June 01, 2006


Caption: You may have heard that the devil is in the details. This is him.

Privatization has many faces. One of these that millions of American seniors have had to face recently is the Medicare Part D drug program. Actually, the term is a little misleading and is part of the problem.

Instead of being a program run directly by Medicare, which has low administrative costs and could negotiate lower prices from the pharmaceutical industry, Part D is only available through private plans. The legislation that created Part D actually forbids the government from negotiating lower prices. This creates a bonanza for insurance and drug companies but will add hundreds of billions of dollars to costs paid by taxpayers and seniors.

It's another classic example of what authors Si Kahn and Elizabeth discuss in their book, The Fox in the Henhouse: How Privatization Threatens Democracy (although El Cabrero's henhouse has had more problems with weasels than foxes).

Speaking of seniors, many recently faced a May 15 deadline to sign up for one of the many private programs or face lifetime financial penalties. It's not clear at this time how many were unable to meet the deadline. Many advocacy groups supported an extension of the deadline and removal of the penalties. So far, this effort has not been successful, although legislation to do so has been proposed.

It won't be long before many people who did enroll in the program will hit what has come to be known as "the doughnut hole," a gap in coverage of annual drug costs between $2,251 and $5,100 in which seniors must pay for all prescriptions themselves even as they continue to pay monthly premiums. This will probably lead many to skip vital medications altogether.

For the philosophically inclined, I would suggest that the program approximates the Platonic ideal of a goat rope.

Around West Virginia and the nation, seniors and allies are coming together to urge Congress to fix the program. This article from today's Charleston Gazette does a good job of outlining the problems and the solutions.


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