Pharmaceutical companies used to offer patient assistance programs that would provide free or deeply discounted drugs to the elderly and the disabled. But with the new Medicare drug coverage benefit now in effect—the biggest Medicare expansion in Medicare's 40-year history—the federal government is forcefully taking over that role. Just thirteen days into the new year, many patients are already longing for the old days.

From the Wall Street Journal¹:

What is clear is that the new Medicare drug benefit, created to make prescription drugs more affordable for the elderly, is having the unintended effect of making it more expensive, or prohibitive, for some poor older Americans to get their medications.

At least one million people who would have qualified for the industry programs make too much money to get any government assistance to help with the out-of-pocket costs under the new Medicare plan.

Additionally, what isn't failing by design is failing in execution. From the Philadelphia Inquirer²:

Many of the most vulnerable elderly and disabled patients have been unable to get medicine since the program's start on January 1. Calls for help to Pennsylvania's health insurance hotline have reached record levels, and several pharmacists said they had never seen greater chaos.

[A Medicare spokesperson] said the agency had identified a computer glitch that caused several hundred thousand of the poorest recipients nationwide to be overcharged and thus they had to go without their drugs. The agency is working on the problem.

In policy planning and design, there is no such thing as a "side-effect." There are only effects, some of which are understood and anticipated, and others which are ignored or evaded.

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¹Levitz, J., Armstrong, D. "Low-Income Seniors Get Tangled In Unexpected Medicare Glitch." The Wall Street Journal. January 13, 2006.
²Sullivan, J. "Medicare meltdown." Philadelphia Inquirer. January 12, 2006.

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