By Michael Kaufman
One day last week my wife went to Akin’s Pharmacy in Warwick to have a prescription filled. Akin’s has been our family’s pharmacy since we moved to this area some 10 years ago. We appreciate the attentive personal service offered by the pharmacists, Robert Newhard and his sister Jean, and their associates and support staff. In the last few years we have shunned the insistent urgings of our respective employers’ health insurance companies to use their mail-order services to have our prescriptions filled. Their hard-sell approach includes discount offers and other incentives designed to convince us of the advantages of abandoning our home-town pharmacy in favor of an impersonal, far away post-office box.
As she awaited her turn to be served, my wife overheard a conversation between an Akin’s customer and employee. The customer, an older woman with a physical disability, had just expressed her shock at the high cost of her prescribed medicine. “Medicare always covered it before. Why aren’t they covering it now?” As the employee gently explained that she had arrived at the perfidious “donut-hole” stage of her coverage, my wife heard another patron grumble something about “Obamacare.”
The woman said she didn’t know what to do. She needed her medicine but she didn’t have the money to pay for it. After conferring with the pharmacist, the employee returned with the filled prescription. “We’ll put it on your tab,” she said, “and the pharmacist will call them and try to see what we can do to get it covered.”
Several lessons may be drawn from this episode. Obviously, no mail-order pharmacy would have provided this woman with her medicine without payment. The same is true of big-chain drug stores like CVS and Rite-Aid, both of which have branches in Warwick. But this incident also illustrates the widespread ignorance on the part of citizens who are unfamiliar with the implications of the healthcare-reform legislation passed last year. For all its faults, “Obamacare” aims to eliminate the donut hole—that is, if the Republicans about to assume control of Congress allow reform to go into effect.
The donut hole is a carryover from Medicare legislation enacted in 2006 during the Bush administration, when elected officials who are in the pocket of the big pharmaceutical companies insisted on its inclusion. After a Medicare beneficiary surpasses the prescription drug coverage limit, they are financially responsible for the entire cost of prescription drugs until the expense reaches the “catastrophic coverage” threshold.
This paved the way for the big health insurance companies to start selling “gap insurance” to those seniors who could afford it. According to a study done in 2007, premiums for plans offering gap coverage are roughly double those charged by the same insurers for their standard plans.
With the passage of the Patient Protection and Affordable Care Act of 2010 (so-called Obamacare), people who fall within the donut hole receive a $250 rebate within three months of reaching the coverage gap to help with payments. (The U.S. Department of Health and Human Services began mailing rebate checks earlier this year.) The donut hole is slated to be completely phased out by 2020, but that seems a long way off and we are currently witness to an all-out assault against “entitlements.”
As U.S. Sen. Bernie Sanders, I-Vt., wrote recently, “The billionaires and their supporters in Congress are hell-bent on taking us back to the 1920s, eliminating all traces of social legislation designed to protect working families, the elderly, children and the disabled. No ‘social contract’ for them. They want it all. They want to privatize or dismantle Social Security, Medicare and Medicaid and let the elderly, the sick and the poor fend for themselves.
“They want to expand our disastrous trade policies so corporations can continue throwing U.S. workers out on the street as they outsource jobs to China and other countries known for low wages. Some want to eliminate the minimum wage so American workers can have the ‘freedom’ to work for $3 an hour. They want to eliminate or slash the Department of Education, making it harder for working-class kids to get a decent education, child care or the help they need to go to college.
“They want to curtail the powers of the Environmental Protection Agency and the Department of Energy so ExxonMobil can remain the most profitable corporation in history and oil and coal companies can continue to pollute our air and water.
“They want to make sure billionaire hedge-fund managers have a lower federal tax rate than middle-class teachers, nurses, firefighters and police officers by maintaining a loophole in the tax code known as ‘carried interest.’
“We know what billionaires and their Republican supporters want. They’ve been upfront about it. But what about Democrats? Will President Obama continue to reach out and compromise with people who have made it abundantly clear that the only agreement they want is unconditional surrender? Or will he use the powerful skills we saw in his 2008 presidential campaign and bring working families, young people, the elderly and the poor together to fight these attacks on their well-being?
“Will Senate Democrats continue to pass tepid legislation, or will they use their majority status to protect the interests of ordinary Americans and—and for a change—put Republicans on the defensive?”“
While it’s true billionaires and their supporters are ‘fired up and ready to go,’ there’s another, more important truth: There are a lot more of us than there are of them. Now is the time for us to stand together, educate and organize. Now is the time to roll back this orgy of greed.”
This is a lot easier said than done. So far the billionaires have done a good job of misleading people by pointing the finger and blaming “big government,” “government spending,” and “Obamacare” for all our country’s woes. But Bernie is right. We see the victims of the orgy of greed each day of our lives, even in our own little drug store in Warwick.
Michael can be reached at firstname.lastname@example.org.