- The Washington Times - Wednesday, March 15, 2006

The Medicare prescription drug benefit program has been available to seniors and people with disabilities for over two months and in that time has been decried as convoluted and ineffective. The enrollment period has been anything but the smooth transition expected by the Centers for Medicare and Medicaid Services.

The missteps can be traced to misinformation, political grandstanding and competing agendas and other irrelevant concerns. What has gotten lost is the intent of the program and the seniors and people with disabilities it is designed to help. We must lend a voice and a hand; seniors cannot bear the burden or cost of missing the Medicare prescription drug program deadline.

The Medicare Modernization Act of 2003 is the most dramatic change to Medicare its 40-year history. The need for affordable prescription drug coverage for our seniors and people with disabilities prompted the drafting of Medicare Part D. This new supplemental drug benefit can pay for prescription drugs and make them more affordable. It also allows for more preventive services, including physicals, mammograms, and flu shots.

This benefit is available to 43 million individuals, an estimated 4.2 million of whom are African American and depend on Medicare as their primary source of health care coverage and protection. What’s most troubling is that this group has some of the lowest enrollment rates in the program.

A recent Gallup Poll found that approximately 25 percent of seniors don’t understand the program, and more than half don’t plan to enroll. A Wall Street Journal/NBC News poll found that 77 percent of seniors find the program “too complicated and confusing.”

With talk of dual eligibles, co-payments, deductibles, higher premiums, “donut holes,” enrollment periods, and the need to choose from myriad plans, it’s no wonder our seniors and their caregivers find this a daunting task.

An entirely different picture is being painted by Health and Human Services Secretary Mike Leavitt. He recently announced, “The number of Medicare beneficiaries receiving prescription drug coverage continues to grow with more than 25 million Medicare beneficiaries covered.” He is “encouraged by the millions of people who are enrolling each month…well on track toward the goal of 28 to 30 million enrollees in the first year.” Mr. Leavitt has said that these enrollees include in the new stand-alone prescription drug plans, Medicare Advantage plans, and retirees who are in employer- or union-sponsored plans. We must ask, who are these people? What are the demographics? The anecdotal evidence is that enrollment is low in the African American community.

The National Medical Association issued a call to action this week to mobilize leaders in the African American community. We want to take the politics out of the equation and focus on the positive benefits of Medicare Part D. We must first inform our seniors that although enrolling in Medicare Part D is voluntary, the enrollment period will end on May 15. While some recipients may already have retiree drug coverage and might not need to enroll, the majority of recipients still face some consequential decisions.

If an eligible person does not enroll prior to the deadline they will be penalized 1 percent for each month for the cost of their drugs and their monthly premiums for the rest of their life. Once the May 15 deadline passes, Medicare beneficiaries will not have another opportunity to enroll until the next open enrollment period, which starts in November 2006, and coverage will begin January 2007. A person will have to pay 100 percent of their drug costs out-of-pocket until the coverage begins and the penalty continues to mount every month until you are enrolled. That’s an additional 6 percent added to a person’s prescription drug costs and monthly premiums once they enroll in the program.

As an African American physician who leads the nation’s oldest and largest African American professional health organization, we cannot allow our seniors to be financially penalized for not enrolling in this benefit before the May 15 deadline.

The National Medical Association is committed to supporting efforts that improve the quality and availability of health care and engages in outreach efforts to promote improved public health — ensuring that our seniors have the benefit of receiving prescription drug coverage without penalty is one of them.

If we think we have a health disparity crisis now, imagine if we do not succeed in enrolling the most needy of our eligible seniors and people with disabilities. Where will we be then?

This is our call to action.

Dr. Sandra L. Gadson is president of the National Medical Association.

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