Paul Krugman: D is for Debacle

Rozius brings us Paul Krugman's Monday (May 15th) column on the Medicare Part D Debacle. Here's a big snip-snip-snip:

President Bush refuses to extend the sign-up period. "Deadlines," he said last week, "help people understand there's finality, and people need to get after it, you know?" His real objection to extending the deadline is probably that this would be an implicit admission that his administration botched the program's start-up. And Mr. Bush never, ever admits mistakes.

But Part D's bad start isn't just another illustration of the administration's trademark incompetence. It's also an object lesson in what happens when the government is run by people who aren't interested in the business of governing.

Before we get there, let's talk for a moment about the problems older Americans have encountered over the past few months.

Even Mr. Bush has acknowledged that signing up for the program is a confusing process. But, he says, "there is plenty of help for you." Yeah, right.

There's a number that people needing help with Part D can call. But when the program first went into effect, there were only 300 customer service representatives standing by. (Remember, there are 43 million Medicare recipients.)

There are now 7,500 representatives, making it easier to reach someone. But should you believe what you're told? Maybe not. A survey by the Government Accountability Office found that when Medicare recipients asked for help in determining which plan would cover their medications at the lowest cost, they were given the right answer only 41 percent of the time.

Clearly, nobody in the Bush administration took responsibility for making Part D's start-up work. But then you can say the same thing about the whole program.

After all, prescription drug coverage didn't have to be bafflingly complex. Drug coverage could simply have been added to traditional Medicare. If the government had done that, everyone currently covered by Medicare would automatically have been enrolled in the drug benefit.

Adding drug coverage as part of ordinary Medicare would also have saved a lot of money, both by eliminating the cost of employing private insurance companies as middlemen and by allowing the government to negotiate lower drug prices. This would have made it possible to offer a better benefit at much less cost to taxpayers.

But while a straightforward addition of drug coverage to Medicare would have been good policy, it would have been bad politics from the point of view of conservatives, who want to privatize traditional social insurance programs, not make them better.

What really pissed me off - besides huge issues like how Bush and the GOP gifted PhRMA with an agreement not to demand better pricing at a time when med prices are going up astronomically each month - was that Bush refused to allow any protection for confused seniors who didn't get in by Monday citing that seniors "had to learn that there are consequences for bad actions."

When the flying frick has Mr. Bush E-V-E-R paid a consequence for HIS bad actions? Name a single time.