Time will tell effectiveness of Medicare drug plan

THE ISSUE The state human services director says a new federal prescription program is off to a relatively good start in Hawaii.

AS FORESEEN, the elderly are dizzied by a variety of drug plans with different premiums and covered drugs thrust at them under a new Medicare prescription program. State officials claim the transition is smoother in Hawaii than in other states, but changes are sure to be needed in the months and years ahead.

Skepticism was understandable regarding a vast program cobbled from conflicting ideologies. Conservatives sought a private-sector system of drug companies competing in a free market, while liberals preferred simply adding drug benefits to Medicare, with the government negotiating for standard benefits and discounts. The result was private competition with federal subsidies.

Of the 42 million older and disabled Americans eligible for the drug benefits, 6 million qualify through both Medicare and Medicaid, the government health program for the poor. Many of those "dual eligibles" are experiencing special difficulty in avoiding falling through the cracks. The 28,000 dual eligibles in Hawaii lost their free Medicaid coverage.

Hawaii officials anticipated that problem and initiated a Pharmacy Assistance Program to cover costs for people both poor and elderly. The plan has been copied by 31 other states, says Lillian Koller, the state human services director, and the federal government will compensate the states for transition drug costs and most of the administrative costs.

Companies began marketing their Medicare drug plans last October and started enrolling people in mid-November. The program began on Jan. 1, and seniors have until May 15 to avoid paying an additional 1 percent per month on premiums.

More than 150,000 of Hawaii's Medicare beneficiaries already have drug coverage from present or past employers. Of the 30,000 who may benefit from the new drug program, only 3,000 or so have enrolled. The governor's Executive Office on Aging is taking calls from eligible beneficiaries and helping them select a program through its Sage PLUS health information arm.

Older Americans in Hawaii have among 14 prescriptions drug plans, encompassing 52 options, from which to choose. Richard Carlson of Palolo told the Star-Bulletin's Helen Altonn that the monthly prescription cost for his 85-year-old mother has plummeted from $200 to $14. However, one woman said she was shocked to learn that $22 was subtracted from her Social Security check, and many others still are trying to comprehend the program.

It is barely into its infancy, and a clearer picture of its effect is likely to surface later this year. Soaring drug prices in the past decade prompted calls for relief by the elderly, and they will not be silent if the program fails.