Plan D Becomes Plan Disorderly
By George Anderson
The new Medicare prescription plan has created confusion and longer waiting times at pharmacy counters in Corpus Christi, Texas, reports KRIS-TV.
Pharmacy workers are finding that they need to spend more time on the phone and the computer to answer questions and sort through early implementation issues.
“What’s happening is that this is creating wait time…for the customer,” said H-E-B pharmacist Balde Garcia.
H-E-B has posted a sign alerting customers that problems may arise as the new program gets underway but that medication will always be available.
One of the immediate issues being faced, said Ms. Garcia, is that “co-pays are coming in at much higher rate than what they’ve (Plan D participants) been told so we’re working
through those right now.”
H-E-B has assigned extra people to its pharmacies simply to deal with Plan D questions and issues.
“There have been some trying times but I know we’re going to work through them. I see a light at the end of the tunnel. There’s things that are happening [on an] everyday basis
that’s allowing me to better serve my customers…my patients,” said Ms. Garcia.
Moderator’s Comment: Are the issues described in the KRIS-TV report common in other parts of the country? How are pharmacies dealing with the challenges
posed by Plan D? –
George Anderson – Moderator
The confusion is overwhelming everywhere. A perfect recipe for big trouble: simultaneously starting a new program for millions of people with dozens of insurance companies and thousands of pharmacies all on the same day, with many of those millions in poor health. Back in the late 1990’s, when IT shops debated gradual switchover versus big bang installation of Y2K compliant systems, the brightest systems people created exhaustive test procedures and ran those tests repeatedly, with realistic volumes. The key players in this fiasco could’ve made this launch the best-known advertisement this year for complete systems and procedures testing, including training and education. Instead, they mailed out a 98 page book to millions and ran for cover.
This has to be the poorest implementation of a new program or procedure that I am aware of. Trying to get straight answers was incredibly difficult because many of the people that were supposed to have the answers didn’t know either. That didn’t stop some of them from giving out information anyway and that resulted in conflicting and bad information being given to many people.
My mother is in a nursing home and I received different interpretations from the nursing home, the state of Illinois, and her insurance carrier. I decided that the state would be the most likely correct source in her case and we changed insurance companies. This decision could change if her medications change to something that is not approved by her new insurance company.
Is it any wonder that the bureaucracy that is responsible for making our tax laws so simple that a child can do them would make this so hard?
As usual, our government made Part D too confusing for the average consumer. I spend over an hour running options for my mother-in-law. The majority of seniors don’t have friends or family with big fast computers and years of analytical experience to evaluate options. While the insurance providers need options, the complexity is beyond reality and market needs.
Cain’t see what all the fuss is about. I’ve been seeing a television commercial frequently over my few weeks in the US, fronted by a former Republican politician turned actor (who, I’ve been told, has coached both John Roberts and Samuel Alito for their judiciary committee interviews) recommending a single website that will answer all questions and advise on the best decision for the individual concerned. No sweat.
Medicare Part D — another disaster that the country has to now deal with? And, once again, government is slow to react.
Much of the confusion stems from the auto-enrollment process from state Medicaid programs to Medicare. The planning was poor, the system is not equipped and the communication incoherent. So … what does this mean? It suggests that we now know there are problems and the system must be fixed. Pharmacists, although frustrated, will persevere. Patients, although troubled and confused, will be calmed. And government? They hopefully will allow the commercial sector of the country to pick up the pieces and put Medicare back on the path it belongs on.
There are several certainties: Medicare is here to stay and the hurdles in a very bumpy road will be paved smooth.
I heard a news report this morning of another sweeping change that caused similar ripples that are now being addressed – much after the fact. In the State of Wisconsin, a brand new Department of Motor Vehicles computer system was launched at the beginning of 2005. Designed to improve communication, speed the process and streamline the challenges oft related to the DMV. The outcome – processing time for new license plate requests and renewals did indeed change … it went from 2 weeks to up to 5 months! This is yet another example of a well-intended plan that was simply not thought out well.
And the beat goes on!