Friday, December 29, 2006

Health Care Politics and the Elderly

This piece of news is a few days old but what it describes is still relevant:

Some prescription drug plans did not inform Medicare beneficiaries of impending changes in their costs and benefits, as they were required to do, Bush administration officials and Congressional aides said Tuesday.

This could be a serious omission in a program where beneficiaries need accurate information to choose among dozens of competing private plans.

Administration officials have told Congress that they may give these beneficiaries a six-week extension of the open-enrollment period, which ends Sunday. Beneficiaries could use the extra time to compare the options that will be available to them in 2007.

Drug benefits are administered by private insurers under contract to Medicare. Premiums, co-payments and the list of covered drugs vary by plan. In general, people who are enrolled in a drug plan and take no action by Sunday will remain in that plan throughout next year.

Even when a Medicare drug plan keeps the same name, its costs and benefits may change substantially on Jan. 1. Medicare officials repeatedly told insurers that they must notify beneficiaries of such changes by Oct. 31 of this year. But some insurers did not send out the "annual notice of change" documents, which can be 30 or 40 pages long.

Thirty or forty pages of information to decide which plan to sign up with? How many of the insured elderly can digest that and make meaningful choices, what do you think? How many of the non-elderly could do so?

This is a real problem with the patient-initiative school of pro-market health care politics. Patients don't really have the time and the expertise that is needed to make sense of the myriad different policies which often differ in ways that are hard to spot but which may come back to bite your ass. Note that people are not just asked to compare prices the way we do when buying ordinary groceries. They are also asked to compare the quality of the services and to try to predict their own health needs in the coming year. Now, a voodoo board might do as well for all that as poring over those forty pages.