January 14, 2006

Republican Health Care Benefits

Another month, another policy disaster, another way to screw the American public while spending money as inefficiently as one can imagine. The prescription drug benefit is doing all kinds of interesting things in its initial rollout. There is that nifty way of creating new jobs for people whose only purpose is to deal with the bureaucracy setup to suck up precious health-care dollars.

A running joke here is that the luckiest person on the staff is the one who was called for grand jury duty last week and thus spared the early scramble of making sure every resident had a plan. There is fallback coverage for those not properly assigned, but it requires a 14-step application process that Maria Wurpel, the pharmacist at Sarah Neuman, is desperate to avoid.

But the alternative to the 14 steps may be equally Kafkaesque, said Thomas Mathew, comptroller for the Jewish Home system. To track down an unassigned resident, it is necessary to document enrollment in both Medicare and Medicaid. A resident who had different ZIP codes when enrolling in each of the programs, a not uncommon situation, is often unrecognizable to the government's database.

Even those who received their new prescription drug cards on time are not home free. Each person has an ID number, an Issuer number, an Rx Bin number, an Rx PCN number and an Rx Group number. Type one digit wrong when ordering medications and the computer flashes an error message.

Why so many numbers and what do they all mean? "Ask the man above," said Annette Lobo, director of patient accounts for the Jewish Home system.

Each plan also has tiered subplans, labeled bronze, silver or gold. And each of those has its own formulary, the list of drugs that are covered, and its own appeals process for those that are not. But search the plans' Web sites looking for instructions for appeals. "Sorry, the document you request doesn't exist," comes the mannerly reply.

"Navigating this, if it doesn't get easier, could be someone's full-time job," Ms. Wurpel said, after an hour trolling without success for the appeals forms.

And how about all those states that have stepped in to fix the problem? At least 14 states have declared medical emergencies in order to cover the elderly and poor that have found themselves drowning the the bureaucratic nightmare created by our lovely administration. The cost to cover just 15 days of the Bush administration's screwup for California will be $70 million, for a state already in deep budget trouble. And after all the promises of a seamless transition, the Bush administration says that if the states want to get reimbursed for the money out of pocket, they will need to go after the private insurers.

That's what I call a stunning success. The Republicans have figured out how to make the economy cough up money right and left.

Do you remember why the Republicans were so worried about Single Payer Health Insurance? Why, because it would create a huge bureaucracy. Yes, a well-run government bureaucracy is so much worse than the private sector.

Don't kid yourself. This Kafkaesque nightmare *was* the plan, just like the well-planned outcome in Iraq administered by the CPA where corporations made out like bandits and Iraqis went without clean water or electricity. Like good Republican policy makers everywhere they know that only when massive amounts of tax payer dollars have been skimmed off and used to pay the CEO salaries and to pay lobbyists who will give it to Republicans to keep the system going, can a few of those tax payer dollars be used to help people. But not too much, because then people might become dependent on government.

If we can ever get our country back from these thuggish bandits, perhaps Americans will be ready to try a health plan that can work. It's time to consider Single Payer again and stop wasting our money on the boondoggles of the crooks.

Posted by Mary at January 14, 2006 07:42 PM | Health/Medicine/Health Care | Technorati links |

My doctor's office has two full-time employees to help older patients navigate the drug plan and Medicare. Wonder what people do when they are thrown on their own resources.

Posted by: Scorpio at January 15, 2006 10:08 AM

I am a registered pharmacist in Washington. This "plan" was conceived by and for the insurance and drug industries. Most of the people in Washington DC who voted for it never even read it. This program was specifically designed to fail! When that failure is complete then we can just say, "see the plans don't work even with the private sector so we will just have to kill it and Medicare all together."
This whole clusterfuck is brought to you by the GOP!

Posted by: denny at January 16, 2006 11:33 PM