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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Friday, January 13, 2006

    Good Question: I've been wondering this, too:

    But if it's really necessary for the government to pay for prescription drug coverage--if Americans are truly choosing between food and medicine, as so many politicians are fond of saying--why do federal officials have to spend so much time and money persuading people to sign up? If seniors are able to climb aboard buses and head for Canada to buy their medications at discounted prices without a government ad blitz, why can't they handle a few Medicare forms?

    Even the peoplein my office who complain about their drug costs aren't signing up for the program. When pressed, it often turns out that they already have generous coverage from a secondary insurance. They either just like to complain or think that their cost should be $0.

    I've yet to meet the patient who expressed any gratitude or relief that the program existed. Kind of makes you wonder exactly how many seniors do have to choose between food and medicine.

    My experience tells me not many. And most of those I know who say they can't afford their medicines are using their money for something else. I often get flack from other bloggers for my closed heart on this matter, but I've just sat with too many people who tell me they can't take their medicines or come in for an office visit to monitor their diabetes twice a year (a $61 visit in my practice.) When I try to help by suggesting social services to get them some aid, it always turns up that there's something else taking their money - taxes on their high-end home ("I deserve that house. I will not sell it."), paying the gambling debts of a grown child, making sure their grandchildren "have a good Christmas."

    The one that took the cake, however, was this week's patient who had gone far too long between visits for his diabetes and had only been taking his medication fifty percent of the time because he couldn't afford it. He could, however, afford to take up smoking again - at the rate of a pack a day. His medications don't cost near the price of a pack of cigarettes a day.

    We could use some hard data rather than anecdotes and conventional wisdom when it comes to the burden of drug costs for senior citizens. Or rather, we could have used it before the expensive Medicare Part D program became reality.

    posted by Sydney on 1/13/2006 08:41:00 AM 5 comments


    I don't think you're being remotely hard-hearted about this. People need to take responsibility for their lives to the fullest extent that they can. There really are people who need help, but not many. Like I tell my deadbeat cousin, it's darn near impossible to be truly poor in this country if you're willing to get off your butt and work. Of course, that means no flat-screen plasma tvs when the doctor needs to be paid. Oh! the injustice of it!

    By Blogger Daisy, at 12:14 PM  

    Perhaps it's because they tried to get millions of computer-illiterate seniors to primarily signup for an already confusing, bewildering program through a poorly designed, difficult to navigate *website*?

    By Anonymous Graham, at 8:23 PM  

    And of course there is the three-pack-a-day patient (one of them is a 6-pack) who doesn't have the money for the visit. Old story, sadly.

    By Anonymous Anonymous, at 10:26 PM  

    I agree with graham -- take a look at the site. You have to try to compare the total of all the premiums you pay, and there are a bewildering number of plans, plus your subsequent cost, which depends on what drugs you're on and whether their preferred drugs or not, and then compare that with what you are paying or would pay without it. You have to choose plans one by one, and your drugs one by one to use the site.
    Or you can rely on the "honesty" (heh,heh) of the insurance companies to "help" you decide.

    By Blogger Greg P, at 10:28 PM  

    Like I tell my deadbeat cousin, it's darn near impossible to be truly poor in this country if you're willing to get off your butt and work.
    It is near impossible to be truly poor - sure, if you mean to go hungry like people in poorer countries do. But medical care and drugs are pretty expensive. I am fortunate enough to have pretty high salary and savings, but not everyone is. Consider for example a secretary with 20K a year net who has a child. Let's do some math: 20000/12=1666. Rent - 800 (where I live that wouldn't rent a barn, but let's be optimistic). Food - $300 (again pretty conservative). If you work fulltime, you need to find childcare - can you find it for $566 a month? I doubt it. Now, instead of a single mother, assume a family of 3 where man makes 30K and a woman doesn't work. Sure, she can go and work, but then they'll have to pay for childcare and unless she can make over 30K it is a bit tricky. Private medical insurance costs a few hundred dollars a months. A bit difficult for a family living on 30K - 40K. What was the average income for a family of 4 in the US?

    As far as prescription drugs plan is concerned - it is pretty complicated and many people who really need it haven't heard about it. Other people are not eligible because they buy an HMO or some other plan that has prescription coverage. A few years from now they may loose the plan they have, but by then they'll have to pay for all the years they weren't members of the plan.

    By Anonymous Anonymous, at 11:53 AM  

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