New Medicare has unfair cost for subscribers

Let’s talk about Medicare. Many of us have grandparents or other relatives that use the system, and one day we will use it too, if Medicare is still in existence then. This new program is another example of the Bush Administration pandering to big business lobbyists.

The New York Times reported that insurance and drug companies are battling over the medicines that will be available to those on Medicare. The pharmaceutical companies lobbied for this very plan, but now they are at odds with the private owners and insurance companies.

This doesn’t seem like a big deal, but changes in Medicare will determine health care for years to come. Medicare will only rely on private health plans for different drug needs, and the government refuses to choose which drugs will not be covered. Instead, each company will create a formulary, or drug list of what is available for reimbursement.

A list of the different drug types that should be covered, including two drugs in each category, will be created by a private nonprofit organization called the United States Pharmacopeia. The insurers will choose the actual drugs, but the United States Pharmacopeia’s list will ensure that all different types of drugs are covered.

The problem here is that the insurers want to limit the drugs available, while doctors and drug companies would like as many drugs as possible on the lists.

Those on Medicare must now check to see if their plan covers the drugs they are currently on. The drugs not included on the formulary are not always paid for by the health plan, so those on Medicare may be forced to pay for the drugs themselves, the cost of which will not be included in their outofpocket expense limit.

Because the formulary must include all different classes of drugs, not every drug will be included. So all the drugs for, say, depression will be lumped into the same class, and newer more effective drugs will not always be included.

Overall, the new plans are not necessarily better for Medicare users. The Bush Administration, by pandering to the lobbyists, has caused more confusion between drug companies and insurance companies.