Cost of drugs should be cut, not the access to the drugs

The Miami Herald: Even weeks after the nation's Medicare prescription-drug program took effect, it's still not working smoothly. Some of the worst snafus have lessened. Yet problems still plague the program. Many poor and disabled beneficiaries as well as middle-class seniors continue to face barriers to getting their normal medications, and not just because of implementation glitches. If Medicare Part D is to fulfill its promise, Congress must address inherent flaws in the program.
Medicare Part D was a child of political compromise and budget constraints. Congress ultimately forged a complicated plan that relies on private markets. In theory, private insurers negotiate with pharmaceutical companies to lower drug costs; and competition among insurers controls the cost and quality of the plans sold to Medicare beneficiaries. The federal government also subsidizes the drug costs, particularly for those who are low-income.
The reality has been daunting. At least 40 private insurance plans in most states have made comparisons difficult. The process has confused many seniors and their caretakers. Seniors also have encountered hurdles, erected by insurance plans, that keep them from getting prescription drugs that are supposed to be available.
Preauthorization
Miami resident Bunny Feinberg, 77, for example, was featured in a recent Miami Herald article. Though she did the research to pick a plan that offered the best deal for her needs, it turned out that one of her medications needs preauthorization to be covered, which requires her doctor to send forms to her insurer. Her plan won't cover another drug that she has been using unless she tries two other medications first.
Similarly, Lena Homer of Margate, Fla., is having trouble because her private insurer will cover only half the dosage of the blood-pressure medication her doctor prescribes. The issurer didn't acknowledge her doctor's request for authorization. Attempts to call the plan's managers have resulted only in hours on hold.
Complaints are echoed by Steven A. Levenson, president-elect of a national association of doctors who care for nursing home patients. "We have seen signs that Medicare drug plans are using management controls to deter access to medically appropriate drugs, including drugs on their own formularies," he told The New York Times last week.
Such barriers to access, on top of other difficulties, are provoking calls for congressional action.