Who profits from Medicare drug discount cards?

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I have spent the past week trying to find out how the new Medicare-Approved Drug Discount Cards work. It’s been a tedious process.

On May 20, I received a letter from Social Security about the new law that supposedly will provide improved Medicare coverage by adding prescription drug benefits. In 2006. This would be the same law that our representatives were told would cost $395 billion over the first 10 years. To the fiscal conservatives in Congress who had already announced they would kill a bill that cost $400 billion or more, the $395 billion sounded okay. Since then we’ve heard from a poor researcher at the Office of Management and Budget that he was warned by a former boss he would be fired if he even hinted that the real figure would be at least $100 billion more. Many in Congress say they would not have voted for if they had been told the true cost estimates. Well, underestimating worked for the bill to finance the war in Iraq, so why not?

Since most of us may be around to vote in November, but may not be making plans that extend until the Medicare benefits kick in sometime in 2006, not a national election year, our politicians have rushed these drug discount cards onto the market beginning June 1. The fact that the process is so confusing nobody eligible for Medicare has a prayer of understanding it may or may not bode well for those seeking reelection.

If, as the letter suggests, only low-income seniors are eligible, then I surely would qualify. My federal tax refund for 2003 was a whopping $2, so I must be low income. If I were wealthy, I’d have gotten a major tax cut, hence a respectable refund. Right?

My first call was to Medicare, where I remained stuck in the voicemail vortex for 25 minutes, never to connect with a live human voice. About par for government agencies. Next I called Kaiser, which advised me that as a Senior Advantage Individual Plan member, I already have drug benefits-generic prescriptions at $10 copayment and limited brand prescription drugs at $30 copayment from Kaiser pharmacies-and might not need the drug discount card. But if I “feel the need to consider one,” they have an option for me. I don’t, and I don’t even need prescriptions, but it bugs me that nobody will disclose how this thing really works.

If HMOs and drug manufacturers are fighting for approval to market these discount cards, which seem to cost the patient about a $30 enrollment fee, who is making money and who is saving money, and is it taxpayers, those of us who still have to pay taxes, who are ultimately footing the bill? Probably so.

I read that pharmaceutical companies spent billions lobbying the government to get approval to offer these drug discount plans. This from the same administration that saw to it Medicare would never be able to negotiate price controls on those drugs. Now, we all know there’s plenty of room in the price structure to sell drugs at huge discounts to other countries, like Canada, which can then sell them back to us at discounted prices and still make a profit. At least one drug manufacturer also had enough profit margin to offer doctors and hospitals kickbacks to prescribe its cancer drug. That company has already paid $875 million to settle such charges brought by federal prosecutors.

Meanwhile, HMOs and drug companies are spending millions advertising their plans and courting patients to enroll. Until I find out who is making all the money and where it’s coming from, I’m not buying it.

And doctors wonder why alternative therapies are growing in popularity.

Maybe because most of them work and they’re cheap. Nobody’s making a profit on the 30 minutes you spend meditating every morning, even though it’s lowering your blood pressure as much as the prescription that was straining your budget and destroying more liver cells than the daily double martinis.

How did the Medicare bill get so screwed up? We may never know, but I’m betting it’s because there are more pharmaceutical industry lobbyists in Washington than there are members of Congress. And that’s the truth.