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Pay no attention to the people behind the curtain

Sunday, March 18, 2007

Saving SeniorCare, and how you can help

by folkbum

Thursday afternoon I had the chance to do a "blogger conference call" with Wisconsin's Lieutenant Governor Barbara Lawton. The topic was Wisconsin's SeniorCare program, which, if you're a regular reader, you'll note is not exactly my issue. But these blogger conference calls so seldom get scheduled for a time when I can actually do them (since I, you know, work for a living and stuff), I wanted to Reward Good Behavior and do the call.

Anyway, if you're not familiar with the deal, Wisconsin has the, as in sole and only, alternative supplemental drug coverage program for seniors anywhere in the country--alternative to Medicare Part D, that is. Medicare Part D is probably the single biggest domestic boondoggle initiated by the Bush Administration, and, things being what they are, that's an incredibly damning assessment. Conservatives hate it because it's an unnecessarily expensive new entitlement program, and liberals hate it because it's an unnecessarily expensive new entitlement program.

But Wisconsin's got something a little different, offering better coverage for seniors' prescription drugs for about half the cost. But our waiver to do SeniorCare, in lieu of Medicare Part D, expires on June 30. And there's a real fear that a new waiver won't be granted. This despite SeniorCare's clear advantage. From one of many stories on the issue lately:
Wisconsin began the SeniorCare program in September 2002--years before the Bush administration began Part D in January 2006--as a way to provide low-cost prescription drugs to the elderly.

The state program is expected to cost $173.4 million this fiscal year, with state taxpayers paying $57.6 million, according to the state Department of Health and Family Services. The federal government is paying $53.6 million, and rebates from drug companies is netting $62.2 million, the department said.

A 2005 study by the Wisconsin chapter of AARP found that a person with an annual income of about $15,000 and $1,000 in annual prescription drug costs would save $632 each year under SeniorCare compared to Medicare Part D. A person with an income of about $18,600 with $7,000 in drug costs would save $2,311 under SeniorCare.

Advocates say that not only does the state program save the elderly money, it saves the federal government money and is easier for people to use than Medicare Part D. [. . .] Whereas the federal government subsidizes drug costs for Wisconsin senior citizens at $617 per person per year, it pays $1,174 per Wisconsin senior citizen each year under Medicare Part D, according to the Health and Family Services Department.

Advocates also point to the ease of using SeniorCare. SeniorCare has a one-page application, a $30 annual fee and covers more drugs. Deductibles are low and depend upon annual income. Medicare Part D, by contrast, has a monthly premium, a $265 annual deductible, and co-pays vary depending on the drug. It also includes dozens of program choices, and advocates for the elderly say the elderly have difficulty navigating its many choices.
Sounds, great, right? Who wouldn't be in favor of such a great program? Why would anyone stand in the way of keeping SeniorCare rolling?

Two words: Mike Leavitt. Okay, two more words that might make it a little more obvious: drug companies.

Leavitt is the current Secretary of Health and Human Services, and it's his say-so we need if the program is to continue. But there's one thing that SeniorCare has that Medicare Part D doesn't, and that's the ability to negotiate with drug companies for cheaper prices. If you recall, that was among the single biggest sticking points during the debate over Medicare Part D, with the bought-by-Big-Pharma Republicans in the House rejecting a Senate-approved amendment to allow such negotiation. That pretty much killed any chance that Democrats in large numbers would support the new program. President Bush, no stranger to Big Pharma money himself, has threatened to veto the new Democratic Congress's plan to add negotiating power to Medicare Part D. And Mike Leavitt has maintained the party line, even when asked about it directly by people here in Wisconsin:
During his appearance, two audience members pressed Leavitt on whether the Bush administration would allow Wisconsin's experimental SeniorCare program to continue. SeniorCare is a state program, authorized by the federal government, to provide discounted prescription drugs to the state's elderly.

The popular program's future is in jeopardy because it needs an extension of its federal authorization before mid-summer. Since the creation of the Medicare Part D prescription drug benefit in 2003, the administration has discouraged state-level drug assistance programs.

Leavitt was noncommittal, saying only that it was a regulatory decision he could not prejudge.
Want to know the most insidious part of all of this? It isn't just that forcing all of Wisconsin's seniors onto Medicare Part D is a big hassle, but it's entirely likely that not all 108,000 seniors currently in SeniorCare will even be eligible for Medicare Part D. According to Barbara Lawton and a new analysis just completed of Medicare Part D, Wisconsin as a whole has the second-least number of seniors eligible for the federal program:
"It would be unfair, to say the least, for more than 100,000 of our seniors to be forced onto Part D," Lt. Governor Lawton said. "Many of them would end up with nothing at all. Wisconsin ranks 49th out of 50 states when it comes to seniors being denied access to Medicare Part D."

The average annual federal subsidy for a SeniorCare participant is $617; the average Part D participant costs the federal government $1,174. Further, only 35.4% of Medicare applicants in Wisconsin are deemed eligible. Only Illinois has a lower acceptance rate.
So not only would it get more expensive--both for the government and for Wisconsin's seniors--if the waiver isn't granted, it's entirely possible that as many as 70,000 of Wisconsin's seniors would end up with no supplemental coverage at all! And Mike Leavitt seems utterly unconcerned.

On the other hand, all of Wisconsin's Congressfolk seem to be in favor of extending the program, even Petri, Ryan, and Sensenbrenner, who voted for Medicare Part D in the first place. Senator Russ Feingold, in fact, grilled Leavitt at a committee hearing last month. The list also includes newbie Steve Kagen, who's gotten a pretty negative vibe from the feds, and who's currently circulating petitions up in his district. Tammy Baldwin, also, has been gathering signatures. A call to your representative, whoever it is, would not be unwarranted.

At a more local level, Wisconsin State Senator Tim Carpenter is asking people to sign "Save Our SeniorCare" postcards, and a variety of other state lawmakers are asking people to sign petitions, including Amy Sue Vruwink, Tom Nelson, Louis Molepske, Jr., and Peggy Kruscik. You can get some of Carpenter's postcards by calling his office directly at (800) 249 8173, and contact your own state representative or senator to find out if you can get your name on a petition.

You can also go see Senator Carpenter and the rest of the committee he chairs--the Committee on Public Health, Senior Issues, Long Term Care and Privacy--at an event next week. There is a SeniorCare town hall here in Milwaukee Friday, March 30, from 12:30-2:00 at Oasis, located at 24th and Mitchell.

You can also give Secretary Mike Leavitt a call directly. It's not his home number, sadly, but his toll-free office number is (877) 696 6775. Be nice to the people who answer the phones, and tell them that you want the Bush Administration to grant a new waiver for SeniorCare. Over the next four years, SeniorCare could save more than $200 million in negotiated drug prices alone. Lawton and Carpenter are pretty convinced that the resistance is the result of the simple fact that Wisconsin is the only experiment. And even though our experiment is successful--the numbers just don't lie--our ability to negotiate with drug companies and the administration's hard line on that point make it an uphill battle.

This is something liberals and conservatives ought to agree on. (Our members of Congress do, after all.) This is something young and old ought to agree on. (Most of us bloggers, I assume, aren't enrolled in SeniorCare, but my friend Mixter explains its relevance to people of all ages.) So do your part, why don't you? Call somebody or do something else about it today.

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