Liberal Values Defending Liberty and Enlightened Thought

The Bush Administration is generally does a good job of considering the political implications of their policies. When they wanted to give huge tax breaks to their supporters, they gave into demands for a middle class tax cut and timed it so the tax cuts were increasingly favorable to the top 1% in future years. They manage to keep embarassing reports on Iraq delayed until after election. When they wanted to give huge benefits to the pharmaceutical and insurance industries, they hid them in a proposal billed as a prescription drug benefit. It looks like they goofed with that donut hole. An increasing number of beneficiaries have reached the point where they are still paying the monthly premium but are shocked to learn that they have to pay for their prescriptions out of their own pocket until they spend $3,600.

While I’ve had some patients reach the donut hole earlier in the year, an increasing number are doing so just prior to the midterm elections. Coverage such as seen in today’s Washington Post won’t help the Republicans this fall. If the program hadn’t been designed to maximize payments to the pharmaceutical companies, such as by prohibiting Medicare from negotiating for better prices, then the donut hole would not have been necessary. It is sure strange that Medicare discounts their payments for other services, such as payments to physicians and hospitals, but does not allow discounts in what they pay the pharmaceutical companies.