Will Democratic Gains Bring Part D Changes?
Changes in the federal government's Medicare Part D program will surely be on the agenda of the Democrats in Congress, who won control of both houses on election day last Tuesday. They can expect tough resistance by the Bush administration.
On Sunday, Secretary of Health and Human Services Michael O. Leavitt said the Democrats claim to want merely to negotiate drug prices, but in reality what they want is government-run health care. The administration will oppose that strenuously.
Leavitt said negotiating prices would shatter the entire Part D program which, he said, depends upon the hundreds of competing private insurance plans to keep drug prices down.
But the resurgent Democrats will not be swayed by that argument and seem hellbent on making a move to amend the program that serves seniors in Medicare.
Congressmember Nancy Pelosi, a Democrat from San Francisco, California, who's slated to become the next Speaker of the House-and who will be the first woman in history to hold that powerful post-has mentioned Part D reform several times in interviews following the sea-change in power in Congress as a result of last week's election.
Ever since drug subsidies took effect this past January, Queens Democrats in Congress have railed against certain features of the program that cost seniors too much money and were so confusing that many seniors would not even join the program.
Congressmembers Joseph Crowley (Queens/The Bronx), Carolyn Maloney (Queens/Manhattan) and Anthony Weiner (Queens/Brooklyn) were among those who complained often and loudly about the plan created by President George W. Bush.
They cited the huge benefit and major financial windfall which the program presented to the insurance industry, which exclusively operates Part D, and the great profits it brought to the pharmaceutical industry, which is free to operate without any price controls.
United States Senators Hillary Rodham Clinton and Charles Schumer also complained and proposed changes in the program. So did local lawmakers, including Assemblymember Michael Gianaris and state Senator George Onorato. Like Maloney and Crowley, they held forums for seniors to help them cope with Part D complexities.
One of the changes in the law that created Part D, and which the Democrats will likely seek to change, is the provision that prohibits the federal government from negotiating with pharmaceutical companies for lower prices, due to the huge amount of drugs that the program purchases collectively.
Large purchasers of drugs, such as private operators of drug plans, labor unions and pension plans, for example, already take advantage of the large amount of medicines they buy for their members at discounted prices, saving millions of dollars and passing the savings on to their members.
Another feature of the Part D program that may be changed is the so-called "doughnut hole", which costs many plan members lots of money. Under Part D, once any member spends about $2,500, which entitles him or her to federal subsidies, the next $2,250 spent on medication must be paid totally by the member.
Lawmakers have also complained about other features associated with the administration of the plan-strict filing deadlines and monetary fines for not signing up for the plan on time-which Democratic lawmakers will seek to change to make the program more member-friendly.
Getting amendments passed may no doubt take some negotiating and horse trading with Bush and the Republican minority because the president pushed very hard to get the plan passed originally. But Democrats are now in a position where they can score some legislative victories since they hold the upper hand in both houses.
FAULTY FLU SHOTS: The city Department of Health reported last week that "ineffective" flu vaccine had been administered to about 4,000 elderly city residents. The recipients were advised to get a second shot.
The ineffective shots were given out between October 13 and 19 at the agency's health centers in Corona and in the Chelsea section of Manhattan, and at two dozen senior centers, which were not identified.
The DOH said it notified anyone who might have gotten the ineffective vaccine and urged them to come in to get a new vaccination. The notice emphasized that anyone who received the ineffective vaccine faced no safety concern. However, it also emphasized that everyone in that grouping must be sure to get revaccinated in order to be fully protected this winter.