|
Archives | (July 2003)
Printer Friendly
The Prescription Drug Benefit: Boon or Boondoggle? (cont.)
------------------------------------------------------------------ Page 5 of 6 Across the nation, private health care plans and HMOs have doubled, and even tripled the amount of co-payment beneficiaries must make for prescriptions. Also, where it was once common for the co-payment to be a set amount — say, $10 for less costly drugs and up to $60 for more expensive ones – insurers are increasingly requiring beneficiaries to pay a set percentage of the price. In some instances, this can be as much as half! Another current trend among private insurers is to require prior authorization from a doctor before a patient can be reimbursed for the cost of certain medications. Since both of the proposed Medicare drug benefits are modeled after similar private sector plans, if drug costs begin to rise sharply – as is almost certain – similar cost cutting measures could be put in place increasing the burden on seniors even as drug companies are fattening their bottom line! But there is a third problem with the proposed Medicare drug benefit as well. Currently, only about 27% of senior citizens do not have some form of prescription drug plan. About 33% retain benefits from employer-sponsored insurance they had while working. Another 15% have a drug benefit through membership in a Medicare Risk HMO. About 12% are covered through Medicaid and 10% through individually purchased insurance. Roughly 3% have coverage through other, unspecified programs. The trouble is that if the Medicare drug benefit is passed in its current form, many individuals covered through employer-sponsored programs may lose their coverage. It would be all too tempting for employers seeking to reduce health care costs to argue that benefits under their private plans are not needed because Medicare is providing coverage. Employer-sponsored plans, however, are often more generous than the proposed benefit, so the seniors would actually see an increase in their prescription drug costs. Since there is little the federal government can do to prevent such a move, it may be the seniors who lose in the end. So what to do? First of all, the program should place a premium on prevention. It should reimburse 100% of the cost of products, including vitamins, minerals and herbs that can help keep people well. Keeping people healthy is always cheaper than treating them after they get sick! Moreover, their quality of life is improved as well, so there is a double benefit from this approach. |
|
