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Copyright © 2001 The Seattle Times Company
Editorials & Opinion: Friday, February 16, 2001
Guest columnist
Drug-discount program won't help the poor
By Kathleen O'Connor
Special to The Seattle Times
We all know about the road to Heaven's opposite being paved with good intentions. Well, that's what we have with the governor's proposed AWARDS program for prescription drugs. It is a token program that is a bandage on a gaping wound.
It helps the middle income, not the poor. It takes the discount from those in the food chain who are least able to afford it - pharmacies, especially small, rural mom-and-pop pharmacies. It is being implemented by rules rather than by a thorough legislative review and discussion. In fact, only one hearing was held on this issue - in Kent in December. It can be implemented quickly because no "new spending" is required.
Worst of all, it does not address the problem of offering affordable prescription drugs to truly low-income seniors. It may be step one in a multiple-step dance, but it is a bad first step that creates adversaries unnecessarily.
Here's how it works
AWARDS is a discount program. Just like an AARP or Safeway card, it offers the cardholder a discount. No income test is required to participate in the program - all you have to do is sign up if you are over 55 and don't have other prescription drug coverage (for information online, see www.wa.gov/hca). Over 3,000 people have signed up so far. The rules were effective Jan. 15 and the program will be up and running March 1.
While there is no doubt this is a benefit for seniors and others who have no prescription coverage, including the uninsured, the fact remains that it is simply a discount program. And, the discount comes out of the hides of only one group: pharmacists.
At the hearing in December, over 90 people protested the program - seniors as well as pharmacists. But, it is still being implemented. Two lawsuits have been filed: one to prevent its immediate implementation (dismissed), and another that challenges the authority of the governor to implement this through rules.
Let's do the numbers
Discounts are nice, but they don't solve the problem. My mother is 82 years old. She receives $905 a month from Social Security - hers and half of my father's after he died. Luckily, my father had some retirement and some investments. She can afford the $76 a month she pays for Fossamax; a 20-percent discount would be frosting on the cake.
But, Social Security income is also based on pre-retirement income. So, those who worked at the poorest-paying jobs and who may or may not have additional retirement income or ever owned their own home are paying for rent and food out of their Social Security checks. If it were not for being able to receive half of my father's Social Security, my mother's Social Security check would have been close to $450 a month. Some women live on as little as $400 a month from Social Security.
What doesn't get purchased when $76 of $450 goes to Fossamax? Or maybe you don't take Fossamax and fall and break a hip.
Maybe someone can do without an osteoporosis drug; after all, it is not life threatening like diabetes. Take the case of the 76-year-old man whose diabetic medications, including insulin, syringes and testing supplies, come to $650 per month. The AWARDS program means he will only have to spend, maybe, $520 a month to stay alive, depending on whether they include syringes and testing supplies in the discount.
Leadership by lament
With laments of "it's the best we can do and offer a balanced budget," the governor's office said its hands are tied. They say that because of the Initiative 601 spending limits and the other state initiatives, they cannot propose money for new programs when there is not enough money for existing ones.
Are these choices what the people really intended when they voted for I-601 or to give teachers raises? Leadership would get out there and say these are not acceptable choices. We, as a state, are better than this - better than being forced to choose between roads and adult day health care. Someone needs to say this.
That's really why the AWARDS program is so bad. It caves in to the "we don't have any choice" victim approach to public policy. It tries to ramrod a solution rather than engage us in a public dialogue that might have produced viable alternatives. It asks only one group to finance the discounts - pharmacies. Worst of all, the true victims - the low-income elderly - still can't afford their medications.
Several bills will be forthcoming in Olympia on prescription medications. Let's hope they address the inequities and inadequacy of the AWARDS program.
Kathleen O'Connor is a health-care-industry analyst, consultant and speaker based in Seattle, and publisher of The O'Connor Report.
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