[Congressional Record Volume 150, Number 66 (Wednesday, May 12, 2004)]
[Senate]
[Pages S5243-S5244]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MEDICARE PRESCRIPTION DRUG DISCOUNT CARD
Mr. DASCHLE. Mr. President, this morning in the New York Times, there
was yet another reminder of the great difficulty seniors are having in
dealing with the Medicare prescription drug discount card, so-called. I
noticed with some amusement a number of our colleagues on the other
side of the aisle came to the floor highly critical of those of us who
have expressed skepticism and concern about the drug card. Some have
even expressed the belief that our motivation in coming to the floor to
talk about these shortcomings in the drug card and the prescription
drug benefit were politically motivated.
The New York Times has an article this morning quoting people who
have nothing to do with politics. The title of the article is ``73
Options for Medicare Plan Fuel Chaos, Not Prescriptions.''
I ask unanimous consent that the article be printed in the Record.
There being no objection, the material was ordered to be printed in
the Record, as follows:
[From the New York Times, May 12, 2004]
73 Options for Medicare Plan Fuel Chaos, Not Prescription
(By John Leland)
When Mildred Fruhling and her husband lost their
prescription drug coverage in 2001, they suddenly faced drug
bills of $7,000 a year. Mrs. Fruhling, now 76, began
scrambling to find discounts on the Internet, by mail order,
from Canada and through free samples from her doctors.
``It's the only way I can continue to have some ease in my
retirement,'' she said.
Last week, when the federal government rolled out a new
discount drug program, Mrs. Fruhling studied her options with
the same thoroughness. What she found, she said, was
confusion: 73 competing drug discount cards, each providing
different savings on different medications, and all subject
to change.
``I personally feel I can do better on my own,'' she said.
But she added, ``At this point, I don't think anyone can make
an evaluation.''
Even before they go into effect on June 1, the cards--which
are approved by Medicare but offered by various companies and
organizations--have been the subject of heated political
debate, an AARP advertising campaign about how confusing they
are and anxious speculation from those they are supposed to
help. Among retirees of different income groups interviewed
last week, the initial reaction was incomprehension.
``Even the person who came to explain it to us didn't
understand it,'' said Mary Shen, 77, at the Whittaker Senior
Center on Manhattan's Lower East side. ``It's not fair to
expect seniors, who have enough difficulties already, to have
to figure this out.''
Shirley Brauner, 75, pushed a metal walker through the
center's lunchroom. ``All I've got to say is they confuse the
elderly, including me,'' she said. ``I'm furious. They're
taking advantage of the seniors. How can the seniors
understand it?''
The prescription drug discount cards are a prelude to the
Medicare Prescription Drug, Improvement and Modernization
Act, which will provide broad drug coverage starting in 2006.
The federal government projects that 7.3 million of
Medicare's 41 million participants will sign up for the
cards.
Those who wish to do so, however, face the daunting task of
choosing the right card.
``What it's like is a bunch of confusion,'' said Katharine
Roberts, 77, who said she had not been to a movie in six
years, in part because of her drug expenses. ``You might find
you really need three cards, and you can only choose one.''
The cards are a 19-month stopgap measure to provide
discounts of 10 percent to 25 percent for Medicare
participants who have no other prescription drug coverage.
In addition, low-income participants are eligible for
subsidies of $600 a year.
The Department of Health and Human Services approved 28
companies or organization to issue cards; among them are
AARP, insurance companies and health maintenance
organizations. Cards cost up to $30 a year. Each card
provides different discounts on different drugs, and is
accepted by different pharmacies. Participants can choose
only one.
To help people sort through the options, Medicare and a
company called DestinationRx set up a database on its Web
site, medicare.gov, that lists the prices charged under
various plans for whatever medications a user types in.
People can get similar help by telephone at 1-800-MEDICAR.
But some providers complained that the prices on the site
were inaccurate, and some cards are not listed at all.
For many retirees, it is too much.
``I'm 85, do I have to go through this nonsense?'' asked
Florence Daniels, a retired engineer who said she received
less than $1,000 a month from Social Security, of which she
paid $179 a month for supplemental medical insurance. She
gets drugs through a New York State program, which provides
any prescription for $20 or less. To make ends meet and
afford her drugs, she said she bought used clothing and put
off buying new glasses. Some of her friends travel by bus to
Canada to buy drugs; others do without, she said.
Ms. Daniels did not use the government Web site to compare
drug cards, in part because she cannot afford a computer.
``I'm trying to absorb all the information, but it's
ridiculous,'' she said. ``Not just ridiculous, it's scary. If
there was a single card and it was administered by Medicare,
and it got the cost of drugs down--wonderful, marvelous. But
with these cards, the only thing we know is that we'll have
to pay money to other people to administer what we can get
and can't get.''
The discount program, which is financed largely by the
cards' sponsors, reflects the Bush administration's desire to
open Medicare to market principles without allowing
participants to import drugs from other countries, which many
Democrats favored.
Mark B. McClellan, an administrator at the Center for
Medicare and Medicaid Services, said the complexity of the
plan encouraged competition. ``We're seeing more plans
offering better benefits,'' he said, estimating that people
will be able to save 15 percent or more using the cards.
But the complexity of choices will keep many people away
from the program, said Marilyn Moon, director of health at
the American Institutes for Research, a nonprofit research
organization in Washington.
Often, the discount provided by the cards is not as good as
what people can get from exiting state programs, union plans
or consumer groups, said Robert M. Hayes, president of the
Medicare Rights Center, a nonprofit organization that helps
individuals with Medicare problems.
Sydney Bild, 81, a retired doctor in Chicago, compared the
discount cards with the prices he paid ordering his drugs by
mail from Canada. Dr. Bild pays $4,000 to $5,000 for year for
five medications. When he checked the government Web site, he
said the best plans were about 50 percent to 60 percent
higher than what he was paying.
But Dr. Bild said his main objection to the new plans was
that companies could change prices on drugs, or change the
drugs covered. Medicare requires plans to cover only one drug
in each of 209 common categories. Consumers can change cards
only once a year. Committing to a card is ``like love--it's a
sometime thing,'' Dr. Bild said ``What if I chose one? They
could drop my drugs two weeks later.''
Companies began soliciting customers for their discount
drug cards last week. When the first pamphlets arrived at
Beverly Lowy's home in New York City, Ms. Lowy said, she
looked at them carefully. She does not have drug coverage and
last year spent about $3,000 on prescription drugs. but the
more brochures she read, Ms. Lowy said, the less clear things
became.
``You really have to be a rocket scientist,'' Ms. Lowy, 71,
said. ``It takes time, energy, and you don't even save money.
I thought, `This one is offering this, this one is offering
that.' Finally I decided this isn't for me.''
At the Leonard Covello Senior Center in East Harlem, the
new cards seemed opaque. Ramon Velez, 72, a retired taxi
driver, said he had watched AARP advertisements in which
people read the dense language of the federal Medicare bill.
``I was laughing at the people in the ads, but it's true,''
Mr. Velez said ``Everyone's confused.''
Mr. Velez receives $763 a month from Social Security, and
often skips his psoriasis medication because he cannot afford
the $45 co-payment under his Blue Cross/Blue Shield plan. He
wondered if the new drug cards could save him money.
``But it's very confusing,'' he said ``I'd go to the Social
Security office to ask about the cards, but I don't think
they'd know.''
Alejandro Sierra, 67 a retired barber, paced around the
center's pool table. Mr Sierra takes six medications for
diabetes and complications from cataracts and colon cancer,
and sometimes skips a medication because he cannot afford it.
``I'm interested in the cards,'' he said. ``But I can't
figure it out on the computer, because I can't see.''
Carlos Lopez, the director of the center, said the cards
had so far produced little but anxiety. Mr. Lopez asked
participants to bring any applications to him before signing
them, and warned them about people selling phony cards.
``They're not nervous, but concerned,'' he said. ``They
feel, why now? Why do I suddenly need a card for
medications?''
Mr. DASCHLE. Mr. President, to excerpt from this article, it talks
about:
Last week, when the federal government rolled out a new
discount drug program, Mrs. Fruhling--
Mildred Fruhling studied her options with the same thoroughness with
which she has been reviewing all of this now for some time. ``What she
found,'' according to the article, ``was confusion: 73 competing drug
discount cards,
[[Page S5244]]
each providing different savings on different medications, and all
subject to change.''
Quoting Mrs. Fruhling:
``I personally feel I can do better on my own,'' she said.
But she added, ``At this point, I don't think anyone can make
an evaluation.''
The article goes on to say:
Even before they go into effect on June 1, the cards--which
are approved by Medicare but offered by various companies and
organizations--have been the subject of heated political
debate, an AARP advertising campaign about how confusing they
are and anxious speculation from those they are supposed to
help.
Among retirees of different income groups interviewed last
week, the initial reaction was incomprehensible.
It goes on to quote Mrs. Florence Daniels, a retired engineer who
gets less than $1,000 a month from Social Security. She did not use the
Government Web site that is currently available to compare drug cards,
in part because she cannot afford a computer. She states:
I'm trying to absorb all the information, but it's
ridiculous. Not just ridiculous, it's scary. If there was a
single card and it was administered by Medicare, and it got
the cost of drugs down, wonderful, marvelous. But with these
cards, the only thing we know is that we'll have to pay money
to other people to administer what we can get and what we
can't get.
Sidney Bild is another retiree quoted in the article, a retired
doctor in Chicago. He compared the drug discount cards with prices he
paid ordering his drugs by mail from Canada. Dr. Bild pays $4,000 to
$5,000 a year for five medications. When he checked the Government Web
site, he said the best plans were about 50 to 60 percent higher than he
was paying.
At the Leonard Covello Senior Center in East Harlem, the article
quotes another senior, Ramon Velez, a 72-year-old taxi driver who is
retired. He said:
I was laughing at the people in the ads [that I have seen
on television] but it's true. Everyone's confused.
That summarizes what many of us have expressed now for some time.
People are confused. They are terribly frustrated. They are anxious.
They do not want to have to deal with 73 different options and there is
chaos as a result. Unfortunately, the Congress had an opportunity to
side with seniors or side with the drug companies, and clearly this is
a drug company benefit, this is a drug company program. It has nothing
to do with helping seniors.
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