Bad mood rising over Medicare coverage

Ask people on Medicare what they think of it and you will hear generally good things; nearly three-quarters say they have a favorable opinion.

But when people on Medicare were asked recently what they think of the new Medicare prescription drug benefit, they had generally bad things to say. Only 26 percent liked it, the Kaiser Family Foundation and Harvard School of Public Health found in a recent survey.

Even though drug discount cards came out this year, the real Medicare drug benefit won’t start until January 2006. Virtually all of the drug bill’s goodies are front-loaded. Many of its worst features – including provisions that could force drastic benefits cuts or privatization if spending rises to a certain point – won’t kick in for several years. That, presumably, will give those who ginned up this disaster the time to run for cover.

Five times more people said they were “angry” about the new Medicare drug benefit than said they were “enthusiastic.” Two-thirds of those polled want Congress to fix the problems, while just 13 percent say it should be left the way it is.

What should lawmakers learn from this?

Some choice is good. Too much choice is confusing. Among those who dislike the new law, 72 percent said it is too complicated for people on Medicare to understand. They’re not just talking about other people, either. About one-in-five said they had read “a lot” about the new benefit, and another 35 percent say they have read “some.” But more than half said they still don’t understand it.

Keep it simple. What has made Medicare so attractive to older Americans is its stability and simplicity. People know what’s covered, and they know they won’t lose coverage as they get older and sicker. Congress needs to stick with those basic concepts.

Drive a better bargain on price. More than two-thirds of those who dislike the new law said it benefits private health plans and drug companies too much. They’re referring to the portion of the bill that ostensibly fosters competition by paying private companies 109 percent of Medicare’s cost. People are also upset that the law precludes the feds from negotiating the lowest possible drug prices. They’ll be more upset in a few years, when the amount of general revenue going into the program will trigger a provision in the bill that makes Congress cut Medicare spending. That means it will either have to cut benefits or limit eligibility. It makes no sense to overpay insurance and drug companies, then argue Medicare is too expensive and must be cut.

Congress must make Medicare do what the Veterans Administration and Medicaid have done for years: negotiate the best price for drugs.