Medicare: Less is more

Some drugs cause confusion in elderly patients. So will the new Medicare prescription drug discount plans that millions of older Americans began signing up for this week.

Congress could have provided affordable medications to Medicare users simply by expanding existing programs that supply inexpensive drugs to veterans and the poor. Instead, the government has cobbled together a complicated and confusing "free market" system to offer discounted drugs for the next 19 months until a new drug benefit debuts in 2006. A cynic might wonder if the confusion was built in to discourage seniors from using the discounts.

Seniors will have to choose one of more than 30 discount cards. Eventually, nearly six dozen cards may offered.

Only for people with very low incomes will the decision be simple: enroll. They'll pay nothing for their cards and will get a $600 credit toward drug purchases.

The one in five seniors who has access to the Internet can start weighing her options by visiting Medicare's web site (www.Medicare.gov), which proclaims that choosing a discount card "isn't confusing." Anyone game enough can then peruse an online comparison guide, which requires answers to eight detailed questions about income, assets and eligibility before even mentioning specific drug prices. Companies offering discount cards will be able to raise their prices under some circumstances. Consumers, however, will have to stick with the card they choose until November. They'll have a chance to switch to another company's card then. After that opportunity, they'll be locked in until the new drug benefit is rolled out in 2006.

Others can get more information over the phone (1-800-633-4227). They're likely to find is a mix of discounts. Drug companies may offer lower prices on one drug but not another. It's as if you had to pick one supermarket based on advertised specials knowing the store with the lowest meat prices charged more for vegetables.

Seniors will get discounts with their drug cards, if they can negotiate the government's confusing system. But even if they can, knocking 15 percent off a high-priced prescription drug only makes their medication a little less unaffordable.

- St. Louis Post Dispatcha