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Confusion Over Care

Monday, June 14, 2004 at 8:34 AM

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Efforts to get seniors to sign up for drug discount cards under the Medicare Modernization and Reform Act have fallen short of expectations, according to government officials. Low-income seniors stand to gain the most, but widespread confusion about the cards persists. ideastream's Tasha Cook has this report.

Frida Franyin: It’s in here. This one has the fact sheets.

At the age of 87, Frida Franyin is unstoppable. She protests, writes letters to politicians and watches C-SPAN like a hawk. She likes to keep tabs on the government. Few public policy issues upset her more than last year’s Medicare reform act and its provisions for prescription drug benefits.

Frida Franyin: The bill that was done in 2003 is just - it’s a joke. I mean there’s nothing that anyone can get out of it.

Paying for her prescriptions drugs is painful, Franyin says. Every month, she spends about $400 on medications. That $400 is more than half her monthly income of $733 from Social Security and a small union pension.

Under the Medicare prescription drug plan, Franyin qualifies for a $600 federal subsidy this year and another $600 next year if she signs up for a voluntary Medicare-approved discount card. But she says everything about choosing one card among the 49 different discount cards is confusing and unfair.

Frida Franyin: It’s like a deck of cards. And who knows which one is right for you? And many people are on as many medications as I am, maybe not as much, but certainly an awful lot, so how can an individual be able to decide which card will take care enough of their medications to make it valuable for them.

But even seniors who take the time to calculate the cards’ value could be in for more surprises. According to state officials, once enrolled, seniors cannot change their Medicare card until 2005, even if their prescription needs change. And card issuers can change their drug prices every week.

Franyin is not the only one feeling flustered. Margie Barron, a pharmacist at a drug store inside University Hospital, is having a difficulty deciding which cards her pharmacy will accept. Barron says sorting through the sheer volume of information some pharmaceutical companies have mailed so far has been daunting.

Margie Barron: This company I believe sent me a card: Do I want the information? I said, ‘Yes.’ I got boxes and boxes. So you can’t have - there’s 50 different companies - you can’t have all those papers around.

Barron complains there’s too much homework involved for consumers and pharmacies.

But Stan Levine, a counselor with the Ohio Senior Health Insurance Information Program, says change is always difficult. He wants to see a greater emphasis placed on enrolling the 330,000 low-income seniors in Ohio, like Franyin, who qualify for the government subsidy.

Ron Hill, who heads the Western Reserve Area Agency on Aging, which serves five Northeast Ohio counties, also sees value in the discount cards.

Ron Hill: Oh, I believe it’s significant. Even for seniors who have a lot of chronic problems and take a lot of prescription drugs. I mean $600 will help. I mean it will definitely help.

But Hill is concerned because enrollment has been lower than expected, especially among the low-income seniors who stand to benefit the most.

Ron Hill: Historically, that has been a hard population to reach. That is a disadvantaged population that faces a lot of language barriers, a lot of cultural barriers. You know, you have to be real aggressive in trying to outreach and educating that population.

Hills says the majority of hard-to-reach, low-income seniors are minorities. He believes their enrollment would increase if the government tapped into the network of caregivers at local senior centers.

But even if enrollment improves, some critics aren’t likely to be satisfied. Last month, labor, health-care and senior groups began forming a coalition with a goal of repealing or modifying the new Medicare law.

John Gallo: It’s a sham. I think the purpose of the whole thing is to ultimately eliminate Medicare as a public service.

That’s John Gallo of Cleveland’s AFL-CIO retirees council. He says the plan is a step toward privatizing Medicare. Gallo also argues the discount drug card plans were deliberately designed to be confusing as a way to deter needy seniors from enrolling.

Gallo and other advocates led the campaign for the creation of Ohio’s Best RX prescription card, which is expected to offer greater savings to all low-income Ohioans when it’s unveiled in November. They hope to build on their success in Ohio, and carry it to Congress.

Frida Franyin says she’s eager to join Gallo’s fight to repeal or change the Medicare law.

Frida Franyin: I believe that it’s necessary for us to fight for our justice, and we’re not getting it.

In recent weeks, the federal government has pledged to spend more than $25 million to promoting the cards. That includes $4.6 million to help community-based organizations provide counseling to low-income seniors. In Cleveland, Tasha Cook, 90.3.

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