Medicare Rx Benefit Needs High Turnout for Success Three weeks into the new Medicare drug benefit, federal officials are still scrambling to fix problems with its rollout. Things are improving somewhat, say pharmacists and patient advocates. But now some worry that short-term problems may jeopardize the program in the long run.
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Medicare Rx Benefit Needs High Turnout for Success

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Medicare Rx Benefit Needs High Turnout for Success

Medicare Rx Benefit Needs High Turnout for Success

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Federal officials are scrambling to fix problems with the rollout of Medicare's new prescription drug benefit. Pharmacists and patient advocates say things are improving somewhat. Some worry that the program's short-term problems could jeopardize the program in the long-term.

NPR's Julie Rovner has more.

JULIE ROVNER: Three weeks into the new program people are still having trouble getting their drugs says Vicki Gottlich of the Center for Medicare Advocacy.

VICKI GOTTLICH: They are still very, very frustrated. In fact, somebody on our call yesterday was in tears.

ROVNER: That could spell trouble down the line if seniors don't sign up because they see their friends and neighbors having a hard time. That may be one reason why Health and Human Services Secretary, Mike Leavitt, has been touring the country to explain how Medicare is working to address the problems. Among his stops was a meeting on Capitol Hill with senators who wrote the law.

MICHAEL O: The measure of success isn't whether the plan had reached perfection on the first day, it's how we respond to the inevitable, unpredictable problems. And we are. The plan is improving every day.

ROVNER: And in a conference call with reporters earlier this week, Leavitt said new enrollment numbers show the efforts are working.

LEAVITT: In the last 30 days more than 2.6 million people have enrolled in the plan, bringing the total to 24 million. We're on track to meet the 28 to 30 million goal this year.

ROVNER: But others say those numbers aren't as impressive as they sound.

ROBERT LASZEWSKI: They talk about well on the way to 30 million people being covered under the new Part D Medicare drug program, but in fact, 22 million people already had drug coverage before Part D went into effect.

ROVNER: Bob Laszewski is a consultant to insurance companies. He says the more important statistic is what the 21 million Medicare patients who didn't have drug coverage have done.

LASZEWSKI: Only 3.6 million have signed up through January 15th. That's only about 17% and, you know, that's after more than two months of hype about Part D, about advertising, about the President going around the country and giving speeches about it.

ROVNER: Judging from the early sign-up, Laszewski says he thinks the program is on track to enroll between 30% and 40% of seniors.

LASZEWSKI: And that certainly is not a public policy success. It's clearly not a political success for the President and for the Republicans because so many seniors are upset about the way this thing's been handled.

ROVNER: And Laszewski says the program could be on its way to being a business failure as well.

LASZEWSKI: Because it's important in a voluntary program like this to get a good cross-section of people, the sick and the healthy both, coming together to finance the program, if we're getting just 30% to 40% of seniors, chances are we're getting just the ones who think they can make money on it, which means the insurance companies won't make money on it.

ROVNER: In other words, unless both healthy and sick people sign up for the plans, they won't be financially viable for the private firms that are offering them. But Medicare officials say they remain confident about the program's future. Deputy Administrator Leslie Norwalk told a forum yesterday that the Medicare program itself suffered some of the same growing pains when it began 40 years ago.

LESLIE V: We probably have a stack over a foot long of newspaper articles between 1965 and 1966 that read almost identical to the articles we see on the front page of every paper today about the difficulty in implementation, the confusion, and so forth.

ROVNER: Meanwhile, in the short-term there's concern that the implementation difficulties could make it harder for President Bush to push further plans to make the healthcare system more market driven. Oregon Democratic Senator, Ron Wyden, voted for the Medicare law and supports a stronger role for the private market in healthcare, but he says the administration has bungled the Medicare drug rollout.

RONALD L: The way they've done this in the beginning day has really damaged the cause of a private role in American healthcare and it didn't have to be this way.

ROVNER: President Bush is expected to unveil new plans to encourage a more active role for individuals in purchasing medical services in his State of the Union speech next Tuesday. Democrats, meanwhile, say they'd rather he talk about ways to fix the Medicare drug program already under way.

Julie Rovner, NPR News, Washington.

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