Newspapers Examine Democrats' Criticism Of 2007 Medicare Handbook, Prescription Drug Benefit Enrollment

Main Category: Medicare / Medicaid / SCHIP
Article Date: 01 Nov 2006 - 20:00 PST

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The 2007 Medicare handbook is biased in favor of the private insurance companies that market Medicare Advantage plans, Democratic Sens. Max Baucus (Mont.) and John Rockefeller (W.Va.) and Reps. Sherrod Brown (Ohio), John Dingell (Mich.), Charles Rangel (N.Y.) and Pete Stark (Calif.) wrote in a letter sent last week to HHS Secretary Mike Leavitt, the New York Times reports. The letter states that the 2007 handbook "presents a misleading and biased view of Medicare coverage and options" and "strongly favors health maintenance organizations, preferred provider organizations and other private Medicare Advantage plans over the traditional fee-for-service program." MA plans offer packages of benefits -- including physician care, hospital services and prescription drug coverage -- but can include higher fees than traditional Medicare if beneficiaries seek care outside of a plan's provider network, the Times reports. About seven million of the 42 million Medicare beneficiaries are enrolled in MA plans, an increase of more than one million since 2005. According to the Times, the 2007 handbook includes a chart comparing traditional Medicare with MA plans. It states that under traditional Medicare, "your costs may be higher than in Medicare Advantage plans," adding that under MA plans, "you may get extra benefits," such as dental care, eyeglasses and hearing aids. CMS spokesperson Lorraine Ryan said, "Our only goal is to provide information that is accurate, useful and objective" (Pear, New York Times, 10/30).

2007 Enrollment
USA Today on Monday examined how many beneficiaries enrolled in the Medicare prescription drug benefit are finding they "need to switch plans" for 2007 to manage costs or obtain the coverage they need. Experts say that "virtually everyone in the program should shop around" during the upcoming open enrollment period because many plans have changed significantly in terms of coverage and premium levels, USA Today reports. Medicare officials are urging beneficiaries who wish to change plans to do so by early December to avoid coverage delays when the new plan year begins on Jan. 1, 2007 (Wolf, USA Today, 10/30).

Opinion Pieces
The Charlotte Observer on Monday published two opinion pieces on the Medicare prescription drug benefit. Summaries appear below.

• Rep. Jim McDermott (D-Wash.): "Medicare Part D was a historic opportunity to provide real relief for seniors to help cover the cost of prescription drugs, ... [b]ut Republicans were more interested in special interests than the common good," McDermott writes in an Observer opinion piece. "The legislation neutralizes the enormous purchasing power of 40 million seniors that would otherwise yield dramatic savings in the cost of drugs," he writes, adding that administering the benefit through many different private plans "fragments purchasing power into hundreds of pieces, and the legislation reinforces this artificial price support by explicitly prohibiting the secretary of health and human services from negotiating on behalf of seniors for lower drug prices." McDermott continues, "In the richest nation on earth, affordable health care should be a right, not a privilege." He concludes, "It's time for America to have universal health care that will put the interests of Americans ahead of the special interests" (McDermott, Charlotte Observer, 10/30).
  
  
• Grace-Marie Turner: "Competition works in health care, and consumers are starting to exercise their buying power to get more choices and bring prices down," Turner, president of the Galen Institute, writes in an Observer opinion piece. According to Turner, beneficiaries enrolled in the benefit "have driven the average monthly premium for the drug benefit down by 40 percent," and "[t]he vast majority of enrollees said they are happy with their coverage and are saving money." Although critics of the drug benefit "argue that government could use its huge buying power to get a better deal for seniors ... because the government is such a big buyer that means it wouldn't 'negotiate' prices but would dictate them," Turner writes. She adds that if the government negotiated prices, "[i]t could force companies to cut their prices so much that they would have fewer resources left to invest in research to produce the next generation of drugs." Turner continues, "Consumers are smart shoppers, and they have shown they can exercise even stronger buying power than the federal government and do so without killing innovation and research" (Turner, Charlotte Observer, 10/30).
  

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