Just about every day I read about problems with Medicare Part D (and that's no exaggeration). Whether it's beneficiary confusion or provider headaches, media outlets across the country have aptly chronicled Part D's initial problems. I personally have bemoaned the new benefit's complexity when having to write on the topic. So it's easy to become pessimistic and have a negative attitude toward Part D.
But no one ever said this was going to be easy. The prescription drug benefit is the biggest change to Medicare in its history. Yes, Part D has many flaws. I agree with the critics: Seniors face too many and too confusing plan options; Congress should have allowed Medicare to negotiate lower drug prices; and some program elements make little sense when applied in the real world (does the “doughnut hole” come to mind?). Part D is hardly a perfect program.
Yet Part D is the best we have at this point. Of course it has its flaws—show me a government program of this size that doesn't. Seniors and people with disabilities need prescription drug coverage, and I'm confident that having some coverage is better than having no coverage at all.
I'm not implying that federal lawmakers and administrators are off the hook. Part D has serious problems, and a more bipartisan effort would have produced a better benefit. Changes are definitely needed, and I suspect the program will undergo much reform over the ensuing years (just look at how long we've been tinkering with Parts A, B, and C). Your input as behavioral health providers and payers will be critical as changes to Part D are debated.
But for my part, I am going to try to not get too overwhelmed by negativity when voicing my concerns. Part D deserves a chance to succeed. I know that it's easier for me, as a writer, to say this than for you, as professionals facing Part D's problems every day. Yet I've decided to take a more optimistic view. Despite all its flaws, Part D has good intentions—intentions that will take time to fully materialize.
Sure, consultants will get rich, fraud and waste will be found, and beneficiaries will be unfairly denied important medications. But many people suffering from mental illnesses no longer will have to choose between paying for prescriptions or buying food or turning up the thermostat. To me, that makes getting through this initial rough period with Part D worth all the effort.
Let's not give up our fight for a better benefit, but let's not get too weighed down by Part D's problems, either. A healthy dose of optimism might just be the prescription that leads to cures for many of Part D's ills.
Douglas J. Edwards, Editor-in-Chief