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Health Leaders Urge Changes in Medicare Drug Benefit

By Sarah Abruzzese, CQ Staff

July 14, 2006 -- The majority of health care opinion leaders surveyed in a poll released Friday say they believe the Medicare prescription drug benefit helps beneficiaries but that modifications are needed.

"Part D is really helping millions of people afford prescription drugs," John Rother, group executive officer of policy and strategy for AARP, said in a commentary on the survey published by The Commonwealth Fund. But, Rother said, the benefit needs to be changed to eliminate the asset test and simplify the process so more low-income beneficiaries will receive the subsidy and be covered.

Harris Interactive conducted the survey online for The Commonwealth Fund. It was sent to 1,246 opinion leaders in health policy and innovators in health care and finance and 180 responded.

Ninety-five percent of the responses from the business, insurance, and health care industry sector support the law. Those in academic and research institutions, health care delivery, and other related sectors were less supportive—56 percent to 67 percent said it was good for beneficiaries.

The majority of respondents said changes should be made to the benefit. A minority said making Medicare drug coverage available only through private plans is good for beneficiaries, while a little over one-third agree the current benefit structure—including the "doughnut hole," or coverage gap where enrollees are responsible for all their coverage out-of-pocket—will help beneficiaries most vulnerable to high drug costs.

The majority of respondents are in favor of several proposed changes to simplify the benefit. While a greater number of respondents in the business sector favored leaving in the deadline penalty for late enrollment, only 8 percent overall said the 1 percent monthly penalty for late enrollment should be left in place. The majority, 51 percent, favored extending the May 15 deadline and removing the penalty, and 39 percent favored leaving the deadline in place but allowing people to enroll in the program next year without a penalty.

The survey overwhelmingly shows support for the Medicare drug benefit, but Stuart Guterman, director of the Program on Medicare's Future at The Commonwealth Fund, said there are big differences in opinion between groups. Specifically business, insurance, and health care industry groups differ with all the others on the best way to proceed and how satisfied they are with the status quo. "The business and insurance and health care group is much more satisfied with the status quo," Guterman said.

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