Drug Benefit Draws Fire at Conference on Aging


WASHINGTON — Delegates to the 2005 White House Conference on Aging made it clear that they weren't happy with Medicare's new prescription drug benefit.

Challenging administration claims that the benefit's tools were accessible and easy to use, delegates recommended that Part D be simplified to create one prescription drug program for beneficiaries.

The Medicare drug benefit was one of 50 resolutions chosen as the “top” issues on aging by the 1,200 delegates at the meeting. Delegates were then charged with drafting implementation strategies suggesting how these resolutions might be put into action.

Nearly half of the resolutions addressed health care issues, including Medicare and Medicaid, long-term care, and training health care personnel.

The new drug benefit is “clearly in line” with the principles of the White House Conference on Aging to promote the dignity, health, and economic security for current and future generations, Mike Leavitt, secretary of the Department of Health and Human Services, said in his address to the delegates.

“The benefit will be of immediate help to older Americans now,” plus the next group of rapidly expanding aging Americans, the baby boomers, said Mr. Leavitt, who said he helped his own parents enroll in the drug benefit.

“By having the medicines they need, seniors will have the ability to live longer lives. They will save money, they will stay healthy, and they will have peace of mind that their savings will never be eroded because of prescription drugs,” he said.

His remarks were a hard sell for the delegates, which included governors, members of Congress, and representatives from the National Congress of American Indians, national organizations, academia, business, and industry.

The main source of frustration has been the complexity of the plan, said Ellen Camerieri, a delegate from the Bronx, N.Y., and executive director of Riverdale Senior Services Inc. “Secretary Leavitt talked about how easy it is to sign up … and to get your family together to do it. But what if [you're an aging patient] and you don't have a family?”

In her own community, she said, there's a sense of “confusion and paralysis” over the drug benefit.

Opting into a new drug program under the benefit can be daunting, especially if a beneficiary has a Medigap policy that's not a union or government pension, “but a policy to help them bridge the gap between what Medicare covers and what the actual costs are. You have a vast number of seniors who have had a relationship with a policy, and now must decide whether to continue in the new version of that policy under Part D, or go to the [numerous] other odd policies [offered] within their state.”

Dr. Mark McClellan, CMS administrator, assured delegates that the agency is taking steps to ensure that there is not any lapse in drug coverage.

“For example, we have worked closely with states over the past year to obtain very high match rates between their enrollment information and Part D enrollment—match rates well over 99%,” Dr. McClellan said.

The agency also has developed a process for a “point of sale” solution, if the beneficiary somehow has not been automatically enrolled in Part D. In addition, multiple efforts are taking place to provide counseling and assistance to beneficiaries, he said.

Seniors can ask, before they sign up for the plan, whether all of the drugs they are taking now are covered, and the agency has tools so that patients can find the lowest cost for a particular drug, Dr. McClellan said. Yet his praise of the new 800-MEDICARE customer service line evoked jeers from some delegates.

“He claims that every call was answered right away,” said Steve Kofahl, a delegate from Seattle. But when one of Mr. Kofahl's employees tried to call the number to get information, that person “could not get through.”

The problem is a patient has to be able to predict the future to know which plan he or she should sign up for, Ms. Camerieri said. Certain plans under the new benefit cover certain drugs and not others “and you might not be on a medication you'll be needing in 6 months” when you sign up, she said. There's a limited ability to change your plan without some penalty, she said.

Many in the health care field would like to think that Part D is for the people, Ms. Camerieri said. “But the underlying suspicion is that it was drafted to benefit the pharmaceutical and insurance companies who are the people putting together these plans,” she said.


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