MEDICARE PART D DONUT HOLE REPORT-Andrew Stelzer

07/12/06

When the new Medicare part d prescription drug plan went into effect at the beginning of this year, one of the dire warnings from consumer advocates was of the donut hole. When someone has spent more than 2,250 dollars on prescriptions for the year, the next 2,850 dollars must come out of their own pocket before the coverage kicks back in. This summer, seniors and others began hitting the donut hole, and according to a new report by the institute for America’s future, more and more Americans will be realizing that the plan they signed up for is going to put them in dire financial straits.

ACT-Worley “On Jan 1st my total bill was 140 dollars..On April 1, I was in the donut hole..�

Ray Worley is the Vice President of Florida Consumer Action Network’s Board of directors, but the prescription drug issue has become personal for him. Worley was disabled on the job years ago, but is having to stop taking prescriptions he’s used for years.

ACT “770, my income is 1246..I wont be out of the donut hole until September. I cant live on it and no one I know can..�

Worley was one of about a dozen senior citizens who gathered at the sunshine center in downtown St Petersburg for a press conference calling for changes to the Medicare Part D prescription drug plan. He was joined by Juanita Nicks who last year was getting two $300 prescriptions, but her insurance company told her she had to sign up for Medicare part D this year.

ACT-Juanita Nicks “I reached the donut hole this month, and my insulin is over 200 bucks a month…I take erimidex for cancer..I told my doctor I needed something cheaper..he gave me 2 months free sample..�

ACT-Compton “A lot of seniors are confused..wondering what’s going on..�

Phil Compton is with the Florida Consumer Action Network; he says the plan developed by congress does not benefit the country financially or in terms of quality health care.

ACT-Compton “The donut hole costs taxpayers more money…worsening health…tragically those are 25% more likely to die…�

Juanita Nicks is an example of one of those people who may be putting their lives in danger.

ACT-nicks “I take other drugs for high blood pressure…port for chemotherapy..all I could afford because they were generic, but now I don’t know what ill have to do, I guess ill have to do without the cancer drug..�

The new report, titled “Falling into the donut hole, how congress and the drug industry created a trap for American seniors and people with disabilities�, says that of the 11.8 million people on the part D plan, 7 million will hit the donut hole this year. September 22nd is the date when the average senior will hit the donut hole, and has been named “Doughnut hole day�. That Donut hole, or the amount people will have to pay 100 of their drug costs, will grow larger every year, and the date by which the average person will move up further in September every year.

ACT-Reynolds “My parents lived into their 90s, I don’t remember them struggling…people will stop taking meds and will die or become burden to society..�

Seniors in the US have an average income of less than $15,000 a year. Bob Reynolds is HIV positive and had open-heart surgery last year. His medications cost 1,300 per month. His former employer encouraged him to leave their plan and switch to Medicare earlier this year, and now he’s hitting the donut hole this month.

ACT-Bob Reynolds “I am disabled because of HIV aids, I had open heart surgery, I have a third major illness..my medications run 1,300 a month..they have worked, I am functioning…In January I was covered under my employer, Feb 1 I became medicare..Verizon they made me choose, over 500 of regiment, so I opted to do part d, and the first couple months I got away because of a glitch….now im going to be responsible for donut hole, in the meantime 400 a month and im responsible for 5%…I figure out of pocket would cost me 7-8,000 and my income is 24,000,

The report also cites the problem of immense price fluctuations, where people will be paying minimal prices during part of the year and then have a tremendous increase, which is hard for people on a fixed budget to adjust to. FCAN is offering to show a 14-minute film narrated by Walter Cronkite, and speak to civic, church or senior groups about part D. they are also urging seniors and others to contact their members of congress, and ask them to support the Medicare Prescription Drug Savings and Choice Act, which would get rid of the donut hole. They are targeting retiring representative Mike Bilirakis.

ACT-Compton “There is no excuse for Bilirakis..he was the only member to help create it and write it…we call on Bilirakis to fix the problems that are apparent and to make it affordable..theres no better way to achieve that than to negotiate prices..�

Hillsborough county commissioner Kathy Castor has been volunteering for SHINE since January counseling seniors through the sign up process for part d.

ACT-castor “We need to reform Medicare part d right away before the insurance companies get too entrenched..this plan was forged to benefit pharms and not seniors..�

Castor also called for an extension of the deadline, which has already passed, anyone who now signs up for part D has to pay higher drug prices for the rest of their lives. The Bush administration has refused to grant any extension. She also said that the government needs to be able to negotiate lower prices.

ACT-castor “At a time when pharms are making $$$ why cant the govt negotiate in bulk, whats good enough for vets should also be for seniors..�

Castor, who is also running for congress this fall, says part of the problem is there is no more accountability because private companies are running the plan instead of the federal government—so a call to an elected or other government official is less likely to spur action related to an individuals problem. September 22nd is only 6 weeks before the election, and the republican led congress may act in order to prevent the drug plan form becoming a major issue on the campaign trail. Reynolds hopes that will motivate some action.

ACT-Reynolds “Congress will have to do something otherwise it will fall to the states, and it costs them more…�

To view the new report on Americans falling into the donut hole, log onto www.ourfuture.org

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