The Medicare FUBAR...Thanks George!

[mom cat]

I just wrote the Globe about the Medicare Drug Plan mess.
Legally, people who have been on Medicaid and Medicare are all supposed to get "extra help" under the new Medicare Drug Plan. Medicare provided the insurance companies with the names and Social Security numbers of all of the people eligible for this special consideration. These are the disabled people in the states. They are supposed to pay no mote than $5.00 for brand name perscriptions and no more than $2.00 for generic perscriptions.
However, there is a big nightmare of a snarl out there because the new drug plan providers have got serious computer foulups. I have been on the phone for days trying to rectify just one such situation. The pharmacy wants to charge an exorbitant rate for a medication that a certain disabled person used to get for one dollar. The pharmacy is relying on the information that the insurance companies computer is giving to the pharmacy. Even though the state's Medicaid program and the Medicare program both say that this person is eligible for the lower rate, the insurance companies computer says differently.
To make matters even worse, the insurance company is not even answering their phone anymore. They just have a brush off message that says "due to have a call volume, we are not able to take your call right now. Please call back later."
Well what if a person would die without the medication in the pharmacy wants to charge $5,000 he even though legally that person should not have to pay more than five dollars. This actually has happened! Fortunately that person's family was able to scrape together the money to get the life-saving medication for that person that day. Also fortunately, the senator was able to intervene and straighten out the mess for that person. I just worry that other people may be dying because they don't know how to reach out for help. This is an outrage! The insurance companies are making out like bandits with this new program. They have known for a long enough and been given enough warning that the nightmare was going to happen. These stingy bastard's could not even get it together to hire enough people to feel the onslaught of phone calls from desperate people.
Right now a senator is working on the medication I originally referred to. The person is scheduled to pick up the medication tomorrow and I have written the Globe telling them about the situation in hopes that this can get straightened out.
The kicker is that here in Massachusetts, the state passed emergency legislation that is now on the books that says anyone with Mass Health can receive a 30 day supply of any medication for the old rate, thus giving time to relieve the bureaucratic snarl. But communications are in such a state of FUBAR that nobody knows what to do. Considering that the insurance companies are literally going to make billions of dollars off of this boondoggle, the least that could be expected would be that they would hire a few part-timers to answer the GD phones.
If you know of any other situations, please share them here.

[oscar111]

1. FUBAR? ? and, privitazation to blame

tas i see it, the problem is that the plan was privatized from birth.
I also suspect that the lion share of the gov funding is grabbed away by the greedheads running the private layer, leaving pennies of fed grant money to the patients.

the soloution is to nationalize all four parts of healthcare.

docs
hospitals/nhomes
insur
Big Pill

Kerry's plan was to only nationalize insur., AFAIK. Good, but not good enough.

leave no corner in private hands or see a repeat of the mess seen in the OP above/

twenty four nations outlive us. no wonder.

HOUSECALLS, in eng. and germany. Possibly others, ask around. We could get them with a nationalized health.

[mom cat]

2. You are so right about the role of privatization in this mess!

I am sure that people are going to die during this transition because the greedy insurance companies are unwilling to hire a number of minimum-wage people it would take to staff the number of phones required to handle this mess. Their profits are going to be in the billions of dollars when all is said and done. They have known since this legislation was passed that they would have to deal with 42 million confused people on the same day. This was a logistical nightmare that was seen by all of the advocacy groups and could have easily been prevented were it not for raw greed.
I fully concur with your assessment that a national health-care system is needed in this country. Unfortunately, this country is for the greedy, not the needy.