Congress to Debate Pharmaceutical Drug Benefit

Published in Pawtucket Times on June, 24, 2002

A looming November election is prodding Congress to get serious and tackle one of the hottest issues of interest to seniors – skyrocketing pharmaceutical costs that hit them hard in their pocketbooks.

At press time, two House Committees have now marked up the 255-page GOP prescription drug proposal. The final GOP bill is expected to be brought to the House floor for a vote later this week.

Congress is now poised to consider three prescription drug benefit proposals – two would expand Medicare and one would follow a private marketplace approach toward creating a meaningful prescription drug coverage for seniors.

Under the 10-year GOP proposal, which has a $ 350 billion price tag, drug coverage would be directly purchased by Medicare beneficiaries from insurance companies. Seniors would pay a $250 annual deductible along with a $ 34 monthly premium.

For low-income beneficiaries, Medicare would pick up the tab, paying for both premiums and deductibles. The GOP drug benefit would cover 80 percent of senior’s annual prescription drug costs up to $ 1,000; 50 percent up to $ 2,000 and none of the costs between $ 2,000 and $ 3,700, after which a catastrophic benefit would kick in.

In sharp contrast to the GOP plan, the Democratic House proposal costing about $ 800 billion includes a $ 25 per month premium with an annual deductible of $100.

Under a new Part D in Medicare, beneficiaries would pay 20 percent of the drug costs -up to $ 2,000, after which Medicare would pay 100 percent. Under a Senate Democratic proposal, costing up to $ 500 billion, seniors would pay a $ 25 premium but have no deductible. The Senate version would also set a limit of $ 4,000 in out-of-pocket expenses and require co-payments of $ 10 for generic drugs and $ 40 for preferred brand-name medications.

A vote on the Senate prescription drug package is expected to take place next month.

Democrats and Republicans are now cranking up their public relations machinery to take potshots at each other’s bills and tout their own proposals as “the real drug benefit.”

The bipartisan bickering surrounding the prescription drug-coverage issue is complex at best, especially for the senior voter ho must attempt to understand the minute details of the Democratic and Republican proposals.

Even wading through the pounds of press releases and background papers, generated by both parties’ spin machines and special interest groups, can become a challenge task at best.

Literature created by the House Republican Speaker’s Prescription Drug Action Team calls the Democratic prescription drug proposal an “election-year gimmick.”

The GOP plan stays within an already-agreed upon federal budget of $ 350 billion over 10 years to strengthen Medicare with prescription drug coverage, a flyer says, noting that the Democratic plans “simply spend billions more.”

Furthermore, the Republican generated literature announces that Health and Human Service Secretary Tommy Thompson has thrown the administration’s support firmly behind the GOP House proposal.

The HHS agency report finds competition among private insurers that offer the pharmaceutical benefit, concluding this approach would provide real financial relief for seniors.

According to HHS, analysis of the GOP proposal, seniors would save as much as 70 percent on their overall out-of-pocket costs for prescriptions. In addition, seniors would save 60 to 85 percent per prescription.

Meanwhile the Democrats have taken aim at the GOP proposal charging that it only serves the interest of the pharmaceutical industry.

U.S. Rep. Patrick Kennedy (D-R.I) gives his thumbs-up to the House Democrats plan, considering it to be the best legislative fix for protecting seniors against spiraling  costs. The Rhode Island congressman told All About Seniors the GOP proposal would pay, at most, 25 percent of the costs of medications. Moreover, Kennedy added seniors would face an enormous  gap in drug coverage, too. Seniors would be responsible for paying the tab if their medication costs fall between $ 2,000 and $ 3,700.

Washington, DC-based aging advocacy groups are also throwing their two cents into this complex congressional debate on prescription drug coverage.

In March 2002, the AARP, the nation’s largest advocacy group, released survey findings that indicate aging baby boomers and seniors see a public-sector response as the way to bringing meaningful pharmaceutical coverage to seniors.

According to the survey, eight in 10 Americans age 45 and over favor making prescription drug part of the Medicare system. Sixty-seven percent strongly favor this benefit.

Ron Pollack, executive director of Families USA, a national group that advocates for high quality, affordable health care, charged the “House Republican prescription drug plan is far designed to provide political protection for House incumbents than drug cost relief for America’s seniors.”

“The proposal provides precious little assistance and keeps prescription drugs unaffordable for millions of seniors,” Pollack said.

The closer you examine the provisions in the GOP prescription drug proposal, you will see major flaws, Pollack stated. “The proposal provides a very meager benefit and forces seniors to pay the lion’s share of drug costs,” he says, adding this will result in many seniors not being able to affordable medications they need.

Meanwhile, Pollack stated that using private insurance companies to provide prescription drug coverage is the wrong approach. He said there is no guarantee insurance companies will offer drug coverage in specific communities, and the GOP proposal allows insurance companies to define the coverage they offer in different locations.

“Seniors will have no certainty about the premiums they need to pay, the cost-sharing they will bear, the drugs that are covered and under what conditions they can obtain those drugs,” notes Pollack.

When both chambers pass their prescription drug proposals, U.S. Sen. Jack Reed (D-R.I.) said he believes the Senate and House can reach a compromise at the conference committee table.

However, he warned a compromise cannot come at the expense of a senior’s bank account.

I hope Congress listens to and hears a key message from AARP’s 2002 survey – that is eight in 10 of those participating consider providing a Medicare prescription drug benefit to be an extremely important priority for the President and Congress.

With pharmaceutical drug costs continuing to increase, millions of senior voters can no longer afford to wait for a solution blocked by political bickering.

At best, with a little more than four months until the November elections, Democratic and Republican lawmakers might just choose to put politics aside and strike a compromise that can achieve  widespread bipartisan support in both chambers for passage of a meaningful pharmaceutical benefit law.

It’s that time.

All Ages Ultimately Benefit from AARP Advocacy

Published in the Pawtucket Times on June 17, 2002

Everyone has seen newspaper articles reporting how direct m ail pieces sometimes do not reach their attended audience.

Years ago, a friend of mine snickered when told me of a published account of a dog who received a draft notice. Now that’s humorous.

Or than there was an article gleefully reporting a fund-raising snafu where a high-ranking Democratic Congressman was invited to a very costly fundraiser. It was a no brainer for this lawmaker- he just chooses not to go.

Many of my colleagues dread receiving AARP membership solicitations, especially those persons in their late 40s. The mailing is viewed as a reminder that we are reaching midlife and growing older by the day.

With a deadline fast approaching and being “temporarily devoid of brow-furrowing themes,” Rhode Island columnist Philip Terzian told the tale of a misdirected AARP membership solicitation. He reports that his 17-year-old son recently received an invitation to join AARP, 33 years before his 50th birthday. In his tongue-in-cheek piece, Terzian talks about how his son was “haunted by the AARP.”

In that membership solicitation, AARP told the youngster “You have to be 50 or over to join- but you don’t have to be retired,” quipped a bemused Terzian. He speculated that his son was targeted by AARP membership because of the youngster’s unusual hobby. Being an amateur ornithologist, the young man’s name probably ended up on the mail lists, ultimately purchased by AARP to recruit new members, Terzian speculates.

Discounts, pharmacy services, a subscription to the glitzy Modern Maturity, along with lots of helpful information for aging baby boomers and seniors did not influence the late 40-ish Terzian to join, the ranks and file of AARP.

“Senior citizens as a political constituency are now almost as insatiable as veterans, nearly as ubiquitous as victims of cultural insensitivity,” says the aging baby boomer writer expressing why he chose not to send in his membership check.

Responding to Terzian’s piece, AARP-Rhode Island President Phil Zarlengo apologized for the marketing faux pas of putting the young Rhode Islander on the group’s mailing list. He publicly pledged to immediately remove the youngster’s name from a future membership solicitation.

At the top AARP spokesperson Zarlengo strongly disagreed with Terzian’s assertion that AARP’s political constituency to “insatiable,” in their efforts to lobby for federal dollars for senior programs.

AARP is pushing for prescription drug benefits that benefit all Rhode Island seniors, even those choosing not to purchase a minimally priced AARP membership, he said.

AARP’s misdirected mailing to a 17-year-old may well help us to ultimately rethink how we age in America.

No longer should we fear turning age 50, waiting for that AARP membership solicitation to drop through the  mailing slot, announcing midlife has approached, and that we are moving quickly toward our senior years.

Our society is aging.

In just 20 years, the proportion of the state’s population who are older than 65 will skyrocket to nearly 19 percent. Like other states, the percentage of Rhode Islanders who are older than 65, than 75 and even 85, is growing.

We also see a surge in the number of growing baby boomers, too – those born between 1946 and 1964.

Some like Terzian, have expressed dismay over AARP’s strong political muscle.

Right now, political battles are being waged at both the state and national levels for adequate pharmaceutical drug coverage, a coordinated long-term care  system, and more importantly, for a better quality of life for elders.  However, the national aging group’s struggle is not  shameless act to benefit one generation.

Ultimately, AARP’s actions will assist every generation that follows in today’s elder’s footsteps.

Aging baby boomers their children and grandchildren will benefit from sound aging policy, implemented through the successful results of AARP’s lobbying efforts.

It is now time for society to not judge age in chronological terms.  You are only as old as you feel, the old adage says. That’s how we should view aging.

Maybe it is time for AARP to rethink its membership age requirement.

With the graying of America, maybe we should view it as a humorous mistake when a 17-year-old receives an invitation to join AARO.  Tomorrow’s AARP members, who represent every generation, could work together on a redefined organizational mission.

Rather than working on late-life issues, the newly directed membership organization could strive to make a person’s journey throughout their entire lifespan a little easier, a bit better and brighter.

Now isn’t that worth the cost of an AARP membership?

Today’s Seniors are Healthier, But More Are Uninsured

Published in Pawtucket Times on May 27, 2002

Three years ago, Alice, 60, lost her job as a graphic designer along with 143 co-workers when the Providence-based company closed. Corporate management had made the decision to  move South to tap into a cheaper labor pool.

The Pawtucket resident considered her full-time job to be a fulfilling one. Most important, she had good health insurance coverage with a very nominal monthly cop-pay of $ 80. Although she received coverage under COBRA, Alice’s monthly health care premium shot up to $ 256. When the federally mandated health insurance coverage ended, her monthly health insurance premium almost double to $ 600.

Alice never went back to full-time employment, choosing to take partial retirement in order to collect a pension. To make ends meet, she is currently teaching art classes and working part-time for a nonprofit art group. When her COBRA coverage ran out, Alice signed up for health insurance coverage from the National Association of Self-Employed. This reduced her monthly premium to $ 253; however she was left with a $ 10,000 deductible per year.

At age 60, Alice recently had a hip replacement surgery. Before the operation, the hospital required a $ 5,000 down payment, forcing her to withdraw money from her several saving accounts. Now recuperating from surgery that costs more than $ 10,000, she is about $ 5,000 in debt.

According to a new AARP report, seniors age 50 and over may be healthier and living longer overall, but their long-term health security remains at risk. In the Ocean State, Alice and other seniors have lived the findings of the report. They struggle to maintain their costly health insurance  coverage.

The report, “Beyond 50: A Report to the Nation on Trends in Health Security” is the most comprehensive picture to date of the state of health care for older Americans.

Changes in health security during the last 20 years have been driven by increased reliance on prescription drugs and other innovative technologies, changes in chronic disease and challenges in chronic care, greater longevity and functional limitations patients’ roles and responsibilities as consumers and fluctuating cost growth, the AARP report finds.

“Americans age 50-plus have the chance to capitalize on wonderful advances in longevity. But they need a chain of dominoes to fall right – initial good health, adequate health care coverage, affordable quality care that’s easy to access and a system that encourages informed decision making,” said AARP CEO Bill Novelli.

“Missing one of these dominoes puts a person’s – and a generations – whole health security at risk,” says Novelli.

At age 50, Americans can expect to live another 30 years, the report notes, almost nine years longer than expected in 1900, and fewer are suffering disabilities. The aging baby boomers are healthier with fewer smoking and more using preventative services and trying to exercise.

The AARP report also found that more people age 50-64 are uninsured than in the past and those with insurance are worried about losing what coverage they have or receiving fewer benefits in the future because Medicare doesn’t cover prescription drugs and few Americans have long-term care insurance.

“It’s a good news/bad news report,” said Novelli. “Personal behavior can make a positive difference in people’s health and longevity, but health care for Americans age 50-plus is harder to get, to pay for and to manage. The health care system is a non-system.”

The AARP report calls for the public health system to continue to promote positive health behaviors.

In addition, the general lack of long-term care coverage and the increasing inadequacy and instability of health care coverage for portions of the 50-plus population must be addressed by policy makers.

In 2000, 39 million Americans were uninsured. Out of this number, 5.2 million were seniors between  ages 50 to 64. With the graying of America’s population, the Rhode Island congressional delegation must work closely together to craft meaningful legislation that will create a safety net for the underinsured and uninsured. It’s now time to fix this long-debated policy problem once and for all.

Every senior must have access to affordable health care services. For me, that right is as American as apple pie.