What Was Life Like Before Part D? (2006)

Anyone care to give a bit of a history lesson on what what life was like for seniors before part D came about? (2006)

I wasn't in the business back then. I remember hearing stories about seniors having to go to Canada to get affordable drugs but that's about it.

Was it worth the expense (deficit) to get it implemented?

Are seniors really better off?

I used to work for a plan that offered a whopping $700 worth of rx a year while our nearest competitor only offered $500!! Our formulary was crap though. Some high rx users would switch plans after so many months to get the NEW Rx benefit of the new plan. Medical groups were the same, so they weren't switching any providers, just receiving a new set of benefits. Seniors ARE better off, but like someone said before, we ARE paying for it through our taxes since Georgie Boy decided not to fund it.
 
I used to work for a plan that offered a whopping $700 worth of rx a year while our nearest competitor only offered $500!! Our formulary was crap though. Some high rx users would switch plans after so many months to get the NEW Rx benefit of the new plan. Medical groups were the same, so they weren't switching any providers, just receiving a new set of benefits. Seniors ARE better off, but like someone said before, we ARE paying for it through our taxes since Georgie Boy decided not to fund it.

Forbes has this to say about it, and we know which side of the aisle they're on:

And not only is Medicare Part D saving Americans money, the program has consistently come in under budget. Costs are now 45% below the program’s initial 10-year projection – the program will cost $340 billion less than original estimates. Even more impressive, Medicare Part D is helping to save costs in other ways: the Congressional Budget Office found every one percent increase in prescriptions filled has led to a .20 percent decrease in Medicare spending.

Medicare Part D Continues To Improve Access To Drugs - Forbes
 
Forbes has this to say about it, and we know which side of the aisle they're on:

And not only is Medicare Part D saving Americans money, the program has consistently come in under budget. Costs are now 45% below the program’s initial 10-year projection – the program will cost $340 billion less than original estimates. Even more impressive, Medicare Part D is helping to save costs in other ways: the Congressional Budget Office found every one percent increase in prescriptions filled has led to a .20 percent decrease in Medicare spending.

Medicare Part D Continues To Improve Access To Drugs - Forbes

Sure, but I wonder how much of the decrease in costs is due to the lack of brand name rx blockbusters that are coming out when compared to the 90s and 00s. This has led to many more seniors taking generic rx as they have become available. The insurance companies now offer a much higher brand name rx copay than what they did back in the 1990s, which pushes the seniors into using the cheaper generic rx when it's available. As far as I know, the ONLY ones that qualified for lower drug costs back before Part D were those on medicaid-medi-Cal. Calif limited medi-cal people to 6 rx/month. Wiser conservative states like Texas limited them to 3 rx/month. On Part D, they are allowed to get more with small copays and LIS is available to a broader class of beneficiaries as well.
 
There is no doubt that Part-D is great for the beneficiaries. They can get medication at a copay rather than paying full price.

What I don't see in the article is how much we're still paying for the benefit. The prediction might have been (for example) $2,000 per senior but now we're only paying $1,000. You can spin that as a 50% decrease in cost or a realistic $1,000 expense to taxpayers. And of course, my example is nothing close to reality but just a "for instance."

The other factor is that the most popular medication - Lipitor - went generic about a year ago. I suspect the end of patent protection for a variety of high priced medication has cause some of this decrease.

If you eliminate the cost to taxpayers it's a great program. As is obamacrap if you forget that it's amazingly expensive to those of us who still pay taxes. There are always two sides to the equation.

Rick
 
There is no doubt that Part-D is great for the beneficiaries. They can get medication at a copay rather than paying full price.

What I don't see in the article is how much we're still paying for the benefit. The prediction might have been (for example) $2,000 per senior but now we're only paying $1,000. You can spin that as a 50% decrease in cost or a realistic $1,000 expense to taxpayers. And of course, my example is nothing close to reality but just a "for instance."

The other factor is that the most popular medication - Lipitor - went generic about a year ago. I suspect the end of patent protection for a variety of high priced medication has cause some of this decrease.

If you eliminate the cost to taxpayers it's a great program. As is obamacrap if you forget that it's amazingly expensive to those of us who still pay taxes. There are always two sides to the equation.

Rick

I will respectfully argue the case for Part D as this. What sense does it make to cover the illness in the hospital due to the lack of medication and cover the medication in the hospital but as soon as they're released the medication is no longer covered? Rinse and repeat.......

The data is showing fewer hospital admissions now.
 
Anyone care to give a bit of a history lesson on what what life was like for seniors before part D came about? (2006)

I wasn't in the business back then. I remember hearing stories about seniors having to go to Canada to get affordable drugs but that's about it.

Was it worth the expense (deficit) to get it implemented?

Are seniors really better off?

When I started in 1999, people in my neck of the woods (or desert) went to Mexico to get their prescriptions. Some really were choosing at times whether to buy groceries or prescriptions.

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Back in the late 90's early 2000's I was running Med supp leads. I can't tell you how many times I couldn't sell a supp due to their monthly drug cost of $500 to $800!! Believe me when I tell you I know what cat food looks like. Those folks faced very difficult choices. Pres. Bush knew this thats why he signed it into law.

I would just like to say this, prior to part D there was NO such thing as a $4.00 generic prescription!

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Yep, what you said. That is something I always remind people about. It was a good thing that George Bush did.
 
M+C drug coverage in California:

1997: $5G/$10B, no benefit max
1998: $10G/$25B in many counties, $500-$1500 benefit max
2002: $15G/no brands, $250 limit in most counties but no generic metformin or lovastatin coverage. LA/OC had a limited drug list with some brands.

Yes, life sucked before Part D.

The overall cost for Part D was less than forecast for sure, but it was not "funded" in the standard way of thinking. It means the federal government didn't set up a new, dedicated revenue stream (tax) to pay for it. It would be interesting to determine the amount of new tax revenue raised due to increased revenue to pharma companies, pharmacies, and individuals due to Medicare Part D.
 
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