Prescription Meds from outside U.S. offer lifeline to Part D

Posted by Daniel Hines
Publisher, www.TodaysSeniorsNetwork.com

(Part One of how and why safe, affordable prescription medicines from licensed, registered phamacies from outside the U.S. can benefit not only American's health, but can relieve the strained budgets of governmental services at the local, state and Federal levels. Part Two will deal with how local governments can generate vast savings for employee benefits, savings that can then be applied to other local services.)

As the U.S. economy continues to reel, the increasing cost of Medicare Part D threatens the very essence of a program that was claimed to be designed to address the prescription medicine needs of the country's aging population.

Increasingly, abuses of the system are apparent. Most recently, the Center for Medicare Services says that private plans that are woven in the fiber of Part D, have 'misinterpreted' the intent of CMS when the Part D was launched by developing a practice of 'locking in' a price structure in which PBMs charge a higher rate to insurers with whom they have contracted to administer their drug benefit than what they pay pharmacies to dispense the drugs to beneficiaries. The PBMs then keep the difference, according to an article in the Wall Street Journal.

Ironically, a CMS administrator says that the agency thought it had a "clear policy"
prohibiting lock-in pricing when Part D launched. "We learned that there are different ways of interpreting a policy statement," she adds in a classic understatment.

Actually, since its inception, Medicare Part D has been flawed. It did not allow price negotiation to guarantee the lowest prices thereby generating savings for the Federal government and the intended beneficaries. The abomination of the 'Doughnut Hole' virtually eliminated hundreds of thousands of seniors who would receive little or no benefit unless they had staggering out-of-pocket costs which increase each year. And, the pharmaceutical industry continues to raise prices on brand name drugs, which makes Part D increasingly costly, although a "PR Spin" has been attempted to make it look as though savings have occured since the amount expended is lower than earlier estimates. The fact is that a large part of this claimed savings is due to lower than anticipated enrollment in plans.

In what can only be described as an American Tragedy, many policy-makers attack the claimed original intent of Part D, to help seniors enjoy the health benefits provided by prescription medicines, by labeling Part D (and Social Security and Medicare generally) as 'entitlement' programs that are burdensome to the country. One author even suggests that there is no alternative other than to cut Part D to 'save Medicare':
"In sum, Part D costs are soaring, and they could harm Medicare's core mission and the elderly. Because a tax increase is out of the question, one obvious solution is to amend the law and limit the drug benefit to save Medicare..." Quote from Spyros Andreopoulos is director emeritus of the Office of Communication and Public Affairs at Stanford University Medical Center.

Another approach comes from The Medicare Rights Center, on whose Citizens' Advisory Board I serve (Midwest Region). MRC advocates support of the Medicare Prescription Drug Savings and Choice Act, introduced by U.S. Senator Dick Durbin (D-IL) along with U.S. Representatives Jan Schakowsky (IL-09) and Marion Berry (AR-01). The bill creates a Medicare administered prescription drug plan to provide seniors an alternative to the privately administered prescription drug plans currently offered under Part D.

The problem is that both of the above approaches suffer from the blinders that too often are worn by policy-makers and advocacy groups, blinders that prevent them from looking at the totality of the factors that can favorably influence a solution to challenges such as the increasing costs of Medicare plans.

The fact is that access to safe, affordable prescription medicines from outside the U.S. must be included in the discussion to the complete (debate) (discussion)on healthcare reform in this country. Such access not only offers a potential benefit to improved health for all Americans, but can almost instantly create savings that will favorably impact Medicare administration by allowing access to lower-cost, but safe medications.

Unfortunately, a Washington-based staff member of MRC says that she is interested only in the passage of the Medicare Prescription Drug Savings and Choice Act, on initiatives of the MRC, and has no interest in even exploring the potential contribution of providing savings and choice by allowing access to prescription medicines from outside the U.S.

Also, a highly informative source in Washington has told us that he fears that in the next Congress in 2009, there will be such a rush to enact 'comprehensive health care reform' that it will be nothing more than a 'trading bloc' for a number of individual Senators, Congressmen, pharmaceutical industry and insurance company reps, each with their own particular agenda, be it liberal, conservative, or even anti- or pro-pharmaceutical and insurance industry oriented. He said he fears that pharma particularly will offer its support for some form of 'comprehensive health care reform' in return for the role of providing continued access to safe, affordable medicines from outside this country to U.S. citizens being discarded.

That's like throwing the baby out with the washwater. It is time for Congress to take action to provide such access to all Americans, and to do so in a fashion in which the role of prescription medicines from licensed, registered pharmacies in Tier One countries not only can maintain or even enhance the quality of healthcare in the U.S., but can provide fiscal savings that can actually help pay for other initiatives that will finally get this country on the road to an improved national health care policy.