Drug out by drug benefits

Seventy-eight dollars. A month. Not bad after the nearly $2000 to pay off the pharmacy in ’05! I wrote each check offering silent thanks for this good Republican program.

Then came the whiplash: October 06’s bill, a Category 5 blockbuster. Three hundred thirty-one dollars! The nearly 425% increase in drug costs hit my solar plexus like a fist. Where was our Part D insurance?

I called the good pharmacist. “Oh,” he said, “Your mom’s ‘out-of-pocket expenses’ are not just hers. The fine print,” he explained patiently, “includes what the insurance companies pay FOR her.” Oops! Even though her “out of pocket” $78 was a slow train to the $2250 senior-citizen cliff-edge of the government “gap,” the insurance company’s share rocketed her into the (donut) hole!

But don’t worry, he said, most are like her. “She’s really the average senior citizen.” This is average? Then being average is downright harmful to your health! Will the 110th Congress do anything to rescue us?

Here you are, skydiving the rarified winds of your golden years, and your parachute, half to three-quarters of the way down, just folds and says, “Sigh. I just can’t do any more. Read the contract.”

Who is living on a fixed income? Not the drug companies. Not the insurance companies. No, that would be my mother. And when you mess with my mother, you’d better be steppin’ light and quick on your way out the door!

Trouble is, they are. Light and quick, with her money in their pocket.

Part D offers drug and insurance companies far more protection than it does senior citizens. In early August ‘06, Novartis profits were up 20%, Pfizer up 9% (before Lipitor’s deadly effects sent them spiraling downward), and GlaxoSmithKline up 14%.

Drug company profits were aided by Part D’s shift of many patients from Medicaid, which could negotiate prices, to Medicare, which under Part D, can not. Those drug companies now charge taxpayers up to 80 percent more under Part D drugs than under other plans.

Insurers won even larger profits. WellPoint Inc., the nation's largest, was up 34%. UnitedHealth, and Humana own at least half of all Part D memberships, with United profits up 26%. Humana’s revenue jumped 52% over last year.

With 65 well-heeled lobbyists for every congressperson, the poor and middle class elderly can’t compete for clout. Even AARP, with their own insurance plan, backed Part D.

Its abject failure is certified by the esteemed New England Journal of Medicine. In March ’06, Dr. Jerry Avorn’s “Part D for Defective” cited a Kaiser Foundation study showing 45% unfavorably impressed and only 23% favorable. “Despite its youth,” said Avorn, “the Medicare drug benefit is already chronically ill.”

June’s issue of NEJM added agonizing details from the birthing chamber of this bill’s partial-birth abortion. Louise M. Slaughter, a Democratic House member with a master’s in public health, said it “was the worst abuse of the legislative process I have seen during my 20 years in Congress.”

A few powerful Republican leaders worked to undermine 59 conscientious reform proposals authored by Democrats and Republicans. Republican leadership rejected all but one, shutting off debate. This gutted the power to negotiate lower prices or to import cheaper drugs from Canada. Both “would have received bipartisan support.”

After that, Senior Republicans physically barred Democrats from the House/Senate conference room but invited in the pharmaceutical industry.
Why such extreme measures? Consider corruption. Representative Billy Tauzin (R-La.), for example, coauthored the bill while negotiating a $2-million-per-year job as a lobbyist for the Pharmaceutical Research and Manufacturers of America (PhRMA), the drug industry's trade organization.

In this corrupt atmosphere, House rules were repeatedly violated. Members had less than a day to read the 850-page bill. When voting Democrats stood unanimously with 22 Republicans in opposition, Republican leadership held the vote open for a record three hours (though the rules dictated 15 minutes) to strong-arm. Tom DeLay was later “admonished” by the Ethics Committee for attempted bribery. Finally, with the House in a choke-hold, the R’s passed it.

In Huxley’s Brave New World, the cure-all drug was named Soma, for sleep. Perhaps the plan, not the drugs, in our new world, are the placebo designed to guarantee our sleep. But we started waking last November 7th. Now we are alert enough to demand from our Congress that they draw up a Part D plan that serves the people, not the powerful. This is one donut hole we will not swallow. Call your congressperson. And don’t take no for an answer.

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