- The Washington Times - Monday, January 1, 2007


At first, Ruth Goundry wasn’t sure about participating in the new Medicare drug benefit. It was too confusing, she said. But in the end, she gave it a try.

She’s glad she did.

As the program’s first year draws to a close, Miss Goundry estimates that she saved about $150 a month on her five medicines, compared with what she was spending before Medicare Part D began.

“I would say I’m very impressed with the whole thing. I have no complaints,” said Miss Goundry, a resident of Chesapeake Beach, Md. “It has meant a tremendous savings. I know other people who are saved by it. I mean that. They don’t hardly pay anything.”

Miss Goundry is among millions of seniors who say they are happy with the benefit, which cost the federal government about $30 billion last year.

But the program affects seniors and the disabled differently, depending upon their income and health. There are many people who think the program could be improved.

Just down the street, at the Chesapeake Care Pharmacy, Wesley Copeland is not so impressed.

In August, he began picking up the total cost of his medicine — about $300 a month. Plus, he had to continue paying his monthly premium of $38. That gap in coverage is called the doughnut hole.

“We’ve got a lot of people in my neighborhood who are seniors like me on retirement. We have to stretch pennies, so when it gets to that doughnut hole, we have to scramble … to keep going,” Mr. Copeland said.

Miss Goundry and Mr. Copeland represent the millions of stories surrounding the addition of a drug benefit to Medicare this past year. The drug coverage often has been described as the biggest change in Medicare in the program’s 40 years.

Under the program, seniors and the disabled enroll in a private plan. They pay a monthly premium to the plan. The government also pays the plan.

The Bush administration estimates that the coverage saves the average beneficiary about $1,200. But many in Washington, particularly Democratic lawmakers, say the savings could be greater if the government were allowed to negotiate with drug manufacturers on the cost of medicine rather than leaving that chore to the plans.

Overall, about 22.5 million people enrolled in private plans during the program’s first year. Nearly 7 million more people get their medicine through their employers, and those employers get a tax credit for providing that coverage.

That total of nearly 30 million getting coverage through Part D is much less than had been projected. However, analysts also didn’t realize that so many seniors had insurance coverage for their medicine through other programs.

The Bush administration acknowledges that the program got off to a rough start as hundreds of thousands of people showed up in pharmacy computers as not being enrolled in a plan.

Herb Kuhn, deputy administrator at the Centers for Medicare and Medicaid Services, said he thinks the federal government learned many lessons from the past year that will make this year run more smoothly.

“We have a much more sophisticated and built-up infrastructure from a year ago,” Mr. Kuhn said.

He said his biggest concern going into the new year are those beneficiaries who waited until the final days of the open-enrollment period to change drug plans. He said seniors should bring to the pharmacy any kind of identification or acknowledgment letter from their plan that would show proof of membership.

Overall, Mr. Kuhn said, 2006 was a good year for beneficiaries.

“We believe it has been a very positive year for Part D,” he said. “As a result of the new program, beneficiaries are living better. They’re saving money.”

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