http://lifeandhealtheditor.com/2010/03/11/no-joke/ Bill Coffin Editor-in-Chief Thu, 02 Sep 2010 21:13:50 -0400 http://wordpress.org/?v=2.8.4 hourly 1 http://lifeandhealtheditor.com/2010/03/11/no-joke/comment-page-1/#comment-371 John Fri, 12 Mar 2010 14:40:09 +0000 http://lifeandhealtheditor.com/?p=117#comment-371 Why the pot-shot at the prescription donut hole? It's a great design. For the first level of drug usage, the coverage reduces the cost. This helps virtually all Medicare participants. Great. For the next level of usage, the participants need to foot the bill. This is fair because if you're on a bunch of meds, you know about it and you are being asked to plan ahead a budget some of your own money to pay for your own care. For even more usage, Medicare kicks in and dramatically reduces the cost. In a world of limited resources and participants who always want as much free for themselves as possible, the donut hole is a very practical idea. Provide broad coverage for moderate normal drug needs. Require self-funding in the mid range. Provide coverage for extraordinary expenses in order to prevent the impoverishment of needy participants. Worst case scenario, under the current plan, is for a participant to spend under $5000 per year on their drugs. This maximum cost certainty appropriately balances the reality of limited resources against the ruinous possibilities when there is no drug coverage at all. Rather than dismiss the concept because it is complex, I think we'd do better to educate people on how it actually works and why it is designed the way it is. Why the pot-shot at the prescription donut hole? It’s a great design. For the first level of drug usage, the coverage reduces the cost. This helps virtually all Medicare participants. Great. For the next level of usage, the participants need to foot the bill. This is fair because if you’re on a bunch of meds, you know about it and you are being asked to plan ahead a budget some of your own money to pay for your own care. For even more usage, Medicare kicks in and dramatically reduces the cost.
In a world of limited resources and participants who always want as much free for themselves as possible, the donut hole is a very practical idea. Provide broad coverage for moderate normal drug needs. Require self-funding in the mid range. Provide coverage for extraordinary expenses in order to prevent the impoverishment of needy participants.
Worst case scenario, under the current plan, is for a participant to spend under $5000 per year on their drugs. This maximum cost certainty appropriately balances the reality of limited resources against the ruinous possibilities when there is no drug coverage at all.
Rather than dismiss the concept because it is complex, I think we’d do better to educate people on how it actually works and why it is designed the way it is.

]]>