This week the most convoluted program in the history of Medicare began. I've heard comments from friends, neighbors and people in the press saying that they can't make heads or tails of the new drug benefit.
Whether you like it or loathe it, there are some interesting parts of the Medicare Modernization Act, including the HSA provision and the disease management provisions. But the main event--drug coverage--is neither rational nor ideologically consistent. It's a dog's breakfast put together to ensure that the PBMs and some private health plans have something extra to sell, and so that the pharmaceutical companies don't have to deal directly with the government on pricing.
Now seniors are going to have to deal with a donut hole, out-of-pocket costs, in-network and out-of-network pharmacies, and deciding whether their employer-sponsored coverage is going to stay around. No wonder they're confused.
And despite all this, the cost to the cost to taxpayers is going to be double what Congress was told it would be. Drug coverage for everyone (especially seniors) is needed. But the only prediction I can make is that a more fiscally and socially responsible government--should we get one--will be forced to re-sort this mess in the very near future. - Matthew