Saturday, November 12, 2005

THE ONLY DOUGHNUT I CAN TURN DOWN

I just returned from a short trip to Florida. While perusing the papers in the town of Northport, which was bathed in sunshine the entire week I spent there, I noted that the Seniors there had attended a meeting where Katherine Harris, who is now a legislator, was to explain the Medicare Prescription Plan.

The meeting, the article said, did not go well. Ms. Harris could not answer the questions asked by the Seniors about the Plan. When the meeting ended, the Seniors were as befuddled as ever about the intricacies of this new "benefit", which President Bush is said to have fashioned in order to fulfill his campaign promise.

Before signing up, Seniors must select a "Plan". There is Plan A, Plan B, Plan C, etc. Each plan seems to involve selecting participating pharmacies. There are varying deductibles and varying co-payments. Some drugs are not covered...probably including those you really need. There are seminars and websites dedicated to helping you understand this plan. Ms. Harris did not understand it. I do not understand it. I called my insurance company and they didn't understand it. So, if you are looking for assistance, don't come to me. I just wonder if President Bush understands it.

There is, I have read, what is called a "doughnut hole" in the plan. Thus, when your drug expenditures reach a certain level, around $2,500....you cease receiving help for your prescriptions. You are on your own until your drug use reaches an expenditure of $5,000. And you cannot buy an insurance policy that will cover this "Gap". You must reach into your own pocket.

Now, it seems to me that anyone spending some $3,000 on prescription drugs is the person really needing help....but no one asked my opinion when writing this legislation. And, it also seems to me that, if anyone can afford the difference between about $2,500 and $5,000, perhaps they don't need help in the first place. But now I am getting as confusing as the Plan itself.

Now, this is the really confusing part....or should I say, one of the really confusing parts. This Gap seems to be a yearly occurrence, sort of like Christmas or Veteran's Day. If, during any year, you spent more than the designated amount on drugs, you fall into the Gap until you have spent $5,000. Then, the next year, that Gap looms again. There's no escaping it.

So, you seem to have a choice. Either you can go lightly on your drugs, failing to take a few essential doses....just to make sure you don't reach the critical amount that leads to the Gap. Or, you can rush into the Gap and use so many drugs you zoom in and out like a Gecko on a sidewalk scurrying out of harm's way. Neither of these methods will be recommended by your physician, I'm sure. But, if you fall into the Gap, there are no Rescue Squads to pull you out. You pay.

It seems to me that the people writing this legislation were either completely wacko or drunk on something a little stronger than Evian water. What would be wrong with a Prescription Plan for Seniors that is based on need, with low income citizens receiving a lot of help and richer ones receiving not so much help? Is that too simple to comprehend? Is that beyond the brains of our Republican Congress who passed this Prescription Puzzle? Why all this mish-mash of deductibles and Plans and co-pays and Gaps? Why a doughnut hole?

Well, I guess we can't expect much better of them, our Congressional leaders. I have a feeling they've never been there, never worried about paying a bill, never worried about falling into a silly Gap? Perhaps we should make them eat the paper this crappy bill is written on, or would that be the torture included among those they are trying to figure out a way to approve?

I remember Katherine Harris. She lives in the Land of the Hanging Chads and Shoot-'Em-Up Gun Laws. She looked like a clownish harridan as she directed the 2000 election from her state seat, but turned into a polished, attractive lady as she ran for higher office. Another Republican makeover! It's enough to make you claim you slept with Clinton just to qualify for a nose job and a few tips on cosmetic glory.

According to the newspaper article, Katherine Harris left the meeting "confused" over the details of the Medicare Prescription Plan. She ain't alone. Thousands....perhaps millions...of befuddled Seniors are now expected to join up, to become willing participants in this convoluted excuse for prescription assistance dreamed up by the diabolical minds of demented radicals intent upon causing mass mayhem among the realm of the ill and aged. Heaven help us.