[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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