Lots of deserving and eligible people will be missing from the Medicare Part D rolls this year, individuals who could well benefit from the biggest expansion of the program since it was created by Congress in 1965.
A great deal of money is on the table, with spending projections of more than $700 billion during the next decade. But big chunks of that cash may be left unspent by people who could really use it. Why? The program is complex and confusing (the number of offered plan combinations exceeds 1,000); the government was ill prepared to handle the problems of worried beneficiaries; and many politicians and advocates have been sharply critical of the program's legislation and design, which is delivered through private insurers rather than as a direct benefit through Medicare itself.
About 15 million of Medicare's 42 million beneficiaries had no drug coverage before Part D, which represents the first opportunity for them to get coverage. Approximately 7 million Medicare beneficiaries enrolled in the first three months of 2006. The federal government promised an aggressive drive to enlist as many as possible of the other 8 million people it says are uncovered before the May 15 shutdown date for the first year of the program. Those 8 million are hard to persuade: Many are low-income people less likely to read newspapers, or even watch television news, and quite a few are skeptical of government programs. Also, these more vulnerable elders are often members of minority groups, and some speak English only as a second language.
Although lots of money is available for the benefit, a relatively paltry sum is allocated for public education. The federal government has $300 million to spend in three years for Medicare information activities. Even if all this money was aimed at Part D education-and it isn't-the commitment would come out to little more than $7 for each Medicare recipient. That's chump change. Studies have shown it may take $100 or more per person to educate people about a new government benefit and get them enrolled. That's what it cost to sign people up for the Medicare discount card that preceded the Part D benefit.
PART D EDUCATION FUNDS DON'T MATCH NEED
Volunteers at health insurance counseling and advocacy programs in every state, programs that have provided Medicare counseling for years, have been overwhelmed with phone calls and pleas for help. They are doing yeoman work, along with thousands of volunteers from other groups. The National Council on the Aging, based in Washington, D.C., took the lead in organizing a large training network.
The educational resources, though, simply don't match the need, especially for a program so complex it could give just about anyone a headache. Consider Michael Levitt, secretary of Health and Human Services. In a heavily publicized account, he spent several hours discussing medications with his parents, …