As you may already know, I am not a proponent of the Bush Administration's Medicare Prescription drug plan. I believe it is wrong for our country, and that is why I voted against it. I am holding this Online Town Hall meeting to discuss your experiences with this flawed program, and ways to fix it. Click here to submit a question for the Town Hall.
I believe this Medicare bill will harm many more seniors and disabled persons, than it will help. Here are some of the problems:
Pushes retirees out of their current private prescription drug plans
Jeopardizes New Jersey's successful Pharmaceutical Assistance to the Aged and Disabled program
Provides inadequate relief for people without any coverage
Makes significant cuts to funding for cancer care
I believe under this plan, the winners are HMOs and big pharmaceutical companies. The losers are America's seniors and disabled persons.
As always, I welcome your comments and questions. You can call, write, or email me at any time. It is an honor and privilege to represent you in the United States Congress.
Welcome!
Thanks so much for attending my Online Town Hall on the Medicare Prescription Drug Program! I’m pleased to have this opportunity to answer your questions, and to hear your experiences with this plan.
As you may know, I am strongly opposed to the Medicare Part D plan for a number of reasons, and voted against it when it came before the House. I think that this plan is counterproductive, and awards big HMO and pharmaceutical companies at the expense of our nation’s seniors.
So, without further ado, let’s get to some of your questions!
Mary Ann asks: Why are these plans so complicated that even people with knowledge of health insurance coverage cannot find the best plan. Why not one formula for all?
Mary Ann, these plans are so complicated because private insurance companies were given too much input into how the bill was written. Medicare has worked well for over 40 years largely without involving insurance companies. Their role should have been much more limited here.
I think the Medicare Part D should be reformed so it works like New Jersey PAAD--except unlike PAAD Medicare should not be limited to seniors with very low incomes. In other words, if you choose to be in Part D, you should be able to get your prescription from your doctor, go to the pharmacy, pay a modest co-pay, and go home with your prescription.
Thanks for the question.
Ann asks: Why is it so hard to secure an appropriate drug plan for people who are just retiring?
Ann, it is so hard because the President and Congress have spent our money in the wrong places. We could have a plan where a new retiree could choose to enroll in Medicare Part D and, as I said to Mary Ann, pay a modest co-pay as the beneficiaries of New Jersey PAAD do. This would cost more than the present law. I think we should make this better plan a reality by stopping spending on huge payments to big agricultural companies (paying them NOT to grow food); on outdated weapons systems, and on wasteful programs. I also believe we should not make President Bush's tax cut permanent for people making more than $300,000 a year--the top 1 percent in our country. If we made these choices, your choice of a prescription plan under Medicare would be much less dificult.
Thank you.
Leon asks: There is no question that the drug medicare bill was a financial windfall for the pharmaceutical industry as well as private health insurance companies. What can Congress do to revise the drug medicare bill so it may be run by Medicare (which only has 2% administrative cost overhead)? Why doesn't the Government use its power to buy prescription drugs in bulk to force a decrease in the price to participants of these plans.
Leon, the basic answer is that the corporate interests who benefit from Part D made a lot of campaign contributions to ensure that they would get their way. I agree that Medicare should run Part D, not the insurance companies. I also agree that we should find an appropriate way to use the purchasing power of 30 million Americans to moderate price increases. Thanks.
Rosemary asks: Does this mean that if your present health insurance covers a prescription, it no longer would? (When you're able to use the Medicare program)
Rosemary, if you use Medicare Part D it MAY be the case that your new plan will not cover a prescription that your present plan does cover. It also MAY NOT! The chaos and confusion that has resulted from this issue has created a lot of trouble for my neighbors and constituents. I favor changing the law so that EVERY prescription that is written by a legitimate doctor for a valid reason, and that obviously is approved by the FDA--is covered.
Joseph asks: I would like to see more "non-preferred" drugs included in the "preferred" category. I don't understand how they qualify them.
Joseph, I don't understand this either. The law now permits insurance companies to influence--or even determine--what prescriptions you will have. I think your doctor should make this judgment. If we had a Medicare Part D run like New Jersey PAAD, this would not be a problem. I think we should--as I outlined earlier. Thank you.
Betty asks: Why is the government being reactive, instead of proactive to problems with healthcare? I am a nurse of 24 years. I have worked in all kinds of clinical settings and even pharmaceutical settings. The insurance companies up their prices, the pharmaceutical companies up their prices, the hospitals up their prices. Everyone needs to make a profit, but it is out of hand. I talk to people everyday who can not afford decent medical care. These people are young, middle, and of old age. No one knows where to turn to. They are only one voice and easily swept under the carpet. We need to make some changes from the top down, not just robbing Peter to pay Paul.
Betty, we are being reactive rather than proactive in solving health care problems because we have permitted the development of an insurance market that rewards companies that hoard money rather than investing in better care for people. Research has shown that as much as 25 cents of every premium dollar is kept by health insurers, rather than paid to doctors, nurses and providers. Much of this 25 cents is profit. I think we should change the laws so that companies have an incentive to prevent illness. I also think we have starved our public health care programs--Medicare and Medicaid chiefly--and prevented them from doing effective prevention.
Thanks.
Robert asks: Why so many plans? Why can't the government lay out a plan that dictates one set of rules? If the insurers don't want to participate so be it. All this multiple plan concept doesn't do anything but confuse the older citizens and takes their hard earned money. Thanks and have a good day.
Robert, there are so many plans because there are so many donors to campaigns....
I think a Prescription plan based on traditional Medicare would work a lot better, and I favor converting to such a plan, with reasonable safeguards to protect those already in private plans.
Chuck asks: Congresman, I am not part of the of the Medicare Program obviously from my age, however, I will be someday and would like the system to be run much better than I have been hearing about lately. When is someone who knows and understands these types of bueracratic systems going to propose a system that can work that most common people can understand? I have read how the program is flawed and does not work, however, I have not seen a proposal presented that can work and be understood by everyone. You are asking the people for input on what they want and it is obvious. They want Medicare program that gives them what they need, healthcare, prescription program that won't make them broke or is too confusing to use. Keep it simple and understandable.
Thanks Chuck. Here is what I would do.
(1) Any person who did not want to be a part of the Medicare plan would not be forced to join.
(2) For those who chose to join, they would go to the pharmacy with the prescription written by their doctor, pay a small co-pay, and take their prescription home.
(3) We would pay for this by reasonable premiums tied to the income of the retiree (people making $100,000 a year would pay a littl more thansomeone making $30,000 a year. Those on Medicaid would pay no premium). We would also pay for this by stopping spending on wasteful weapons systems, agriculture subsidies to big businesses, inefficient government programs, and by repealing the Bush tax cut for people making over $300,000 a year.
That's my plan.
Carl asks: Could this problem (Part D) be fixed by universal, single-payer health care ("socialized medicine")? If not, why not have it administered by Medicare in the same way that parts A & B are handled? Eliminating insurance companies and forcing drug manufactures to measure up on pricing would make those who finance political campaigns unhappy, but it would make many, many voters very happy.
Carl, it is not necessary to put the entire health care system under a single payer to fix Medicare Part D. As I just said to Chuck, the way to fix Medicare Part D is to have Medicare run the Part D the way it runs the rest of the program. Thanks.
George asks: Do you support a universal healthcare plan which includes prescription drugs? George, I support a law that would guarantee every American health insurance provided that (a) they make a reasonable contribution based on their ability to pay and (b) they are not forced into a plan that they would not choose for their families. Such plans would certainly include prescription drugs.
Arlene asks: I am very concerned with the current medicare prescription drug program and why we are forced to joint or be penalized..... It should be an open season once a year and whoever wants to join be allowed to do so without penalty...when they get the bugs out of the program then maybe more people will join, but not under the current structure....
Arlene, you are very right.
I think it is wrong to penalize seniors and disabled persons because they could not make a choice under this chaotic law. I think the penalties should be repealed and forgive.
Thanks.
Rodolfo asks: Is it true that the government does not have the right to negotiate the price of drugs included in the formularies of Medicare Part D with pharmaceutical companies?
Rodolfo, unfortunately, it is true the government does not have the right to negotiate drug prices. The provision was included in the law because the Republicans friends, in the pharmaceutical world, asked for it. If the Democrats win the majority in the House in November, you can believe one of the first things we will do is repeal this provision and allow the government to use the purchasing power of 30 million Americans to moderate price increases.
Thank you
James asks: I don't see the benefit of this drug plan when they have a cap of I think $2500 for drugs...after you reach that cap, you are on your own paying full price until you reach the second plateau of $5000 (not sure of exact amounts) where is this a saving for us? I am selling my house right now because I can no longer afford to live here and pay my health care, etc. Yet they still take out the monthly charge for Medicare D......even though we are paying full price for our drugs during this "donut" stage.....
James, I agree. Medicare Part D provides you far less of a benefit than you need or deserve. We need to reform the law so that Part D works like New Jersey Pharmaceutical Assistance to the Aged and Disabled program (PAAD); however, without an income test that excludes all but the lowest-income seniors and disabled persons. You should not have to choose between paying for prescription drugs and selling your house.
Thank you
Tom asks: I am positively sure you are very much interested in having a Medical Prescription Plan that is fair and "workable" My question.Are we expecting too much for your peers to work for that goal?
Not at all Tom. On the contrary, the least Congress can do is reform Medicare so that you are able to get your prescription from your doctor, go to the pharmacy, pay a modest co-pay, and go home with your prescription.
Thank you
Dennis asks: How does the Medicare Prescription Drug Program jeopardize New Jersey's Pharmaceutical Assistance to the Aged and Disabled program? Dennis, when the Medicare Part D law was first enacted there was a major concern over whether it would interfere with PAAD benefits. A lot of thanks should go to the state and the NJ Congressional delegation for ensuring that those on PAAD received the same benefits as they had before they enrolled in Part D.
Pauline asks: Under the present plan, there is a "donut hole" for prescription coverage. If I reach that "donut hole", am I to assume that PAAD will not cover my prescription costs? I live on a limited income and should I reach that donut hole, I will be unable to buy the necessary prescription drugs I need. I didn't have this concern prior to this recent change.
Pauline, you should receive the same benefits you receive now when you enroll in the Medicare Part D program. Thanks to the state of New Jersey, those on PAAD are one of the few groups shielded from having to pay higher premiums, deductibles, or any other out-of-pocket costs to use the Part D benefit. You will continue to pay only your regular $5 PAAD co-payment for each covered prescription and may even pay less for some drugs. Remember though, you must enroll in the Medicare Part D program to maintain the benefits of PAAD.
Thank you for your question.
Theresa asks: I work for a Geriatrician and know that Medicare is cutting back on reimbursments to Physicians. In speaking with Physicians, I know there is talk about not seeing any new Medicare patients, or not seeing any Medicare patients at all. I understand that the Physicians require payment, what they receive now is not enough for their services. But, what is going to happen to the Medicare recipients?
Theresa, your concern is shared by many. This year, Congress is scheduled to cut physician Medicare payments by 5.1%, putting patient access at greater risk. I am working with many of my colleagues in fighting to ensure these cuts do not occur. Furthermore, we need a permanent fix to the physician payment problem. As a co-signer of legislation to provide this fix, I am committed to giving doctors adequate pay for services so that we stop jeopardize patients’ lives. This legislation will annually adjust and increase Medicare physician payments, which will provide doctors with a fair reimbursement rate for their services.
Thank you
Thanks!
Thank you for your great questions. Unfortunately, I’ve run out of time for today. The House Armed Services Committee, of which I’m a member, is about to begin a markup on military commissions legislation.
I apologize for not getting to all of your questions. I will get to the rest of your questions on Medicare Part D, and will post them to this site. Please feel free to check back here periodically.
Additionally if you have specific questions or problems I can help with, please do not hesitate to contact my office.
Thank you very much for taking the time to attend my town hall, and for submitting your questions and comments. I look forward to working with you in creating a better healthcare system for our nation’s seniors.
