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    Monday, May 03, 2004

    Taxing Medicine II: There have been a lot of stories in the news lately about the new Medicare discount cards which go into effect today. Most of the coverage indicates that choosing the best deal is a complicated process and that the Medicare website is error-prone. I visited the website yesterday to see what kind of a deal I could get if I were an elderly person living on $36,000 a year with $20,000 in savings and who had diabetes, hypertension, and heart disease.

    Like most of my patients with those three problems, I gave myself two diabetes medications, a blood pressure drug, a beta blocker so my doctors would be meeting the standard of care for a heart patient, and a statin. The estimated cost per month of my medications, according to the website was $350. There were no cards that covered all of them. And although one card promised to knock the monthly cost down to as low as $70 - $150, when I checked the pharmacy coverage in my area (within a 3 mile radius), the savings were less impressive, reducing the cost by $50 to $75 a month. If I made a change in any of the medication brands, the cards available to me also changed.

    This does seem rather complex, especially for an elderly person who might not be used to computers and the internet. What's more, when drugs get changed, as they often do, then the whole process has to start again. Many of the savings cards require a fee to sign up, so it's more than just a hassle. The discount cards are a good idea, but their implementation leaves a lot to be desired. After touring the site myself, I've got to wonder if many people will use them at all.

    One solution would be to have one card with a sliding scale user's fee based on income. That one card could cover a predetermined formulary of drugs, just as insurance plans and hospitals use formularies for drug savings. The sticking point may be getting pharmacies to participate in it. But there must be a better way than this.

    posted by Sydney on 5/03/2004 07:56:00 AM 0 comments


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