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New Medicare Drug Card Puzzles Seniors

Survey likens new system to a Rube Goldberg device

THURSDAY, June 3, 2004 (HealthDayNews) -- Far from clarifying essential health issues, the new Medicare prescription law and its discount drug card have left seniors and disabled people hopelessly perplexed about their benefits.

"Beneficiaries are badly confused at this early stage about this law, and that means that it will take a major effort to educate and inform if the law is to be successful and if seniors and disabled people are to make the best choices for themselves and for their families," Drew Altman, president and CEO of the Kaiser Family Foundation, said Thursday at a teleconference.

Altman was presenting the results of research that found seniors and the disabled were confused by the new cards and not pleased with the new law.

The law took effect two days ago, on June 1, when seniors and the disabled became eligible to sign up for the prescription drug discount cards, which will be used until Medicare offers prescription insurance in 2006.

But, according to a report in Newsday, the number of seniors who actually have signed up is minimal.

According to the Democrats, the newspaper said, only 500,000 out of 2.8 million Medicare enrollees voluntary signed up for the new cards. The rest were automatically enrolled.

Health and Human Services Secretary Tommy Thompson said the lag was due to "window shopping."

Democrats assailed the new program this week, insisting that negotiating lower prices or buying drugs from Canada would result in more savings.

For its survey, Kaiser commissioned 10 focus groups in Pittsburgh, Kansas City, and Washington, D.C. The participants were divided into household income groups: of less than $17,000 yearly; $17,000 to $35,000 yearly; and above $35,000 a year.

The panelists were asked how they felt about the Medicare system in general, how they felt about the new law, and about specific aspects of the new law.

Both seniors and people with disabilities registered negative feelings toward the new drug benefit even as they expressed positive feelings about Medicare in general.

On a scale of 0-to-100 (with 100 being the most favorable), seniors rated their perceptions of the new drug benefit at 31.

"The fact that the system is confusing is one of the reasons people give it a negative score," said Geoff Garin, a partner with Peter D. Hart Research Associates, which conducted part of the research. "There is a view they've created a [Rube] Goldberg contraption."

Specifically, seniors were worried about costs, potential changes to their current coverage, the limited duration of the plan (two years), and having to select from a wide range of choices.

Fourteen of 65 panelists said they felt favorably toward the discount drug cards, 14 had no strong opinion, and 37 had an unfavorable opinion. Results were similar for the 2006 drug benefits, with 15 favorable, 12 no strong opinion, and 38 unfavorable.

Seniors also tended to confuse the discount cards with actual drug coverage.

"People are much more resentful than they are grateful," Garin said. "There's a feeling that no one's done them a great favor."

On the other hand, panelists tended to believe the law could help people with low incomes. "It is seen as genuinely beneficial for low-income people," Garin said. One group that responded favorably was those with lower income, "but they are very intimidated about navigating," he said. "So the group that most stands to be helped by the law, in some ways, feels most at sea in accessing the law and being able to use it."

Disabled beneficiaries expressed generally the same concerns as seniors, although perhaps more vociferously.

"The one thing that we heard consistently in Pittsburgh, Kansas City, and Washington is that people simply do not have this benefit figured out," Garin said. "Seniors come to this with very little understanding of how to navigate the system that has been created for them."

More information

Visit the Kaiser Family Foundation for more on the report.

SOURCES: June 3, 2004, teleconference with Drew Altman, Ph.D., president and CEO, Kaiser Family Foundation, Menlo Park, Calif., and Geoff Garin, partner, Peter D. Hart Research Associates, Washington, D.C.; June 3, 2004, Newsday
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