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 TIME on politics Congressional Quarterly CNN/AllPolitics CNN/AllPolitics - Storypage, with TIME and Congressional Quarterly

Paying for prescription drugs worries Medicare recipients

By Brooks Jackson/CNN

March 16, 1999
Web posted at: 8:38 p.m. EST (0138 GMT)

CARROLL COUNTY, Maryland (AllPolitics, March 16) -- Like most senior citizens, Dorothy James has a pharmaceutical problem.

Her problem is how to pay for five prescription drugs every day -- for diabetes, blood pressure and her heart. The bill is about $200 a month.

"Well, in order to get medicine -- sometimes I have to miss a bill," said James. "It's called rob Peter to pay Paul."

She does have Medicare, but it pays not a penny of her drug bill.

Medicare was designed in 1965 -- the same year the '65 Chevy Impala rolled off the showroom floor. The car lacks some features you'd expect to be standard today. And so does Medicare: features like coverage for prescriptions.

Drug prices are rising twice as fast as inflation. But drug coverage is getting harder for those on Medicare to find.

One out of three Americans on Medicare have no coverage at all. What coverage exists is usually purchased at extra cost -- and limited. Also, many who have it are losing it.

Wolfgang Rogalinski lost a foot to diabetes. He lost something else too.

"Well, the company where I had prescription drug coverage went out of business," said Rogalinski.

Now he pays the entire cost of his prescriptions and its a lot.

"Since I had the first eye operation the first of January, it's over $400 a month," Rogalinski continued.

It's not just a money problem, it's a national health problem. Rogalinski's doctor says almost every day he worries about the effect on his patients.

"You feel as if by not putting somebody on a medicine that would make them less likely to have a hip fracture, make them less likely to have a stroke, make them less likely to have a coronary event, such as a heart attack, you feel as if you're almost ... committing malpractice," said Dr. Jason Tate. "Yet, the person can't afford that."

A lucky few -- like Pierre Henry -- pay nothing. His bill would be about $300 a month for drugs to prevent stroke, reduce blood pressure and reduce arthritis pain.

"My HMO pays 100 percent," Henry says.

He's lucky to live in the Miami area where Medicare HMOs get such high payments from the government they can afford to offer generous prescription benefits.

Not true in most areas, like Carroll County, Maryland.

At the county senior center, about 800 seniors a year come to see Ann Allen seeking help paying for medication.

"Our clients mostly have incomes of less than $800 a month. By the time you've paid for housing -- medicine at $400 a month is an extra," Allen said.

Some just can't afford to follow doctors' orders.

Allen continued: "You find seniors will say, 'Well, I'm supposed to take five pills -- one a day,' they'll take it three times a week."

The president says he wants to do something. In a February speech in Arizona, Clinton said, "I would also like to see us begin to work into Medicare a prescription drug benefit... "

But he does not say how he would pay for that. And it would be very expensive.

Consider a benefit that would require patients to pay the first $250 a year for drugs, then only 20 percent of the next $3,750, and no more than $1,000 maximum out of their own pocket.

That limited benefit would cost $30 billion a year, says the Congressional Budget Office.

Meanwhile -- Remember Dorothy James? At age 73 she's going back to work.

Why? "To pay for medications," she said.

Medicare graphic

President Clinton hasn't announced his Medicare reform plans yet, but they are already drawing some fire. CNN's Chris Black reports. (6-27-99)video Windows Media: 28K | 80K

What if Medicare patients had more options? CNN's Brooks Jackson explains. (3-18-99) video Windows Media: 28K | 80K

CNN's Brooks Jackson talks with Medicare patients about their rising drug costs (3-17-99) video Windows Media: 28K | 80K

CNN's Brooks Jackson takes a look at how Medicare has held up (3-16-99) video Windows Media: 28K | 80K


Clinton drops Medicare prescription drug change (6-26-99)

Bankruptcy of Social Security, Medicare delayed (3-30-99)

Slower spending is likely to postpone Medicare crisis (3-29-99)

Republicans want Medicare plan before agreeing to money (3-22-99)

Democrats say Republican budget sacrifices Medicare for tax cuts (3-18-99)

The flavor of Medicare (3-17-99)

Clinton, Congress vow to push ahead on Medicare (3-17-99)

Paying for prescription drugs worries Medicare recipients (3-16-99)

Medicare commission's failure doesn't mean debate will go away (3-16-99)

Clinton to draft his own Medicare rescue plan (3-16-99)

Medicare showing its age (3-15-99)

Public opinion does not side with most proposed Medicare reforms (3-15-99)



AARP Web site

American Association of Health Plans

American Hospital Association

American Medical Association

Americans for Free Choice in Medicine

Blue Cross and Blue Shield Association

Consumers Union

Families USA

Healthcare Leadership Council

Health Insurance Association of America

Medicare -- Official U.S. Web site

National Bipartisan Commission on the Future of Medicare

National Center for Policy Analysis

National Coalition for Patient Rights

National Coalition on Health Care

Patients' Bill of Rights Act of 1998

Pharmaceutical Research and Manufacturers of America


Do you think the eligibility age for Medicare should be increased from 65 to 67? Discuss it with other your fellow AllPolitics readers on our "Politics of Health Care" message board.

Also: Aging in America


What do you think about Medicare reform? We want to know. Drop us an e-mail. Don't forget to include you name and hometown. We'll post a sampling of your letters in the next installment of Voter's Voice.


Tuesday, March 16, 1999

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