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Commentary

Playing Medi-Scare Again
Newt Gingrich, Washington Times, 11-8-06

Gingrich takes issue with a new study from Families USA that purports to show that the Medicare Drug benefit is shortchanging millions of seniors of needed prescription drug coverage.

The report says the drug benefit as currently designed endangers millions of seniors by imposing financial penalties and creating considerable anxiety.

By ignoring the overwhelming approval millions of beneficiaries give the Medicare prescription drug benefit, the radical left has shown again its sole strategy is to score political points—particularly before the election—by scaring seniors. Consider the skewed study by Families USA. Though 90 percent of Medicare beneficiaries now have broad and affordable prescription drug coverage, when four years ago only a quarter did so, the report focuses on the narrow issue known as the "doughnut hole." This is the period in coverage where beneficiaries, having used $2,250 worth of medications, might not have their medications covered until they use $5,100 worth. During this time, they might pay for their drugs out of their own pocket. Labeling the coverage gap as "bizarre" and "troublesome" is misleading, as their analysis is based on several fundamental flaws. It defines "meaningful coverage" as only 25 medications, which amount to 0.6 percent of about 4,000 drugs the typical Medicare drug plan covers. They also fail to note there are other generic drugs available to treat the same conditions as those in the 25 drugs they list. In fact, many of the high–priced blockbuster drugs listed have therapeutic alternatives not mentioned in the study. Also, four of the drugs are listed twice because they are prescribed in different doses. Such double–counting is a major analytic flaw that unfairly skews the results for the worse.

Beyond these flaws, the "doughnut hole" in general will not be an issue for 71 percent of Medicare beneficiaries. They either will not spend enough to hit the gap or will be covered under a low–income subsidy program, existing coverage, or Part D plan with partial or full gap coverage. Of the remaining 29 percent potentially subject to the gap, every beneficiary in every state can choose an affordable drug plan that offers gap coverage for both generic and brand–name drugs.



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