It All Depends

If I were a senior contemplating what my Medicare and prescription drug coverage might be like when The Medicare Prescription Drug, Improvement and Modernization Act of 2003 starts to take effect, I think I would start stocking up on Depends. Now.

Id also probably look into hiring an accountant to take me through the shoals of a drug coverage plan so complicated that only our Congress could proudly claim responsibility for it.

Now why would I rush out to my nearest Sams Club and start clearing the shelves of Depends? The answer is simple but terrifying: I (as a senior) am being encouraged to trust myself to the mercy of the federal government and Medicare Health Maintenance Organizations.

Seniors are of a generation for which the old adage “Once bitten, twice shy” still means something. Many of them have been bitten by the two entitiesthe government and the Medicare HMOsthat they are now being asked and encouraged to trust.

Many are still bitter over the experience they had a few years ago when they signed up for what seemed like dream coverage with Medicare HMOs only to be left out to dry when funding from the government dried up.

Many HMOs, particularly in those states with hefty senior populations (think Florida) are holding a full court press to get seniors to sign up (or sign up again) for their Medicare coverage. Seniors are being treated to breakfast and all sorts of other good thingswith the hope that eventually they will sign on the dotted line. Theyre being told that this time around it will be different. And so it may appear.

The bill, after all, promises some hefty funding to Medicare HMOs in order to get them to sign upand keepseniors on the enrollment lists and thereby start to trim Medicare costs.

Feeling flush with this promised cash, Medicare HMOs are all but falling over themselves to get seniors on board. According to some reports, however, it has not been the easiest sell in the world. But who knows, it may be different this time around.

Yet, there always lurks the sneaking suspicion that what Congress giveth, Congress can taketh away. And in the facing of large budget deficits and their concomitant call for spending cuts, this looks like a pretty juicy target for Congress to taketh away.

So if I were a senior being besieged by tempting offers from health care entities that had disappointed (not to mention, jettisoned) me before, Id want to be very sure before I took another leap. Maybe even have them sign a promise in HMO blood.