The US Senate Proposed Health Care Bill (pgs. 121-140): Phasing out the Elderly?

Pages 121-140 focus upon the many changes to Medicare which could possibly take years off of the lives of the elderly. The Senate Bill does not have death panels because death panels will not be needed for this bill. This part of the bill will siphon millions of dollars from the pocketbooks of the elderly. Let us begin.

Starting on pages 121-122, beginning on 7/1/2010, Medicare Part D beneficiaries who make less than $85,000 annually will receive a 50% discount on prescription drugs if their total prescription costs for the year are between the coverage limit of $2,700 and $6,153. On the surface, this appears to be a good thing for the elderly; cutting down on the costs of prescription drugs is great. However, check out all of the loopholes on pages 123 and 124. 1. The discount only applies to brand-name drugs. Knowing that the elderly are thrifty, they have generic drugs prescribed to them by their doctors. 2. Drugs sold and marketed by a US manufacturer would not be covered under Part D unless the manufacturer chooses to participate in the discount. For example, let's say that the largest US pharmaceutical manufacturer, Pfizer, chooses not to put themselves under this discount program because the company would lose an enormous amount of profit. Then, the elderly people that are being prescribed these drugs now under Part D would no longer be able to afford their medication because the prices of the prescription would double due to the lack of the 50% discount. Let's look at who would be affected. The drug Aldactazide is a medication for congestive heart failure and hypertension. Elderly people who would not be able to afford this medication would die of heart failure. The drug Aromasin fights against all forms of breast cancer. Elderly women who would not be able to afford this medication would die of breast cancer. I am just giving you two examples of the over one hundred prescription drugs made by Pfizer for just about every symptom. 3. Any drug can be placed into the discount program by the Secretary of Health and Human Services if determined that the drug would be essential to the health of beneficiaries or if the Secretary has determined that there are extenuating circumstances between 7/1/2010 and 9/30/2010. Let us continue with the Pfizer example. The Secretary of HHS could force Pfizer to place all of their drugs under the discount program. Pfizer would then lose a huge amount of profits. The company would have to cut back on drugs made or even go out of business. Then, nobody would be making the over one hundred drugs they make that people would need for medications. 4. If the manufacturer of a drug violates the discount drug agreement, then the Sec. of HHS would terminate that drug from the program. It would not matter if that drug would save the lives of the elderly. 5. The phasing out continues. A manufacturer would be able to back out of the discount program at any time. For example, if a drug company's profits go in the tank due to this program, then the company would pull the plug on the discount program, causing the elderly to pay double for their drugs. If they can't afford the drugs, then they will die. 6. If the drug company attempts to re-enter into the discount program, there would be a waiting period for 4 months. Four months could be too long for an elderly person to wait for her medication. 7. Those who do not comply with the program will be fined the difference the manufacturer was supposed to have paid if they had complied with the program plus an extra 25% of that amount. What if the company had a penalty imposed upon them for millions of dollars and were unable to pay? That company would go bankrupt, and those particular drugs that they make could possibly be pulled from the marketplace. Page 125 would force some private health insurance companies to be unable to compete. The Sec. of HHS would exclude Medicare Advantage rebates for seniors and bonus payments from the Medicare Advantage Prescription Drug Plan when calculating the regional low-income subsidy. This part of the bill would ensure that more low-income recipients of Medicare would receive plans that would have $0 premiums. There is no way that private companies would be able to compete with zero dollar premiums; they would lose profits and go out of business. That would begin on 1/1/2011. On page 126, it states that the reapplication process would remain the same for widows and for widowers who are low-income subsidy recipients. On page 127, 45 million dollars will fund outreach and education of low-income programs. Page 128 will force the elderly to pay even more for their prescriptions. As of now, Medicare Part D covers at least two drugs in each class: immunosuppressant, antidepressant, antipsychotic, anticonvulsant, antiretroviral, and antineoplastic. These six categories are the major symptoms that affect the elderly. However, the Sec. of the HHS would be given the authority to reclassify which drugs would be covered by Medicare Part D and which ones would not be covered. The Sec. of the HHS will now get to play Russian Roulette with the lives of the elderly by picking and choosing which drugs would be covered by the plan. For example, what if the medication an elderly person is on is covered by the plan, then this decree from 2010 would prevent the person from receiving the proper medication because the Sec. of HHS took that life-saving drug off of the list? This reminds me of a couple of proverbs, "The stone that is rolled out to crush me will roll back to crush you," and "Whatsoever a man sows, that is what he shall also reap." (Quick aside. Former NFL Player Union President Gene UpshawGene Upshaw, a former NFL player who was a staunch opponent of former NFL players receiving extra pension payments to pay for their health care. Many players died because they were not able to receive the adequate health care that they needed. Mr. Upshaw died last year of a heart attack. The reason why he was never checked was because the same health care laws that prevented others from receiving health care also prevented him from receiving an EKG and an EEG on an annual basis which would have shown the blockage that eventually killed him. Back to the bill.) Page 129 states that Part B premiums will remain the same for those who make over $85,000. On pages 130-131, Medicare Part D sponsors will take another hit because they would not be allowed to remove a covered drug from their plan that has been assigned by the Sec. of the HHS. Healthcare providers would have to take on the extra costs for adding all of the new drugs to their policies. Pages 132-137 will look to put existing healthcare providers out of business. New benchmarks will be set for existing Medicare Advantage providers. A new bonus program will be established based upon those benchmarks with the formulation of a 5-star rating system. New Medicare Advantage plans created after 2014 will receive a 2% bonus for the first two years of operation if they meet the criteria for structural measures of quality and network accuracy. Efficiency bonuses would be given for local and regional plans that provide the lowest healthcare costs. Pages 138-140 would force Medicare Advantage plans to use the rebates and bonuses that they received to lower copays, coninsurance, deductibles, and out-of-pocket-spending. What HHS is telling everyone involved with Medicare is to shape up or you will literally be shipped out. Is this part of the plan going to phase out the elderly?