Things have been bad enough for many since the program started. A program may cover one drug and not another, seniors too old and tired to stay on the phone for hours give up. Lots more. Pharmacies have gone broke from providing life sustaining medicines to those who for some reason aren't getting what they need.
No one is talking about it on TV. There is little discussion of it at all in public arenas. Someone has to talk about it on the air, someone has to make a fuss for the sake of these people who will be involved. It is a sin not to do so.
On April 1st it gets much worse. Almost unbelievably worse. On that date insurers can just say they won't pay for a certain drug which is not on their list.
http://www.wtol.com/Global/story.asp?S=4651504WASHINGTON (AP) -- Many elderly and disabled Americans enrolled in the Medicare drug benefit will face new difficulties obtaining their medicines on April 1st, say advocacy groups familiar with the program. On that date, insurers will have more latitude to tell pharmacists they won't pay for a particular drug. Before that, insurers have been told they should pay for a prescription even if it's not on the list of drugs they cover.
"I think that, after April 1st, you're going to see huge problems with access. It's going to be January 1st all over again," said TomClark, policy director at the American Society of Consultant Pharmacists. The association represents pharmacists who serve nursing homes.
And this part sounds reassuring, doesn't it? The very poorest can either switch plans or get access to
"substitute medicine." Oh, you ask, who gets to decide that "substitute medicine." And will it work? How long will it take to tell if it will work? Will there be side effects? So many questions.
Government officials said the Medicare drug benefit covers most of the drugs commonly used by seniors and the disabled. They say beneficiaries who take those drugs will have nothing to worry about come April 1st. And, if beneficiaries find their drugs aren't on a plan's list of covered drugs, often referred to as the formulary, they usually will have access to substitute medicines. The poorest beneficiaries can switch plans at any time.
"What we're requiring is that the formularies all must be broad, all must meet our stricter-than-usual requirements, plus there must be a timely way for beneficiaries to get an exception," said Mark McClellan, head of the Centers for Medicare and Medicaid Services.
I will be posting more later, including a press release from Henry Waxman about "step therapy." Now there's a great concept for the very ill and disabled.
Seniors are hurting now. Many are just too tired and confused to handle things like this. We try to help when we can do so, but too many are slipping under the radar. This should not be happening in our country.
Also I saw a list of drugs that will be involved in the "step therapy". It is alarming. I will find that again also.
By not calling attention to all of this loudly, our party is letting our seniors down. I expected the Republicans to let them down...they just don't care. I did not expect it of our own. Maybe I just missed all the times they have talked about it.