Medicare’s Munchkin Mess

Medicare’s Munchkin Mess

The “donut hole” is here. When the Medicare drug benefit was working its way through Congress, it was such a budget buster that legislators inserted a provision that leaves a gap in coverage: beneficiaries receive benefits until spending reaches $2250, then pay everything themselves until they’ve spent $3600, then receive generous benefits again above that point.

As yesterday’s New York Times points out, beneficiaries are now hitting the donut hole for the first time. Many are surprised. They either didn’t know about the donut hole, thought it started after out-of-pocket (as opposed to total) spending hit $2250, or thought it ended after total (as opposed to out-of-pocket) spending hit $3600. Others thought it was something from Dunkin Donuts.

Seniors are angry and confused. The issue may hurt Republicans, it is said. But let’s keep things in perspective. This non-means tested program for seniors is being subsidized by working people. Plenty of well-off oldsters are getting coverage while there is no equivalent subsidy for those below Medicare age.

Overall, I’m not sympathetic.

July 31, 2006

One thought on “Medicare’s Munchkin Mess”

  1. To not have heard of the donut hole, I think someone would have to have been living under a rock for the last two years. You have to be fairly unhealthy to reach it in the first place. My 70-year-old Mom is on five different meds and won’t reach it.

    Overall, I think as a money-saving maneuver, the donut hole is fair. For starters, there’s a little bit of benefit at the beginning for everyone. For those that need a lot of benefit – i.e. those who spend past the upper limit of the donut hole – they’re coming out ahead, too, since they’re the sickest, and were previously spending scads of money on meds. The sickest get a break, which is the moral thing for our society to do. And for the poorest folk, there’s Medicare’s Extra Help, there are giveaway programs from the pharmaceutical companies, and there’s Medicaid, so if all works as it should, they’re covered, too.

    Frankly, what you’re seeing of people “angry” with the donut hole is the mainstream media tweaking folks for yet another of their insipid stories on the theme of “isn’t-it-awful.” Truth be told, if the reporter were to dig a little deeper, he or she would find that these are probably firmly middle class seniors whose houses are paid off (they are, after all, not on Medicaid, so they must be of some means), and who have apparently forgotten that, up until they reached the donut hole, were paying less for their meds than they were last year.

    I agree, David. No sympathy here.

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