Medicare Part D: (

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Medicare Part D (D is for Disaster)

• A Presentation of the Gray Panthers California
• May 13, 2006
• Margie Metzler
• 916-921-5008
• margiemetz_at_hotmail.com
• Website www.gpcal.org

This program operates under a grant from the
California Wellness Foundation
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Gray Panthers Motto
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Overview

• What is the Medicare Prescription Drug,
  Improvement, and Modernization Act of 2003 (MMA)?
• How does it work?
• Whats wrong with it?
• What do we want, need and deserve?
• What should you do right this minute?
• What can you do in the long run?

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What is the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA)?

• Designed to Support Pharmaceutical and Insurance
  Companies
• Forbids Medicare from negotiating drug prices
  with the pharmaceutical industry
• Gives drug companies power to charge high prices
  under Part D
• Forces you to pay high costs for your drugs
• Gives billions of dollars to the HMOs and other
  Medicare private health plans

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History of Medicare Part D
Jan. 12006
Nov.2003
1993
1988-89
1965
What a mess!
Medicare enacted (drug benefit dropped from orig.)
Limited drug benefit enacted dropped
Clinton plan had Drug benefit
The Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA)
http//www.medicalnewstoday.com/medicalnews.php?ne
wsid9859
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System Problems

• How come a plan designed for Seniors, 25
  Internet users, is completely designed for the
  internet?
• How come we used the most vulnerable (and
  non-computer literate) people in our country as a
  Beta test group?
• How come no one thought of hiring more people to
  answer phone etc?
• How come nobody thought abut the blind,
  homebound, non-English speakers, TTY users,
  people who are functionally or cognitively
  impaired?

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Anti-Medicare

• Jeopardizes the long-term financing of Medicare
• Forbids government from negotiating prices with
  the drug industry, allows drug industry to keep
  drug prices high, drives up Medicare costs
• Authorizes Medicare spending cap when costs
  increase
• Shifts costs to you moves Medicare from defined
  benefit to defined contribution program
• Forces Americans with Medicare into private drug
  plans for drug coverage
• Does not let you use your Medicare card to get
  drugs
• Limits coverage of drugs you need
• Makes you pay each time you fill a prescription
  no supplemental coverage available
• Enables Congress to limit health care payments,
  requiring plans to shift more costs to you

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Five key reasons why Medicare works

• Automatic and reliable coverage health security
• Good choice of doctors and hospitals
• Negotiated and reasonable prices
• Affordable protection from the financial risk of
  needing costly health care services
• The same cost and coverage regardless of where
  you live or your health status

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Part D offers poor coverage for middle income
Americans

• 20 million people with Medicare have incomes
  under 25,000 a year and do not qualify for
  low-income assistance
• Part D likely not to meet your needs if you need
  costly medications
• Pays only about half the cost of your medications
  
• Requires hefty co-pays in addition to premiums
  and big coverage gapdonut holeonce drug costs
  reach 2250.

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The Dreaded Doughnut Hole
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Chaos!
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Whats wrong with it?

• Medicaid/Medicare people were auto-enrolled Jan.
  1. Chaos!
• Late Enrollment Penalty 1 penalty per month and
  the penalty lasts forever.
• Retirees with Current Drug Coverage Beware! You
  can lose all your coverage if youre not careful.
• The Donut Hole. After youve paid 2250, you get
  no coverage at all till you reach 5100. But
  youre still paying premiums!

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More Wrongs

• No negotiating for best prices!
• People are supposed to have choices but they
  cant be informed consumers
• The plans got to change prices, formularies and
  deductibles at any time, but CMS recently changed
  this policy.

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Can we trust the PHRMA-ceutical Industry??
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Dont Blame the Pharmacist!

• Pharmacists are on the frontlines paying co-pays
  and other costs.
• Many of them are working hand-in- hand with the
  rest of us advocates.
• They are going out of business (esp. independents)

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What should you do right now?

• If you have Creditable Coverage in a private
  plan now, STAY PUT!
• Save every piece of paper you get from your
  current plan, Medicare, Social Security, Medi-Cal
  etc. Store in a safe place and make backup
  copies.
• Be careful who you trust. People contacting you
  are
• Insurance companies (Profit motivated)
• Pharmaceutical companies (Profit motivated)
• Government agencies (CMS)
• Advocacy Groups
• Check with HICAP (1-800-434-0222 or
  www.calmedicare.org) if you have questions.
• Remember, most sources are trying to sell you
  something!

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Where You Can Go For Help

• Health Insurance Counseling and Advocacy Program
  (HICAP) Call 1-800-434-0222 to reach your local
  HICAP or go to www.calmedicare.org.
• Social Security 1-800-772-1213 or go to
  www.ssa.gov.
• Center for Medicare and Medicaid Services (CMS)
  Call 1-800-MEDICARE (and say AGENT to talk to a
  person) or go to www.medicare.gov.

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Federal Congress People

• Senators
• http//www.senate.gov/
• Boxer, Barbara- (D - CA) 112 Hart Senate Office
  Building, Washington, 20510 [phone]
• Web form www.boxer.senate.gov/email.html
• Feinstein, Dianne- (D - CA) 331 Hart Senate
  Office Building, Washington DC 20510 (202)
  224-3841
• Web Form
• www.feinstein.senate.gov/email.html

• Representative
• http//www.house.gov/
• Bill Thomas Rayburn Bldg. 2208, Washington, DC
  20515 or 4100 Empire Dr. 150, Bakersfield, CA
  93309 http//www.congress.org/congressorg/mail/?i
  d591typeCOstateCA
• Or
• Jim Costa 1004 LHOB, Washington, D.C.
  20515-0520. [phone] or 855 M St., Ste
  940, Fresno, CA 93721, 559-495-1620 or 2700 M
  St. Suite 225, Bakersfield, CA 93301,
  661-869-1027 http//www.congress.org/congressorg/
  mail/?id1991typeCOstateCA

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What do we need?

• A Real Drug Benefit
• You can use your Medicare card to get the drugs
  and doctor and hospital services you need at a
  reasonable and affordable price
• A simple, fair and cost-effective way to ensure
  that every American with Medicare who needs
  medications gets them
• A way to insure Americans with Medicare
  automatically from the financial risk of needing
  costly medications

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At the national level CIRCULATE ADVOCATE

• Tell people about the problems with Part D and
  urge them to join the fight for a Real Drug Plan.
• Organize to hold your representative accountable
  for real relief from high drug costs
• Support HR 3861, the Medicare Informed Choice Act
  (Stark, Schakowsky) to extend the deadline
• Support HR 752 (S 873 in Senate) (Stark, Berry)
  the Medicare Prescription Drug Savings and Choice
  Act, to create a uniform drug benefit in Medicare
  and require that Medicare negotiate for the best
  possible prices. 
• Dont vote for anyone unless they support this
  fight!

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Lets Change our Language (Lakoff-ian Stuff)

• Dont blame Medicare, blame privatization!
• Dont talk of enrolling in a program, talk
  about buying insurance.
• HSAs theyre not savings accounts theyre High
  Deductible private insurance plans
• Remember, health care is a value. Talk it up!