2007-02-16 / Editorial/Opinion

This Hole Can't Be Found At Dunkin Donuts

Just as there is no doubt that Medicare is a boon for our senior citizens, there is also no doubt that the program is flawed in a number of ways, among them the major problems caused by the fact that the program cannot negotiate with pharmaceutical companies for better prices, the cap on ancillary services such as physical therapy and the infamous "Donut Hole." Now that the Democrats are back in control of both the House and the Senate, perhaps something will be done to ameliorate those problems. The solution to the first is simple: Change the law to allow the agency to negotiate price with the drug companies. The only loser in that change would be the drug companies, whose windfall profits would drop from "obscene," as they were under the Republican majority, to the more reasonable "excessive." The solution to the second problem, that of caps on ancillary services is a little more problematic. The Medicare Cap is an arbitrary dollar amount that, when reached, denies the patient further physical, occupational or speech therapy, treatments that are often needed after a stroke or a debilitating injury. The Donut Hole, however, promises to be the "star" of the Medicare problems. Medicare pays 75 percent of initial drug costs up to $2,250 after a $250 deductible for most seniors. But then the program pays nothing until drug expenses reach $5,100, after which the government program pays 95 percent of all costs. The complete lack of coverage for drug spending between $2,251 and $5,100 is the infamous "Donut Hole" that causes many seniors to reach for the dog food can. Nearly half of Medicaid recipients are expected to be impacted by that donut hole. That glitch in the program (if it was a glitch and not something preplanned by the Republicans), is dangerous, unfair and unconscionable. A senior with $1,000 in drug costs over a year would pay only $438 out of pocket, while a senior with major medical problems and $5,000 in drug costs would wind up spending $3,500 in out of pocket expenses. Something must be done and there are only four local politicians who can do it - Senators Charles Schumer and Hillary Clinton and Representatives Anthony Weiner and Gregory Meeks. We call on them to get the job done. We are talking about the health, well-being and quality of life for people who have dedicated their lives to this nation and who have grown old while doing it. To do nothing to help them would be a disaster.

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