December 10, 2003
"If the elderly voters focus on the deficiencies in the bill, they won't consider it to be much of a step forward," says Timothy McBride, Ph.D., professor of health management and policy at Saint Louis University School of Public Health.
"My suspicion is that the elderly, when they get to be familiar with this bill, will not be too fond of it."
McBride acknowledges that there is some good to come from the reforms. Particularly, for the low-income elderly who currently have no coverage, changes to Medicare offer them very good health insurance. "And a half a loaf is better than none for those who currently don't have coverage," he says.
In addition, because participation in the drug plan is voluntary, elderly people who don't like the new drug coverage don't have to purchase it.
That said, McBride believes there are plenty of reasons senior citizens probably will dislike the changes. Here are his top 10:
1. A patient would have to pay a sizeable chunk of prescription costs - between $2,250 and $5,100.
2. The plan lacks complete catastrophic coverage; patients will pay 5 percent of all costs above $5,100.
3. Many elderly patients still will pay close to half of their drug expenses out of pocket.
4. Prescription drug prices probably will go up because the bill will increase the demand for drugs.
5. Employers may choose to drop health plans for retirees so many may find themselves with worse coverage than they have now.
6. Generally, the bill is confusing.
7. Coverage doesn't begin until 2006.
8. Coverage will come from private plans in local regions, meaning coverage will vary across the country.
9. The bill lacks cost controls, and costs are likely to escalate.
10. Participants are prohibited from purchasing wrap-around coverage to supplement benefits under the Medicare plan.
"All of this may not help the politicians next year when they brag about delivering on the promise of a Medicare drug plan," says McBride, who has done extensive research on Medicare reform, the uninsured and insurance market, health policy and aging and health economics.
Saint Louis University School
of Public Health is one of only 34 fully accredited schools of
public health in the United States and the nation's only School
of Public Health sponsored by a Jesuit university. It offers
masters degrees (MPH, MHA) and doctoral programs (Ph.D.) in six
public health disciplines and joint degrees with the Schools
of Allied Health, Business, Law, Medicine, Nursing and Social
Service. It is home to seven nationally recognized research centers
and laboratories with funding sources that include the National
Institutes of Health, the Centers for Disease Control and Prevention,
the Health Resources and Services Administration, the American
Cancer Society, the Robert Wood Johnson Foundation and the World
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