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John Braswell/Kawheeta

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The Doughnut Hole
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A view of the Medicare Part D

The Doughnut Hole

 

 

The doughnut hole is the term used for the gap in the Medicare Part D prescription drug coverage.  This is an appropriate term because the gap in coverage will sustain life almost as well as the hole in a doughnut.  This gap in coverage caught many of the nation's elderly completely by surprise.  They go to their pharmacy to get a refill that the previous month had cost $5.00 and discover that the same prescription now costs several hundred dollars.  How could something like this get past people undetected? 

 

Unlike the Iraq war, the Bush administration waged a successful war against America's most vulnerable people, the elderly, sick, and disabled.  By using the strategy of confusion, fear, half-truths, and outright lies the administration has gotten millions of trusting Americans to sign-up for a program that would ultimately be responsible for the deaths of an untold number of people.

 

Let's take a minute to examine these claims of strategy.  Confusion – most states had at least fifty, (50); different plans, each with different formularies, co-pays, and monthly fees.  This would be a daunting task to sort through for a well-educated, healthy, young person, with no cognitive involvement.  Fear – If you do not sign up by a certain date, you would be fined so much per month for every month you are late, and of course the option of signing up is then taken away for several months.  Half-truths, and outright lies are too numerous to list here.

 

How could this program be responsible for death among its recipients?

 

Imagine that you must live totally on Social Security and your income is $600.00 per month.  You do not drive anymore, so there is no vehicle expense, and your home mortgage has been paid off for years.  Nevertheless, there is still home-owners insurance, maintenance, repairs, and monthly utilities.  If you take out $100.00 for insurance, maintenance, and repairs, then deduct $200.00 for utilities, that will leave you $300.00 per month for food and the other necessities of life including medicines.  Now that you have reached the "doughnut hole," your medications cost more than you have left over.  So, what do you do?  You do the same as thousands of other Americans in your situation do – first, understand that you are not unique, - second, do not take it personally, - third, accept the fact that outside of the small group of people that know and love you, nobody cares.

 

Now, let's get to it and start juggling money.  Look through your bills and see what you
can do without.  You had to let your phone and cable TV go long ago, and the only utilities you have is water and electric.  No help there.  You think about food, and even if you are willing to swallow your pride and eat at the "soup kitchen," it would take hours to get there using public transit.  The only thing left to cut is some of your medications – but which ones?  If you guess wrong…

 

PS.  There is one more thing that everyone needs to be aware of:

When you reach the "doughnut hole," your coverage stops – not another penny for anything.  Nevertheless, your monthly membership fee that you are required to pay to be in the Medicare Part D plan continues.  You get no help, but you still pay the monthly fee!

 

An easy way to think about it:

 

 You buy a home in the Midwest in what is commonly known as "tornado ally."  You buy home-owners insurance and then find out that the insurance is automatically canceled during the tornado season – but you still have to pay for the time you are not covered.  What is wrong with this picture?   Who wrote this plan?

 

The reason you do not hear about these deaths – these people all die of natural causes.

 

 

John Braswell ă 2007


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