Saturday, January 22, 2011

Part D — for duplicity

The following story is a small tale among volumes regarding the insanity of health care in this country.

Mine happens to be about Medicare, which is supposed to be one of our brighter lights.

I am having trouble seeing the light. The problem isn’t my vision, which happens to be my “presenting” medical problem.

You see I take two pressure-lowering eye drops to ward off glaucoma and possible blindness.

I’m 68 years old, a month away from 69, and I’ve been covered by a Medicare Med Advantage policy (through Oregon Regence Blue Cross/Blue Shield) for four years. It’s worked pretty well up until now.

Still in good health with no need for drugs, I had not enlisted in the Part D “drug coverage.” Then, a couple of years ago, the eye specialist said I needed the eye drops, and I paid out-of-pocket for the small vials. Xalantan vials cost me $86.96 and Istalol cost $129.06.

The total came to $216.02 out of pocket — every five or six weeks.

But late last year, understanding “drug coverage” to mean, well, “drug coverage,” I added Part D to my plan and saw my monthly premium rise. I figured I’d more than make up the modest difference when it came time to refill my eye drop prescriptions.

Earlier this month, I put Part D to the test. I renewed my prescriptions fully expecting to see most of my out-of-pocket costs vanish, save for modest deductibles.

The result: With “drug coverage,” the Xalantan cost me $75.00, the co-pay. The insurance, paid a staggering $11.96.

But the real surprise was the Istalol. It actually cost me more, $144.94. MedAdvantage’s Part D paid zip.

I’m still not entirely sure why, even after talking to the predictably pleasant Regence Med Advantage customer service representative. The price apparently had gone up or, because I had Part D “drug coverage,” I no longer qualified for a small discount through the state’s senior drug discount program.

So to review, without “drug coverage” I paid $216.02 for drugs; with “drug coverage” I paid $219.94. I can manage it, but it is evidence of a system gone mad.

I have since discovered there are bureaucratic explanations about generic and non-generic, and “tiers” of drugs and “formularies,” etc. My vial of Istalol lasts 40 days, which exceeds some 30-day limit.

You need to be a student of fine print to figure it all out. And, as I say, my eyes aren’t all that great to begin with.

Let’s face it, this country needs plain-and-simple, universal healthcare. Not “insurance” but healthcare.

Get rid of the flim-flam, the drug company’s wheeling and dealing with doctors, the formularies, the Big Pharma lobbyists, the donut holes, the tiers and the deductions.

The good news for me is that I’m among the fortunate who can afford these scams, at least for now. I worry about those who can’t, and I worry about a government whose patch-work, contrived program deceives and rips off its people.

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Thursday, January 20, 2011

"Information wars" in Washington DC

Our political culture has a “combat mentality.” It doesn’t exactly fit with our naive civics-class indoctrination from the 8th grade.

How bad are things in the world of politics?

Sometimes the “war” seeps out around the edges, as it did on Tuesday in a seemingly innocuous article about young Washington, D.C. aides hired to digest the news and present it to their bosses.

While news readers in technocratic departments seem to approach their jobs relatively dispassionately, Bobby Maldonado, 26, brings a different mentality to his job working for the U.S. Chamber of Commerce. He's up at 4 a.m. to get a jump on events so that he can strategically analyze, arrange and present them to his big-business bosses at the Chamber.

You get a flavor for his, and the Chamber’s, perspective when you read how young Maldonado describes his job.

“The information wars are won before work....Our executives walk into meetings and they’re doing battles, whether it’s on health care or cap and trade, and information is power, and my job is to make sure they’re armed with the most powerful information.”

“Wars,” “battles,” “armed.”

Reading the story, you don’t get the feeling that Maldonado is some Glock-toting kook. But he's just another soldier — and aide to battlefield generals. His words fit the political culture of victors and vanquished. These folks are out for blood.

And the media amplify it. Of all the headlines that the Times could have put on a tepid story, the one they chose came from Maldonado’s quote. “Where News is Power, A Fight to be Well-armed.”

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Monday, January 17, 2011

The corrosive drip of violent media metaphors

There’s a lot of talk in the news these days about politicians toning down their rhetoric following the Tucson shootings. Some of the talk was on page 2 of today’s Oregonian in a story headlined “Lawmakers take steps toward civility.”

The new speaker of the house, John Boehner, is reported as substituting “job-destroying” for “job-killing” in describing the Democrats’ health reforms. Never mind that there’s no evidence that the reforms either kill or destroy jobs.

This all sounds like just another contrivance of the Republican word-twisting consultant Frank Luntz, infamous for his “death panels (they were never proposed but they sound scary as hell),” “death taxes (aka inheritance taxes),” and “climate change (aka global warming).”

(Oregonians will remember “job killing” from the “Job-killing Taxes” campaign against measures 66 and 67 a year ago. The business-funded organization opposing the taxes even called itself “Oregonians against Job-Killing Taxes.”)

Back to Boehner. In fact, a reversal of the health care reforms, as advocated by Boehner and fellow Republicans could be literally “people-killing” for those without health insurance.

Ooooops. Make that “people-destroying.”

Come to think of it, what’s worse?

But I digress because this is a post about media rhetoric not about politicians defanging (softening?) their pronouncements.

When I say “media” I’m not “taking aim at” (see how easy this is?) FOX commentators exclusively. I’m talking about the likes of the Oregonian sub-editor who wrote the largest headline on today’s front page.

“Battle over Bioswales and Bikes” was clearly written by some over-reaching desk jockey unwilling or unable to take a lesson from Boehner and the suddenly civil. If you read the story bearing this over-blown headline, you will discover it has nothing whatsoever to do with a “battle” over bioswales and bikes.

The operative word in the story is “bungling,” as in Mayor Sam Adams’ bungling his promotion and financing of bioswales and bikeways (not "bikes," as stated in the headline).

Any high school journalism student could find the obvious headline: “Adams bungles bioswales and bikeways.”

But oh no, we need to wage war here (readers love conflict, even if it doesn’t exist, right?), so let’s up the ante to “Battle over Bioswales and Bikes.”

Headlines like this are just one more example of media exaggeration reliant on fabricated, violent metaphors. It is part of the slow, daily drip of “information” and "news" eroding civility in our culture.

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