Reply #23: Dollars to Donuts [View All]

[interregnum]

There seems to be little doubt that Medicare part D is a massive dodge designed to funnel money into insurance/pharma coffers.

There was a push early to mid 2005 to educate community pharmacists on what had to be done in order to smoothly move people into these plans. I was among the many people reading about 'TROOP' and the 'donut hole', etc. It was clear then as now that the structure was NOT designed to benefit the patients.

This donut hole debacle has already been clearly delineated in other posts, but it should be noted that even as far back as February, Pharmacy educators where worried that there would be plans that rushed them through the initial coverage period and kept them perpetually in the donut hole. Simply put, many people who need this coverage in the first place are not going to be able to come up with several grand out of pocket - they'll just undermedicate or worse yet stop getting their medications in lieu of things like eating. Thus the 'TROOP" or true out of pocket expense will inch by or never really reach so-called 'catastrophic coverage' levels. Actually the name was quite appropriate. The coverage would resume after a person's and their families' lives were utterly destroyed. The question was brought during an after lecture Q&A - WTF was this F***G thing doing there in the first place??? All we got was an nod of concern but a warning to be practical: THIS IS JUST THE WAY IT'S GOING TO BE.


And of course the copays even for those who have been doing everything right have been nothing short of astounding. I've seen people go from paying nothing or 5-10$ to having to pay $50 for their medications. Wow. Not good news if you're on a fixed income. BUt then this whole thing isn't good news for any of us.