Tag Archives for Medicare

AARP Rallies for Prescription Drug Benefit

Published in the Pawtucket Times on July 30, 2001

AARP gears up its grassroots advocacy machine to call for the expansion of Medicare at nationwide rallies, urging Congress to enact a prescription drug benefit in Medicare that is affordable, voluntary and available for all.

Using the 36th anniversary of the signing of Medicare as a backdrop, AARP Rhode Island has planned a rally today at 9:00 a.m. at the food court of the Warwick Mall to support the expansion of Medicare to cover the cost of prescription drugs. AARP officials expect hundreds of members and aging advocates at this gathering, hoping to raise the awareness of the Rhode Island congressional delegation about the importance of this policy issue.

“Advocacy and education” will be the goals of today’s event, stated AARP state Director Kathleen S. Connell. To raise the awareness of Medicare’s anniversary and the need for a prescription drug benefit, she stated that all seniors attending the rally will be give anniversary cake and coffee as well as prescription pill boxes with an informational brochure about the issue.

Connell notes that the Washington, D.C.-based advocacy group, which represents 34,000 million seniors, will use today’s Rhode Island rally to urge state lawmakers to act on adding a prescription drug package to Medicare. Costly drugs continue to hi seniors in the pocketbook, she says.

Later in the morning, AARP Rhode Island volunteers will present each of the state’s two senators and two congressman an anniversary cake with a missing piece, to symbolically represent the prescription drug benefit that is missing from the existing law, Connell said. “We will bring them a cake along with anniversary cards to remind them of Medicare’s anniversary and the high cost of prescription drugs.”

Opposing Medicare is considered to be political suicide by lawmakers, especially with the clout of senior voters. Everyone agrees that Medicare is an important federal program that helps 93 million seniors to stay healthy. Last year alone, more than 39 million Americans and their families relied on the nation’s largest health care program for their health care needs.

At present, there is no prescription drug benefit under Medicare because of a lack of political consensus as to how to pay for and implement the policy.

The final version of the Medicare Act was introduced by Rhode Island Congressman Aime J. Forand (D-RI). Connell told All About Seniors. According to Connell, during last year’s congressional elections every candidate had a favorable position on Medicare. “Here is Rhode Island Medicare’s promise has deeper roots in that our lawmakers were the prime movers of the original Medicare efforts. Our message to Rhode Island lawmakers is that we stated it here so let’s do what we need to complete it,” Connell added, noting that the final piece is a prescription drug package.

As with Congress, Rhode Island’s congressional delegation favors a prescription drug Medicare benefit and all are planning to attend today’s rally.

According to remarks that Sen. Jack Reed is expected to make, it is the right time for Congress to move on this issue. “Tremendous advancements in medical treatments, the explosive growth in the price of prescription drugs, and older Americans ever increasing reliance on medications, makes it essential that Congress enact a Medicare prescription drug benefit,” he says.

Taking his Congressional campaign pledge of making prescription drugs more affordable to older Rhode Islanders to Capito Hill, Rep. Jim Langevin also has penciled in the rally on his schedule. The state’s newest Congressman is expected to call for the passage of H.R. 1400, legislation that would drive down the cost of prescription drugs. The bill also provides protection to Medicare recipients from discriminatory pricing by drug companies. A study commissioned by the state’s congressman found that Rhode Island seniors pay on average, 78 percent more for most commonly used prescription drugs than those in five industrial countries.

Also, expect Rep. Patrick Kennedy to drop by the Warwick Mall to show his continued support for Medicare prescription drug coverage. He tells All About Seniors, “It is clear that we must bring Medicare into the 21st century with accessible and affordable insurance coverage of prescription drugs.” Over the years the Congressman has expressed concern not only for those who have no drug coverage at all but for those who pay high prices for private supplement policies or for managed care plans that include drug coverage.

Meanwhile, Republicans Sen. Lincoln Chafee will come to the rally to pitch S. 1135, a bipartisan, comprehensive bill, that would begin to overhaul Medicare and provide a universal prescription drug subsidy. The proposal also calls for different organizations to compete for Medicare’s prescription drug business. Sen. Chafee believes his approach of using a market-based competition will result in lower prices for prescriptions.

But the rising costs of prescription drugs will continue to make the prescription drug benefits a key advocacy issue for Rhode Island AARP and other senior advocacy groups at the national level. Congress must move away from legislative gridlock, away from the flowery words of support for a prescription drug package spoken at public events, to swiftly enact a viable bipartisan solution so this pressing public policy problem. Simply put, lawmakers must now realize that seniors at AARP rallies across the nation are telling you today to “walk your talk.”

Many Seniors Struggle with High Cost of Medications

Published in the Pawtucket Times on June 18, 2001

Many seniors are struggling to pay the spiraling cost of prescription drugs as a politically divided Congress seeks a solution by crafting a bipartisan prescription drug benefit tied to Medicare.

Until this issue is addressed, a tragedy occurs in many communities across the nation.

Often, the high cost of prescription drugs has forced seniors on fixed incomes into not taking their medications at all or using only partial doses.

Noncompliance in taking medication can lead to hospitalization, nursing home admission or premature death.

According to the Families USA study released in June 2001, costly prescriptions continue to hit seniors hard in their pocketbook.

The report found that 50 of the most heavily prescribed drugs for seniors on average rose more than twice the rate of inflation in the year ending January 2001.

On average, the researchers found that prices increased by 6.1 percent from January 2000 to January 2001, though the rate of inflation excluding energy in that time period was 2.7 percent.

Furthermore, the 18-page report stated that seniors are most affected by any prescription drug price  increase.

Although older persons represent just 13 percent of the total nation’s population, they account for 34 percent of all prescribed medications dispensed and 42 percent of all prescription drug spending.

Of the 50 drugs used more frequently by seniors, the average annual cost per prescription as of January 2001 was $ 956, the report noted.

Drug prices rose significantly over the one-year period of the study.

The report findings revealed that the cost of Synthroid, a synthetic thyroid agent, rose by 22.6 percent; 22.5 percent for Alphagan, commonly used to treat glaucoma; 15.5 percent for Glucophage, prescribed for treating diabetes; and 12.8 percent for Premarin, used estrogen replacement.

While rising drug costs are national, Rhode Island fiscal nets are in place to make prescription drugs more affordable to low-to-moderate income seniors, says Susan Sweet, consultant and advocate for a variety of nonprofit agencies and minority groups.

Many aging advocates and state legislators know Sweet as “the mother of the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE).”

“Rhode Island is one of a handful of states that has responded to senior’s concerns and anxieties about the high cost of prescription drugs,” Sweet says.

In 1985, the Rhode Island General Assembly moved to assist elders with rising prescription drug costs by enacting RIPAE.

Initially, the RIPAE program covered only medications purchased by low-income seniors to treat hypertension, cardiac conditions and diabetes.

In the past fifteen years, the General Assembly has expanded the program,” Sweet adds, to over the cost of prescription drugs to treat glaucoma, Parkinson’s disease, high cholesterol, cancer, circulatory insufficiency, asthma, chronic respiratory conditions, Alzheimer’s disease, depression, incontinence, infections, arthritic conditions and prescription vitamins and mineral supplements for renal patients.

Additionally, the RIPAE Plus Program, proposed by Lt. Governor  Charles Fogarty with House and Senate leadership, allowed moderate income seniors to purchase prescription drugs at a lower rate that is negotiated by the state.

The state also pays a portion of the remaining cost of the drug based on the senior’s income level.

“The innovations in RIPAE have made Rhode Island a leader in assisting seniors to stay healthy and independently,” Sweet says.

With the end approaching to this year’s session of the General Assembly, lawmakers are considering legislation to again expand the RIPAE Program, states Fogarty, who authored the legislation.

Fogarty’s RIPAE Next Step would cover all FDA-approved prescribed drugs, excluding cosmetic and experimental drugs, cap out-of-pocket expenses at $ 1,500 annually, and open up the program to people age 55 and over who are receiving Social Security Disability Insurance.

While no one really opposes the passage of RIPAE expansion this year, ultimate passage of the entire legislative proposal is really a question of competing budget needs and limited state dollars, Sweet comments.

House Finance Chair Tony Pires (D-Pawtucket) remembers a time in the mid-1990s when Governors Bruce Sundlun and Linc Almond attempted to roll back the RIPAE program by calling for an increase in the senior’s co-pay and limiting access to benefits.

“The General Assembly made it very clear that it did not want to reduce state support, but rather moved to increase benefits,” Rep. Pires said.

“This year we’ll be expanding the list of drugs to include prescription drugs used to treat osteoporosis,” Rep Pires tells The Times, adding that House leadership also supports an out-of-pocket prescription drug cap of $ 1,500 annually.

With the RIPAE Next Step’s price tag of $ 3.5 million dollars. “We can’t afford to pay for an open formulary program yet because of budgetary limitations,” Rep. Pires states.

In upcoming legislative sessions, coverage for gastrointestinal drugs will seriously be considered, he adds.

“In the upcoming years the state’s pharmaceutical assistance program will remain a top priority to the General Assembly, Rep. Pires says. “There will be an expansion of coverage to a full formulary when more state monies become available, he adds.

Currently, Lt. Governor Fogarty estimates that more than 170,000 Medicare beneficiaries in Rhode Island, who do not meet the state’s pharmaceutical assistance program’s income eligibility requirements, lack comprehensive prescription drug coverage.

With an aging population, Congress and state lawmakers must roll up their sleeves to find innovative ways of making prescription drugs affordable.

Scully Selected to Head Federal Health care Agency

Published in the Pawtucket times on May 14, 2001

Thomas A. Scully, a Washington, D.C.-based health care association executive who holds a law degree from Catholic University and has previous experience on Capitol Hill as a senate staffer and as a high-level White House official, has been tapped by the new Bush administration to run the Health Care financing Administration (HCFA), the federal agency providing health care to 74 million Medicare, Medicaid and the State Children’s Health Insurance Program.

The nomination of Scully, president and CEO of the Federation of American Hospitals, a trade group that represents 1,700 for-profit hospitals, went to Capitol Hill in early May.  When confirmed as HCFA administrator by the U.S. Senate, Scully will replace Nancy Min DeParle, who left last October for a teaching stint at Harvard University. With her departure, a string of acting directors temporarily took the reins of the federal agency.

At press time, Jill Kozney, a spokesperson for Chairman Chuck Grassley of the Senate Finance Committee, stated that a confirmation hearing has not been scheduled yet. “Not every piece of paper work is in, but the chairman would like to act on the nomination as soon as possible,” the Senate staffer says.

A Washington Insider

As Washington insider, Scully brings a potpourri of health policy experiences to HCFA. The health care association executive comes with legal expertise gleaned from his legal practice, which focused on regulatory and legislative work in health care. Scully also brings an understanding of the intricacies of Capitol Hill, gained by serving as a staff assistant to U.S. Senator Slade Gorton (R-Wash.), and as associate director of the White House Office of Management and Budget (OMB) and later as deputy assistant to the president and counselor to the director of OMB under the senior Bush administration.

Ties to the former Bush administration were forged when Scully served on the communications staff of the Bush-Quayle campaign in 1988 and as deputy director of the congressional affairs for the president-elect’s transition team.

“Scully is smart, quotable, and politically savvy,” says Edward Howard, executive vice president of the Alliance for Health Care Reform. “He’s described as a problem solver rather than an ideologue,” Howard adds.

Howard expects Scully to turn his attention to internal problems at HCFA, because the agency has “substantial management problems.” He notes that HCFA has lost a number of good people and Congress will most certainly give the agency new tasks to handle.

“At least Scully will not have to spend one and a half years to learn about the programs he supervises, because he knows them well with his past OMB experience and at the Federation of American Hospitals,” Howard adds.

Bill Benson, former deputy assistant secretary for aging and president of the Maryland-based Benson Consulting Group, warns “Don’t look for Scully to, be much of a consumer advocate,” because he will be sympathetic to providers because of his ties to the hospital provider community.

“That does not mean Scully’s going to be in any position to get hospitals any more money but he will be more attuned to less regulation and more flexibility in rules, and regulations or health care providers,” Benson states.

According to Benson, one of Scully’s first tasks will be to carry out Health ad Human Service Secretary Tommy Thomson’s wish to reorganize HCFA because “this agency is one that everyone loves to hate, especially Republicans.”

Providers Rally Around Scully

Meanwhile, provider groups give thumbs up to Scully’s nomination as HCFA administration.

“Tom Scully has a unique combination of both real-world perspective and public service experience,” states Rick Pollack, executive vice president of the American Hospital Association. “That makes him a great choice for HCFA administrator.”

“From crafting Medicare regulation and budgets to building strong relationships with lawmakers on both sides of the aisle, Tom has the right mix of knowledge or the job,” Pollack adds.

In a letter being distributed to U.S. senators, who must vote to confirm Scully, Dr. Charles H. Roadman, II and AHCA Legislative Counsel Bruce Yarwood states: “As HCFA administrator, Tom Scully will have the responsibility for leading dramatic change.”

The opportunity for HCFA reform is the brightest it’s been in years,” Roadman predicted, expressing confidence that the controversial survey and enforcement apparatus will be closely scrutinized by Scully and the Bush White House.

In a public statement, the American Association of Homes and Services for the Aging’s senior vice president Suzanne M. Weiss states that her nonprofit provider group looks forward to working with the new HCFA administrator.

“As we look for ways to improve the current nursing home and inspection and enforcement system and reimbursement system.  We hope Mr. Scully will be o pen to our efforts in his new position,” Weiss says.