Medicare bill doesn't beat Canada prices, some seniors say
Warren Wolfe, Star Tribune
Published November 22, 2003 AGE22
The money-saving pipeline from Canada to Rae Wilbur's medicine chest may keep flowing even if a sharply divided Congress approves a drug benefit for Medicare.
The reason: Her cancer-fighting Arimidex and other prescriptions from Canada cost her about $3,120 a year, well below the $4,160 she'd spend in Minnesota -- and about $16 less than the drugs would cost her under the proposed Medicare drug benefit.
"I've got a bunch of questions about this Medicare law and how it would affect older people like me," said Wilbur, 82, a retired Minneapolis teacher. "But what I do know is that I can count on my drugstore in Canada. I'm not so sure I can count on Congress."
It's not just Medicare recipients who are trying to gauge the probable effect on Minnesotans of the bill that Congress might vote on this week.
Rae Wilbur gets prescriptions in Canada.Joey McleisterStar Tribune"We know that doctors would benefit because their payments would go up instead of down, and we know that rural hospitals should benefit somewhat, and we know that seniors who are poor or have high drug costs will benefit," said Mark Owen of Medica health plans.
'Better than nothing'
"Our take is sort of like AARP," Owen said, referring to the national group representing retirees and older Americans. "It's a flawed proposal, but it's better than nothing. I understand that Congress put this together with a big gap in coverage in the drug benefit as a way to keep the price tag down, but it's not the sort of plan that anybody normally would devise."
Starting in 2006, under the proposal, Medicare recipients could buy a drug benefit, paying a premium of $35 a month plus the first $250 of their yearly prescription costs. After that, recipients would pay 25 percent of the next $2,000, or a maximum of $500.
Then there's a gap, critics call the "doughnut hole." The recipient would pay everything above $2,250 in yearly drug costs until hitting $5,100, or a maximum of $2,850 out of pocket. Above $5,100, Medicare would pay 95 percent of drug costs.
In all, someone with drug costs of $5,100 a year would spend $4,020 -- $3,600 for drugs, plus a $420 premium.
For low-income people receiving up to $12,123 a year, the premium, deductible and coverage gap would be waived.
"It certainly would be a great benefit to some people, but not much of one to many of the people we serve," said Nancy Feldman, chief executive officer of UCare Minnesota, which serves about 26,000 retirees in the Twin Cities metro area.
UCare's most popular plan pays up to $400 a year for drugs, which covers all costs for about 45 percent of its members, she said.
"What concerns me is partly that the drug benefit really might be written better, but also that there are so many aspects of this legislation that we're just guessing about," she said.
Feldman said that until Wednesday, she assumed that Congress would approve the plan "simply because it's going to be difficult for them to go home empty-handed. But now I think it's going to be very, very close. If Congress votes this week, I think it may pass. If they wait until after Thanksgiving, I think it may not pass."
The Minnesota Medical Association announced Friday "strong support" for the Medicare bill. Physician payments were cut by 5.4 percent last year and were scheduled to drop by 4.5 percent next year. Instead the bill would raise their payments by 1.5 percent for the next two years.
AARP urges passage
Earlier this week, AARP put full-page ads in many newspapers around the country, asking its 35 million members to urge Congress to pass the bill. On Thursday, the organization said a poll conducted Wednesday of 494 members showed that 75 percent favor passage of the bill, but only 2 percent said they were familiar with specifics of it and 33 percent said they would benefit from it.
The Medicare proposal "is far from perfect," said John Hagman, state president of AARP, which has 640,000 members in Minnesota. "But the Minnesotans who are forced to choose between paying for prescriptions and buying groceries cannot wait for perfect."
The Minnesota Senior Federation's leadership council voted Wednesday to oppose the bill, "even though there are parts of it we like -- mainly the parts that raise payments to doctors and give some relief to rural hospitals," said executive director Pete Wyckoff.
"Our members are mainly concerned that this bill does nothing to control drug costs, and it does nothing to address the wide disparity between the low reimbursement that Medicare pays to care for people in Minnesota and the much richer benefit other parts of the country receive," he said. "In fact, it really will make the disparities worse, and be a real benefit to the drug companies that already are making exorbitant profits."
Bus trips to Canada
The federation sponsors the bus trips to Canada to buy drugs; the next one will leave Dec. 9. Last year the federation launched a Web site to link people with a Canadian mail-order company, a practice that the Bush administration and the Food and Drug Administration strongly opposes. More than 4,000 people use that site each month.
The Medicare bill does not include a section sponsored by Rep. Gil Gutknecht, R-Minn., and passed by the House that would have allowed individuals and businesses to import drugs from Canada and 25 other industrialized nations.
Wyckoff said the federation will continue its Canadian drug-purchasing effort even if the Medicare bill doesn't offer explicit U.S. approval of such transactions.
Gov. Tim Pawlenty announced last month that he intends to open a similar Web site to help Minnesotans find out about state-approved Canadian pharmacies.
"Unfortunately, the Medicare proposal is not going to help people as much as the federation programs do," said Barb Kaufman, the federation's metro region president. "We'd love to have Congress do it right so we can go out of business, but we have too many people -- me included -- who need more help than Congress is prepared to deliver."
Her drug costs would be about $4,200 a year in Minnesota, and under the Medicare drug benefit she would save nearly $1,100, "which is good," she said, "except that when I use our Canada drug program I save more than $1,800."
Warren Wolfe is atwolfe@startribune.com. |
