$750 |
|
$2,251 – $5,100 |
100% |
$2,850 |
$3,600 |
|
Over $5,100 |
5% |
No limit |
$3,600 + 5% of costs above $5,100 |
Yes. There is additional assistance to help low-income beneficiaries. There are multiple levels of low-income assistance. For example, seniors with incomes below 135 percent of the federal poverty level (thatÂ’s $12,123 in annual income for a senior living alone or $16,362 for a couple) and with assets below $6,000 for an individual or $9,000 for a couple (not including the value of a home or car) will be able to get drugs at $1-2 per generic drug prescription and $3-5 per brand-name drug prescription. The level of assistance you qualify for depends on whether you are eligible for Medicaid in your state as well as the size of your income and assets. (Consult Families USAÂ’s Web site [www.familiesusa.org] for the table, What Will the New Medicare Drug Benefit Look Like for Consumers?, which provides greater detail about the low-income benefit.)
How do I get the new benefit?
The drug benefit will be provided through private prescription drug plans that contract with the Medicare program. Managed care plans, like those currently in Medicare+Choice, can also provide the drug benefit. To receive the benefit, youÂ’ll have to sign up with a plan offering the drug benefit in your area.
Will there be a plan in my area?
Yes. Medicare is required to contract with at least two plans that provide prescription drug coverage. There may be some areas in the country where no private plan, or only one plan, wants to participate. For those areas, the government will provide a plan and those “fall-back” plans will offer the standard benefit.
Will all plans cost the same?
No. Private plans can charge different premiums. They can also charge different copayments as long as the entire plan is of equal value (as determined by an actuary) to the standard plan described above.
Are all plans going to offer the same thing?
No. The drugs covered can vary from plan to plan. Plans don’t have to cover all drugs. Medicare has guidelines for what plans must cover, but those guidelines do not guarantee that all plans will offer the same thing. Plans are required to cover some drugs in all “therapeutic” classes. However, plans are not required to cover every drug in a class. For example, a plan may cover several drugs for high blood pressure that are similar to the one you take, but not yours. You’ll need to make sure that the plan you enroll in covers the drugs you need. This is important because the plan will only pay for the drugs it covers and only those drugs count towards your deductible and out-of-pocket limit.
Will the amounts that I pay change over time?
Yes. The deductible and the size of the “doughnut hole” will grow each year based on increases in drug spending for the Medicare benefit. Thus, if Medicare drug costs skyrocket, so will your deductible and the “doughnut hole.” Because drug spending increases much faster than regular inflation—and is projected to continue to do so—most people in Medicare will see the amounts they have to pay go up faster than their income.
Not only will the amounts you have to pay in deductibles and in the “doughnut hole” go up with drug spending in Medicare, but your premiums will increase as well. Premiums will be set based on plans’ bids. Plans will base their bids on drug costs. So, as drug spending goes up, you can expect to see your premiums increase, too.
Does the legislation prevent drug costs from skyrocketing?
No. Drug companies, which spent more money lobbying Congress than any other health care group, succeeded in getting a bill that does virtually nothing to moderate drug costs. The legislation actually prohibits Medicare from using its purchasing power to negotiate lower drug prices for beneficiaries. While private health plans will seek discounts for those enrolled in their plans, they donÂ’t have MedicareÂ’s purchasing power, so they will have much less leverage to get lower prices.
Will I be allowed to buy cheaper drugs from Canada or other countries?
No. Under the legislation, drugs can only be reimported from Canada, and then only if the Secretary of Health and Human Services certifies both that it is safe and that it would significantly reduce costs. The Secretary has already indicated that he will refuse to issue such a certification.
Who are the big winners in this legislation?
The biggest winners are the drug companies and the managed care industry. They will reap much larger profits from this legislation. The drug companies will gain a lot from the legislation. Not only are there no mechanisms to contain skyrocketing drug costs, but a new drug benefit will mean a much larger volume of sales. One Wall Street analyst estimated that drug sales could increase by as much as $13 billion a year.
Private insurance companies that participate in the Medicare program also will gain a huge and unjustifiable windfall. Private plans “cherry pick,” enrolling the healthiest and youngest seniors, and, therefore, have considerably lower costs. Study after study has shown that they are overpaid because, despite their lower costs, they’re paid roughly the same per person as the traditional Medicare program, which serves older and sicker seniors. Despite such overpayments, the new legislation will provide these private plans with billions of dollars in increased payments. The legislation also includes a big opportunity for private plans to eventually gain even more, by setting up demonstration programs that lay the groundwork for privatizing Medicare. Will this change how Medicare operates?
In 2010, Medicare will begin a “demonstration project” in six metropolitan areas. These demonstrations could radically alter Medicare.
The communities where these demonstrations will be implemented have not yet been selected. Traditional fee-for-service Medicare will competitively bid against private plans. Since traditional Medicare serves a much more expensive (older and sicker) population, its costs will be greater – and the legislation requires that most of those extra costs be passed on to Medicare’s enrollees. Over time, those costs will skyrocket, and fewer seniors will stay in traditional Medicare. As a result, the program will increasingly be privatized.
Does the bill provide any assistance before the new drug program begins in 2006?
Starting in the spring of 2004 and ending by 2006, seniors will be able to purchase drug discount cards for $30 per year. Seniors with incomes below 135 percent of the federal poverty line ($12,123 in annual income for a senior living alone or $16,362 for a couple) will be able to get these discount cards for free and will also receive a credit worth $600 embedded in the card (like a prepaid telephone card) to be used for the purchase of drugs—although you will also owe a copay of 5 to 10 percent on each purchase.
These drug discount cards are similar to discount cards that many seniors have today. The legislation that creates these new discount cards does not set any rules about the base prices from which these discounts will occur. Thus, the value of any discount will be significantly eroded as base prices escalate.
http://216.239.41.104/search?q=cache:qdwsVKeB1boJ:www.familiesusa.org/site/DocServer/11-25_Q_A.doc%3FdocID%3D2321+New+medicare+prescription+plan&hl=en
Be informed
**It is in effect now. My mother is using it.**
You know I thought freepers were supposed to be well informed.
?? Open your wallet because when this comes into effect your tax $$ a and your contribution to your mom are both going up.
Say thanks to the Republican administration !
http://www.freerepublic.com/focus/chat/1221344/posts?page=7#7
"If you think medicine is expensive now, just wait until it is free."
I guess this explains why the Medicare tax on my pay statement went up.
The biggest loser is the younger working generation who wil be living under a bridge to support this when the boomers retire.
Right. We now know how much. An increase by 26% of all future U.S. spending obligations, accumulated since before Roosevelt, in the single year of 2004, for the prescription drug benefit alone.
http://www.babylontoday.com/#gao_financial
Can we really afford it?
http://www.babylontoday.com/#debt_chart
But what the heck, there are those that think we can monotize it at a rate faster than we are today.
http://www.babylontoday.com/#m3
I have my doubts. GAO projects 8.1 trillion over the next 75 years. Excel projection has M3 at 4,000 trillion, that is, 4 million billion.
http://www.babylontoday.com/us_debt.htm#historical_m3
Another day another dollar.
The real costs of this program are stunning. It dwarfs total projected debt, and dwarfs total projected M3. Microsoft Excel projected spending in the single year of 2083 is projected to be over 5.6 million billion dollars, or 5.6 thousand trillion if you prefer.
http://www.babylontoday.com/prescription_drug_benefit.htm
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