Editorial: Bad plan gets worse

Thursday, Nov. 9, 2006 | 7:08 a.m.

Many senior citizens who were eligible to participate in the federal government's prescription drug program during its first enrollment period, but failed to do so, will pay a penalty if they sign up now.

The penalty - an increase of 7 percent on their annual premiums - applies to those seniors who, in addition to being eligible to enroll last spring in Medicare Part D, were not at the time covered by any other insurance plan.

Seniors who fit that profile, and who want to sign up during the coming enrollment period - Nov. 15 through Dec. 31 - will pay the 7 percent penalty. Those same seniors, if they wait until next year's enrollment period, would pay a 19 percent penalty.

Legislation that would abolish the premium penalties has been pending before a Congress that, until Tuesday, was led by Republicans. The shift to Democratic control of the House and Senate could mean that the legislation will pass. But, for now, the penalties stick.

What hasn't changed about this disastrous prescription drug plan that was championed by President Bush is that it still is confusing, expensive and mostly benefits pharmaceutical companies - many of which significantly raised prices on the most popular maintenance drugs soon after it went into effect.

Participants still must choose from dozens of plans, each of which has its own premiums, its own formulas for co-payments and deductibles and its own list of approved drugs. According to a story this week by The New York Times, some plans may require "step therapy," where cheaper drugs must be tried to prove that patients need a stronger - and more expensive - one.

Participants also have trouble obtaining accurate, objective information from the Part D call centers, which are run by private companies, the Times reports. A recent Government Accountability Office report shows that consumers who called these centers received accurate information only a third of the time.

What's more, people who are eligible for Medicare Part D, but who currently don't need to take any prescription drugs, or take only one drug, actually lose money by paying premiums for a plan they don't need now.

But unless they join now, they will pay hefty premium increases later. Bush's plan penalizes them for being healthy.

Hopefully, Congress will quickly consider - and approve - legislation that would erase the premium penalties for anyone who now joins Part D. Medicare recipients who must rely on this convoluted and poorly penned plan for their prescriptions are being punished enough.