DRUGS AND POWER DON'T MIX

Congratulations senior citizens! Yesterday was a big day. It was the first day to enroll in the government's new Medicare drug benefit plan. If you're not on Medicare yet, double congratulations! You have time to learn from the poor bastards who are, or pray things will change before you get there!!

This is that bill born in controversy. The one that cost over $140 billion more than Congress was led to believe. Of course, when it comes to money, congress isn't all that astute and our executive branch, as it has demonstrated repeadtedly, just doesn't give a shit.

This is the bill that upset lots of incredulous seniors who tried to understand it. This is the plan with the "doughnut hole" that provides coverage for the first couple thousand dollars, then stops until you spend a thousand or two more out of pocket before kicking in again. (To whose benefit is that, do you suppose?)

AARP urged its angry members to just bite the bullet and accept it. Hope to improve it later on. Something's better than nothing, said AARP.

This is the bill our representatives wrote for their constituents--the pharmaceutical companies! Let's get that very straight. Why else would our congress pass a bill that creates so much confusion and consternation and potential for noninclusion among its intended "beneficiaries"?

Here's just some of the great options you as a Medicare recipient face under this new benefit.

1. There are a dozen, give or take, different companies with which to enroll.

2. No one company provides the same coverage as the others. "In most areas there are at least 40 prescription-only plans from which to choose. Each plan has a different list of drugs that it will pay for, so "be sure that the drugs you are taking are on a plan's list - especially your most expensive prescriptions.

"Each plan will charge a different premium and will charge a different amount per prescription. Also, each plan will have certain pharmacies that you must use. Make sure the plan you choose has a pharmacy that's close to you or to whomever picks up your prescriptions for you." If you're an 80 year old in a wheel chair who can't drive in other words, pick a neighborhood pharmacy you can walk to.

Dada knows some folks on Medicare who are mentally competent but very befuddled by all of this. But what of older folks in a less than competent state who are supposed to make the same decisions?

3. Not all medications are available under any one plan. One plan may cover diabetes medications, but not Parkinson's, etc. As advised in Q&A's, if you are now healthly but think you may get ill next March or July, "you should think about what kinds of medications you might need if you get a major illness in the future"! The implication being, by anticipating what illness may befall you and which medications you will need, you'll know which plan that provides those necessary drugs to choose! (No, Dad's not making this shit up. Better own a freakin' crystal ball!)

4. While the plan is voluntary, if you don't enroll by next May 15th, you could be penalized in the premium you will pay for the rest of your life and ever after. Remember, this is a voluntary benefit for you! (Dada suggests that whipping you to enroll with threats of higher premiums is so the pharmas may maximize your new benefit.)

5. These are all fun, aren't they? But one of my favorites that really illustrates who this fuckin' mess was written for is the answer to a question about, "What if I don't like the plan I chose, can I change. Here's your answer. "Yes, but only once a year . The kicker is that the private insurance plans can change which drugs they will cover as often as they like, even though you will be locked into your plan until a new enrollment period is announced each year."

Think about that. Say you're enrolled in a plan because they provide diabetes drug coverage. But the company decides it's expenses are too high because of all the diabetics enrolled. To cut costs and increased profit margins, they can decide to exclude your diabetes medications. Oh, you'll still be paying the same premium for no benefit and you won't be able to opt for another provider for up to a year. Dada says, "It's a beautiful thing!"

6. Of course, there's that stipulation granting your insurer ultimate authority over your doctor by having the option to "require that you get their approval before they'll pay for certain drugs. Plans are also allowed to place restrictions on benefits as long as they do not 'substantially discourage enrollment.' " Roughy translated this means pharmas can screw you as deeply as they want so long as it doesn't affect their profits.

People, people! Look this shit over again and ask yourself, "Who the fuck is this new Medicare drug prescription plan designed to really benefit? How is it the people who passed this are still employed as our representatives?

(NOTE: The above "benefits" were gleaned from NPR's Medicare Drug Benefit: Q & A