Benefit is a Remedy that Really Works: A Striking Success for Veterans'
Many of the
wives and husbands of former military personnel rely on Medicare to pay
their medical bills
By William M.
Matz, Jr., Major General, US Army Retired
16, 2010 - Five years in, Medicare's prescription drug benefit is a
striking success. The program, known as Medicare Part D, gives tens of
millions of seniors access to life-enhancing medicines and dramatically
lowers out-of-pocket spending.
Better yet, Part
D's greatest flaw - the gap in coverage known as the "donut hole" - is
about to start closing. Under the new healthcare reform law, America's
biopharmaceutical companies will start providing eligible seniors who
reach the donut hole a 50 percent discount on their brand-name drug
improvements in Part D are particularly beneficial to veterans and their
families. With the major exception of the Army, the American military
generally does not provide veterans' spouses with health coverage. Many
of the wives and husbands of former military personnel rely on Medicare
to pay their medical bills.
there are over 9.5 million veterans who quality for both VA healthcare
and Medicare. Patients often use Medicare coverage to supplement their
existing VA benefits. For instance, veterans do use the program to
offset some of the co-payments charged by VA health plans.
creation of Part D in 2003, seniors were struggling to pay for
prescription drugs. Half of seniors lacked drug coverage at least part
of the time. Many had to resort to splitting pills, skipping doses, or
foregoing needed drugs altogether. As a result, their conditions
worsened, and Medicare ended up paying more to treat them.
But then Part D
kicked in. By the end of the program's first enrollment period, more
than 90 percent of all Medicare beneficiaries were enjoying drug
coverage. Today, nearly 28 million Medicare beneficiaries are enrolled
in Part D.
drug benefit has helped seniors by expanding access to prescription drug
coverage and lowering out-of-pocket costs, particularly helping those
who previously lacked drug coverage," says Tricia Neuman, director of
the Medicare Policy Project at the Henry J. Kaiser Family Foundation.
Her comprehensive analysis of Part D was published last year in the New
England Journal of Medicine.
predictions that the program would trigger out-of-control costs. But
competition among plans has actually saved seniors and taxpayers money.
components of Medicare, Part D is administered by private insurers. The
federal agency overseeing Medicare recently announced that seniors will
pay an average premium next year of just $30 per month for drug
coverage. That's only $1 more than the average premium this year. And 99
percent of seniors in Part D will have access to a plan in 2011 with a
premium that is the same or lower than what they are paying now.
to overstate how important these savings are for veterans in the Part D
program. The annual median income for our country's former military
personnel across all ages is just $37,000 - and that figure tends to
drop once people shift into retirement.
Part D is also
costing taxpayers far less than expected, thanks to competition, a drop
in the national growth rate of prescription drug costs and the shift
from brand-name to generic drugs. Compared to the initial 10-year
federal estimate, total Medicare Part D costs have declined by 41
percent, saving the government $261 billion.
But money isn't
the most important issue here. When seniors don't have to skimp on
prescribed drugs, they take better care of themselves and their
long-term health outcomes improve dramatically. By taking their
prescribed blood pressure medication, for example, seniors ward off
heart attack and stroke.
the University of Pittsburg recently found that any additional costs for
drug benefits under Part D were offset by savings for other medical
The donut hole
was a big problem. This gap in Part D coverage will affect 4 million
seniors this year. Before reform, beneficiaries with annual drug
expenses exceeding $2,830 had to pay all of their drug costs up to
$4,550, at which point catastrophic coverage went into effect. Seniors
in the donut hole often skip needed medications, which in turn makes
their condition worse.
Experts had been
warning that Part D wouldn't achieve its goals unless the donut hole was
eliminated. Fixing this "glaring defect," said Stephen Soumerai, health
professor at Harvard Medical School, would "improve health and might
actually reduce overall expenses by lowering hospitalization costs."
healthcare law completely phases out the donut hole. This year, the
government sent $250 rebate checks to Medicare recipients in the gap.
Next year, those recipients will automatically be eligible for discounts
on brand name prescriptions that will cut their costs in half. The donut
hole will disappear entirely within this decade.
Medicare Part D
provides crucial drug coverage to our nation's veterans. The program's
continued improvement will mean lower bills and more medical options for
many of our former military folks - and for millions of other Americans
seniors, as well.
William M. Matz,
Jr., Major General, US Army Retired, is President of the National
Association for Uniformed Services.
About the National
Association for Uniformed Services
NAUS was founded
in 1968 to protect and enhance the earned benefits of uniformed
servicemembers, retirees, veterans, and their families and survivors,
while maintaining a strong defense, and to foster esprit de corps among
uniformed services personnel and veterans of the United States, through
nonpartisan advocacy on Capitol Hill and with other government
officials, NAUS is the Servicemember's Voice in Government. Click to website...