If we took foreign and defense policy out of the picture entirely, what’s Bush’s worst domestic policy initiative? The tax cuts were a disaster, the faith-based initiative was outrageous, No Child Left Behind ended up flopping, and there is no coherent energy policy to speak of. But for my money, Bush’s Medicare scheme tops ’em all.
The program was passed in 2003 under unusual circumstances that included bribes on the House floor. Before lawmakers agreed to the plan, the administration went to great lengths to deceive Congress about the cost estimates for the plan. Once it became law, and seniors started to learn about the new program, everyone was completely confused and couldn’t figure out what to do.
That was then. About two weeks ago, on Jan. 1, the Medicare prescription drug benefit took effect. That’s when the real problems started.
Low-income Medicare beneficiaries around the country were often overcharged, and some were turned away from pharmacies without getting their medications, in the first week of Medicare’s new drug benefit. The problems have prompted emergency action by some states to protect their citizens.
And from the weekend:
Two weeks into the new Medicare prescription drug program, many of the nation’s sickest and poorest elderly and disabled people are being turned away or overcharged at pharmacies, prompting more than a dozen states to declare health emergencies and pay for their life-saving medicines.
Computer glitches, overloaded telephone lines and poorly trained pharmacists are being blamed for mix-ups that have resulted in the worst of unintended consequences: As many as 6.4 million low-income seniors, who until Dec. 31 received their medications free, suddenly find themselves navigating an insurance maze of large deductibles, co-payments and outright denial of coverage.
Which leads to today:
President Bush’s top health advisers will fan out across the country this week to quell rising discontent with a new Medicare prescription drug benefit that has tens of thousands of elderly and disabled Americans, their pharmacists, and governors struggling to resolve myriad start-up problems.
It’s going to take more than another Rove-inspired public-relations campaign to put lipstick on this pig.
Jonathan Cohn offered a helpful perspective on the fiasco.
So just how badly is President Bush’s Medicare prescription drug program, known as “Part D,” going? On Tuesday morning, I landed in Nashville, Tennessee, to find this bold headline atop the Tennessean front page: “Pharmacists Decry Medicare Chaos.” As the article went on to explain, “Area pharmacists are saying that the federal government’s new drug plan for the elderly and disabled is a nightmare for druggists and an out-and-out catastrophe for the poor.”
A few hours later, I got a glimpse of such frustration first-hand. While I sat inside a clinic that serves a low-income, rural community near the Alabama border, I heard a nurse in the next room scream. She later explained why: She said she had just spent 45 minutes on hold with a Part D insurer, trying to inquire about a prescription, only to get disconnected. And it wasn’t the first time.
I have an article about what’s going on with the Medicare drug benefit–and why–coming out in this week’s edition of the magazine. But one tidbit I came across in my research seems worth sharing now. It’s a Government Accounting Office report, issued in December, warning that the Bush administration hadn’t done enough to make sure the most medically and financially vulnerable Medicare beneficiaries could actually get their drugs.
If you do get around to reading it, make sure to check out the part where Mark McClellan, director of the Center for Medicare and Medicaid Services, says the GAO has it all wrong–the part where he insists that “CMS has established effective contingency plans to ensure that dual-eligible beneficiaries will be able to obtain comprehensive coverage and obtain necessary drugs beginning January 1, 2006.”
Sometimes there’s a temptation to blame the Bush administration for everything that goes wrong with the federal government, even when its incompetence and negligence are only partially to blame. This isn’t one of those instances — the administration really has screwed this up royally, and people who need medication to live and function are livid.
Bob Novak suggested this “looks like a political blunder of far-reaching consequences.” We can only hope so.