Herald News

Time To Get Up And Fill The Doughnut

Herald News / NorthJersey.com — Friday, July 14, 2006


There are recorded warnings in the British Underground system: "Mind the gap." The message helps prevent riders from falling into the space between subway trains and platforms. Seniors and healthcare advocates should blanket the Capitol with placards emblazoned with the same slogan. Congress did not mind the gap when it created Medicare Part D. And now seniors are falling in.

Under Medicare Part D, seniors sign up for private prescription drug plans. They pay premiums – from $24 to $59 a month – plus a $250 deductible. After their drug costs exceed $250, 75 percent of their prescription costs are covered. Well, they are covered up to $2,250. At that point, seniors are on their own until their drug costs reach $5,100, when catastrophic coverage begins. But the gap between $2,250 and $5,100 is a catastrophic event to many seniors living on a fixed income. The gap must be filled.

It's been called a doughnut hole, a rather benign phrase for such a critical situation. There were members of Congress who criticized the gap, but not enough to force better legislation through the Senate and House. Congress was content to claim that it had delivered a senior prescription benefit plan, never mind the flaws. Much as they did with the Patriot Act, Congress said the flaws in the legislation could be fixed later. That's not good enough.

There is no "later" for seniors on fixed incomes when they stop taking medications because they do not have the cash. It is unconscionable that seniors are expected to continue paying premiums while they cannot collect benefits if they fall into the "doughnut hole."

Would any member of Congress tolerate an insurance plan like that in their private life?

The estimated drug costs for the average senior is more than $3,000. That means the average senior enrolled in a private plan is paying an estimated $1,000 out of pocket, when the $250 deductible is included. This is not even close to acceptable.

Ironically, Congress had no clue how to fund this ill-conceived plan. The doughnut hole lessened the budgetary pain, but it did nothing for the seniors who need it. It would have been better to have passed no legislation rather than bad legislation.

Not surprisingly, Congress found the money to increase its salary this year. It should find the money to fill the gap. Fewer tax cuts, no congressional raises, and more healthcare coverage for seniors should be a top priority for federal legislators. This week, New Jersey Citizen Action and Americans United released a report calling on Congress to plug the gap. Additionally, Medicare should be allowed to negotiate for lower priced drugs.

This is common sense. What is not is the perception that seniors are sitting on pensions, investment incomes and own valuable property. Some are. Many are not. No senior should be forced into poverty to pay for needed prescription drugs. Congress has wasted time debating amendments to the Constitution rather than tackling a problem that affects millions of Americans.

It should "mind the gap" before any more seniors fall in.

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