[Congressional Record Volume 150, Number 75 (Wednesday, June 2, 2004)]
[Extensions of Remarks]
[Pages E1015-E1016]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  RECOGNIZING THE MERCURY NEWS FOR ITS ARTICLE ``DISCOUNT CARD DOUBT''

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Wednesday, June 2, 2004

  Mr. STARK. Mr. Speaker, I rise today to recognize an outstanding 
piece of journalism that appeared in The Mercury News in San Jose, 
California. The article, ``Discount Card Doubt'' presents the realistic 
confusion Medicare beneficiaries face in choosing a discount card. As 
the Centers for Medicare and Medicaid Services and individual card 
sponsors bombard beneficiaries with glossy marketing materials, I am 
proud to know that my constituents are receiving a fair and balanced 
account of the drug card debacle. I would like to thank Barbar Feder 
Ostrov for her exceptional reporting, and for informing the people of 
my district about the benefits and dangers of the Medicare approved 
drug discount card program.
  It is with pleasure that I submit the attached article, ``Discount 
Card Doubt,'' for inclusion in the Congressional Record. The article 
originally appeared in the May 26, 2004 edition of The Mercury News.

                          Discount Card Doubt


 COMPLICATED SYSTEM: CHOOSING ONE OF 73 PLANS IS A HASSLE, SENIORS SAY

                       (By Barbara Feder Ostrov)

       Betty Cozzi is trying to keep an open mind about the new 
     Medicare discount cards. Last week, she dutifully sat through 
     a presentation with a nice lady showing PowerPoint slides at 
     Cambrian Center, the San Jose senior apartment complex where 
     she lives.
       But the whole thing is pretty annoying, in her view.
       ``They've made it so complicated,'' said Cozzi, who is 71. 
     ``We should be able to sit down and read the information 
     without being talked to like we're second-graders. And I 
     don't even know if the card will help me.''
       As Medicare drug discount cards go ``live'' next Tuesday, 
     seniors like Cozzi are wading through a swamp of conflicting 
     and sometimes downright inaccurate information as they assess 
     which card they want to buy--that is, if they want to buy one 
     at all.
       The cards, which offer Medicare recipients discounts on 
     both brand-name and generic prescription drugs, are the first 
     of a series of Medicare prescription drug reforms providing 
     temporary relief from rising medication costs until a larger 
     benefit takes effect in 2006.
       Some cards are free, while others can cost up to $30. They 
     offer discounts of 15 percent to 20 percent on the average 
     retail prices for brand-name drugs, with deeper discounts of 
     30 percent to 60 percent on generics, according to the 
     Centers for Medicaid and Medicare Services, the federal 
     agency that oversees Medicare.
       About 3.2 million seniors in California could benefit from 
     the discount cards, saving about $515 million on their 
     medications in 2004 and 2005, the years when the cards will 
     be available, according to a study released last week by the 
     Business Roundtable, a trade group for chief executives of 
     large corporations. The study also found that about 105,000 
     California seniors will qualify for a $600-a-year credit for 
     low-income people that can be applied toward drug purchases 
     made with the cards in 2004 and 2005.
       But seniors may find deeper discounts purchasing from 
     Canadian pharmacies, U.S.-based mail order houses or even 
     Costco, as a Mercury News analysis of 10 common drugs shows 
     (see chart).


                            Not much savings

       A little-known state program in which participating 
     pharmacies offer prescription drug discounts to California 
     Medicare recipients was the most expensive option for some 
     drugs, the analysis shows.
       Cozzi, a retired executive secretary, isn't poor enough to 
     qualify for the $600-a-year credit, but her income is limited 
     enough that she only takes Plavix, an expensive drug that 
     prevents strokes and heart attacks, every other day, rather 
     than the daily dose her doctor recommends.
       Plavix, which isn't available as a cheaper generic, can 
     cost nearly $1,500 annually, and Cozzi must also take other 
     medications like Lipitor, which can cost an additional $800-
     plus each year. She tries to save money by ordering her drugs 
     through a U.S. mail-order service offered by her supplemental 
     Medicare insurance.
       Cozzi said she is just starting to research which Medicare 
     discount card might be best for her, but it's a trying 
     endeavor. There are 73 different Medicare-approved cards, and 
     every one covers different drugs, with pricing that can 
     change weekly. Once Cozzi buys a card, she won't be able to 
     buy a different one this year.
       She has a few options: She can call (800) MEDICARE and ask 
     a representative which

[[Page E1016]]

     cards cover the medicines she takes. She can call the Health 
     Insurance Counseling Assistance Program, which helps 
     California seniors navigate Medicare, where a counselor can 
     help her determine which card will provide the lowest prices 
     on her medications.
       ``This should be a lot more simple,'' Cozzi said. ``But I 
     guess some discount is better than nothing.''
       Although Medicare was rapped earlier this month for long 
     waits on its telephone hotline, it has added workers to ease 
     the backlog. On two different afternoons last week, there was 
     only a one-minute wait to speak to a representative on the 
     hotline.
       Cozzi also can go online to www.medicare.gov, where she 
     will encounter a complex drug search engine that some seniors 
     have criticized for providing inaccurate information. And she 
     can visit her local pharmacy for card applications, but if 
     it's a chain that offers its own card, it may not display 
     information about competing cards that might save her more.


                         Not worth it for some

       ``People are finding it very complicated,'' said Vicki 
     Gottlich, an attorney with the Center for Medicare Advocacy, 
     a public-interest law firm.
       ``We're hearing from highly educated, highly competent 
     people that it just may not be worth it,'' Gottlich said. 
     ``They're not sure the discounts are that great and the 
     information they're finding is accurate.''
       Gottlich recommends that seniors verify with their own 
     pharmacists the information they receive from the Medicare 
     Web site or telephone representative, because in some cases, 
     pharmacists haven't been notified about the discounts or 
     whether their pharmacy is in a particular card's network.


                           HMO discount cards

       While Cozzi has a supplemental Medicare plan that allows 
     her to purchase any card she wants, some seniors with 
     Medicare HMOs such as Kaiser Permanente's Senior Advantage 
     may only apply for the cards offered by their HMO.
       That irks Kaiser member Caroline Castiglione of East Palo 
     Alto. Castiglione could purchase Kaiser's Medicare discount 
     card for $30, but it will save her only $1.40 a year on 
     Fosamax, a brand-name osteoporosis drug, at Kaiser 
     pharmacies. She called a nearby, non-Kaiser pharmacy to see 
     what discount the Kaiser card might offer, but the pharmacist 
     didn't know.
       ``To pay $30 to save $1.40, it doesn't make sense,'' said 
     Castiglione, who is 81. ``I don't buy a pig in a poke, I want 
     to know what I'm buying. I'm very frustrated.''

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