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Medicare's Discount Cards Dealt
from Bottom of Deck
by Frank Kaiser
Like all things in the new Medicare Drug Bill, the discount card program starting this June is both obscure and ephemeral. First you see it, then you don't.

At least half the 40 million seniors on Medicare have no drug coverage. As the $534-billion Medicare Reform Law won't go into effect until 2006, this discount card program is designed to bridge the gap.

Here's the skinny: The new Medicare cards are intended to offer discounts of 10 – 25 percent. Not much when you consider that you can save far more buying your pharmaceuticals in Canada. But it's something.

Or is it? By law, the private companies issuing the cards can change their prices up or down on a weekly basis. An HMO, for example, can offer you a real deal to get you to sign up for the medicine you need, then launch the price skyward without telling you.

And since no base price need be defined, you could easily end up paying more than you would without the card. Drugs covered — even pharmacies honoring your card — may well change more often than a politician's promises.

The same law says you're stuck with the company for a year. You pay 30 bucks for that privilege.

The fee is waived for seniors with annual incomes of less than $12,569 ($16,862 for married couples). These folks may also qualify for a $600 annual drug allowance, though chintzy, probably the only unquestionably positive aspect of this entire billion-dollar card program. Even this is tarnished. The certification process is so cumbersome, many fear that millions who need the subsidy won't get it.

Complicating matters further, 20 states have approved their own discount cards, 11 of them already up and running.

According to a recent Associated Press poll, one senior in three has serious problems paying for pharmaceuticals. Three-quarters of those regularly can't afford to take drugs prescribed for them.

The need is staggering. Yet most seniors — 60 percent according to a new Kaiser Family Foundation poll — know little to nothing about the half-trillion-dollar Medicare bill Bush signed in December.

CARD TRICKS

Unfortunately, many have already confronted a discount-card pitch. Across the country, door-to-door scammers are collecting $30 and more from seniors unaware that legitimate enrollment won't start until May and will never be offered with a knock at the door.

Even when the real cards are made available, the new Medicare law almost assures that card sponsors — our friends at the HMOs, insurance firms, drug companies and the like — will be less than straight with us. At least two companies intending to provide cards, Medco and Express Scripts, destroy and fabricate records, falsify bills and switch patients to more expensive meds, according to the US attorney in Philadelphia.

The law creates a clear conflict of interest. Although card sponsors are required to pass on a "share" of the savings they get from the pharmaceutical manufacturers, that can be a penny. Even less. Since there's no transparency required, you will never know what price your card sponsor negotiated.

Sponsors will have whopping financial incentives to select the most expensive drugs — that's where the highest rebates are — forcing you to pay even higher prices when you use the card.

That, fellow geezers, is what's in the cards for us.

This preview of the Big Game beginning in 2006 looks like a crooked deal to me. But what can we expect from a law written for and by the pharmaceutical and insurance Mafia?

Isn't it time we all let Washington know that we seniors want a brand new deal? Call the Capitol Switchboard (877) 331-2000 now!

Copyright © 2004 —Frank Kaiser


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