Larry Kissell (NC-08) Coffee, Doughnuts and the Medicare Doughnut Hole
by working for change, Fri Sep 29, 2006 at 08:06:00 AM EDT
It's been about nine months since the Medicare Part D has taken effect and millions of seniors, including those in Hamlet, are now facing the lapse of prescription coverage known as the doughnut hole.
the government picks up the bulk of drug costs only until the beneficiary and the government together have spent $2,250 for the year. At that point, beneficiaries must pay 100 percent of costs until they have spent a total of $3,600 of their own money. Then the federal subsidy resumes, paying 95 percent of any additional expenses.
That's quite a plan, isn't it? A plan that 8th District Representative Robin Hayes voted to enact. While campaigning for re-election in 2002, Hayes promised that he would:
Improve Medicare and provide a real prescription drug benefit so seniors don't jeopardize their quality of life;
So, did Hayes keep his promise to preserve the quality of life for seniors with Medicare D? I don't think so.
These seniors have to cover $3600 out of pocket for their prescribed medications while continuing to pay a monthly premium to Medicare for coverage they are not receiving. An average working person would have a hard time coming up with $3600, but these are retired, disabled, or low income wage earners. After the devastating effects of free trade agreements on the rural mill towns of the 8th district, many of them struggle just to put food on the table or fill the gas tank. Now they must choose between buying life saving medications and eating. And at the end of the calendar year, the cycle begins all over again.
But Hayes did manage to keep his promise to preserve the quality of life for someone...and that someone is currently representing the 8th district. Hayes voted to give his family and a small handful of other families in the 8th district a huge tax break forcing his working class constituents to make up the difference in the gap of federal revenue.
Robin Hayes also preserved the quality of life for his campaign finances when he accepted $53,400 from Big Pharma for his Medicare vote as well as some free re-election TV spots bragging about the "success" of Medicare D.
When the group of seniors gathered in the Birmingham Pharmacy were asked how they feel about pharmaceutical companies running campaign commercials congratulating Robin Hayes for his Medicare vote, Timothy Boyd of Hamlet interrupted the group's response and said
There's a lady present.
To make matters worse, Medicare D is hurting more than just the seniors who depend on their prescription medications. Independent pharmacies are struggling, too.
More independent pharmacies, especially those in rural areas, will close because of slow and decreased reimbursement from Medicare, predicts the Association of Community Pharmacists Congressional Network, a national group that represents 15,000 independent pharmacists.
Under the new Medicare D plan, independent pharmacies, the small family owned business common to rural areas like Hamlet, are required to wait up to 30 days for Medicare reimbursement and receive less than half the dispensing fee they received before the new plan went into effect.
George Brookins, owner of The Drug Store in Lincolnton, said he has "ways of taking the hit" because his store sells wheelchairs, oxygen tanks and other big-ticket items in addition to drugs. Smaller stores "are the ones that are really getting hammered," he said."I've been practicing pharmacy for 30 years," Brookins said, "and Medicare Part D is the biggest train wreck I've seen in a long time."
When Rep. Robin Hayes was informed of this growing problem for small pharmacies in his district, he quickly sent out spokesperson Carolyn Hern to reassure his constituents that he had signed on as co-sponsor of a bill that would require Medicare to reimburse pharmacies in a more timely manner and at a higher rate.
The bill Ms. Hern referred to is HR 5166, the Independent Pharmacy Protection Act and it would go a long way toward helping these small town businesses in exactly the way Hayes described. Too bad for the pharmacy owners that this Bill has been in limbo ever since it was referred to committee back in April.
What's striking about HR 5166 is that it was introduced by a Republican to a Republican-majority House with 186 bipartisan co-sponsors. This Bill could have been passed long before Hayes was ever interviewed about the Medicare-induced pharmacy crisis. Yet, nearly 6 months after it was introduced and 3 months after Hayes tauted his support, HR 5166 sits in a pile on someone's desk while pharmacies close and cash-strapped seniors are forced to drive miles out of town to find another pharmacy to fill the prescriptions they can't afford.
It's just another example of election year politics as played by our do-nothing Republican Congress and specifically, our do nothing Representative Robin Hayes. They introduced the Bill to LOOK like they cared about small business...to LOOK like they cared about the effects of their ill-begotten Medicare Disaster. But LOOKING like you care and ACTUALLY caring are two very different things.
Which brings us back to our story about Larry Kissell and that group of angry seniors at the Birmingham Pharmacy.
As the discussion between Larry and the group went on, Medicare recipient Bob Wood asked
It's already established that this is law. Now what are we going to do to change the law?
to which Larry responded
We have to make a change in those in Washington writing the legislation. (I) want to be the kind of Representative that looks out for the people, not pharmaceutical profits.
You're right, Larry. We do need to make a change....and you're just the guy to help us do it.