Medicare Prescription Drug Benefit Finds "Stride" Despite "Doughnut Hole," Editorial States

Main Category: Medicare / Medicaid / SCHIP
Article Date: 10 Oct 2006 - 22:00 PDT

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The so-called "doughnut hole" in the Medicare prescription drug benefit "makes little sense from a medical or insurance perspective" and "is the inevitable result of designing a program with political rather than programmatic aims in mind, a New York Times editorial states. Under the doughnut hole, the "danger is that some who are ailing, suddenly faced with higher drug bills than they expected, will forgo needed medications and get sicker," the editorial states. Lawmakers included the doughnut hole in the Medicare prescription drug benefit to ensure that all beneficiaries receive some initial coverage in "an effort to please the millions of middle-class elderly voters who had been led to expect they would benefit from the drug plan," but a "more rational approach would certainly have been to begin with complete coverage for the needy and spread that benefit to higher income levels as the money becomes available," the editorial states. However, despite the "irritation over the doughnut hole and some serious start-up problems," the Medicare prescription drug benefit appears to "have found its stride" and "is delivering benefits at lower cost than initially projected and ranks high in surveys of consumer satisfaction," according to the editorial. The editorial concludes, "But those already enrolled in a plan would be wise to check for any changes when full details of next year's offerings are posted. In some cases, premiums are rising and drugs previously on the formularies have been dropped" (New York Times, 10/6).

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