Tuesday, January 24, 2006
The Part D doughnut hole
Speaking of making healthcare more complicated, Michael Hiltzik has another column about George Bush's Medicare prescription drug debacle today:
Let's consider how this system will work in practice, using the drug Actonel, a once-a-week pill routinely prescribed for elderly patients to combat osteoporosis, as an example.
Of the 48 commercial Medicare drug plans offered in Southern California, three don't cover Actonel at all; their enrollees will have to pay full price. Twenty-eight plans require prior authorization. The remaining 17 plans cover the drug, no questions asked.
That's not all. There's wide variation in how much each plan charges for a month's supply. Most price it around $500, or $125 per pill. One lists a month's supply at $470. Blue Shield lists it at $602....[But] any patient can purchase a month's supply of Actonel from drugstore.com, an online pharmacy, for $67.99, cash — spending slightly more for a year's supply than some plans charge for a month.
The column is mainly about the absurd and cynical "doughnut hole" built into Bush's prescription drug plan — the result of policymakers who don't actually care about healthcare policy combined with lawmakers who don't care about anything except pretending that their plan costs less than it actually does. In other words, it's the toxic intersection of incompetence and venality.
Read the whole thing.
Let's consider how this system will work in practice, using the drug Actonel, a once-a-week pill routinely prescribed for elderly patients to combat osteoporosis, as an example.
Of the 48 commercial Medicare drug plans offered in Southern California, three don't cover Actonel at all; their enrollees will have to pay full price. Twenty-eight plans require prior authorization. The remaining 17 plans cover the drug, no questions asked.
That's not all. There's wide variation in how much each plan charges for a month's supply. Most price it around $500, or $125 per pill. One lists a month's supply at $470. Blue Shield lists it at $602....[But] any patient can purchase a month's supply of Actonel from drugstore.com, an online pharmacy, for $67.99, cash — spending slightly more for a year's supply than some plans charge for a month.
The column is mainly about the absurd and cynical "doughnut hole" built into Bush's prescription drug plan — the result of policymakers who don't actually care about healthcare policy combined with lawmakers who don't care about anything except pretending that their plan costs less than it actually does. In other words, it's the toxic intersection of incompetence and venality.
Read the whole thing.
