That's not a typo. It's PUTT''s not putz and this article has nothing to do with golf.
PUTT is the Pharmacists United for Truth and Transparency. PUTT don't like Medicare Part D. The president of PUTT claims in this link and elsewhere that Part D insurers are paid multiple ways, including on a capitated basis, rather than simply for the amount of drugs that flow through them. In other words, PUTT claims that the insurers get your money up front and then make money by denying your claims.
PUTT is correct to some extent. There is a capitation component in Part D. Should there be? It is the theory behind HMOs for 30 something years now. And it is the theory behind the Patient Protection and Affordable Care Act. Obama and Romney need to debate this issue. It seems to be working for Part D in that the program is running 35% below original projections in terms of Federal spending. But as for total costs including the part that we seniors pay, we just don't know.
But PUTT is way over-estimating here and elsewhere what the cost to the government is for direct subsidies. According to the most recent MedPAC report on the subject (March 2012 -- actual for 2010 and estimate for 2011):
In addition, the following sentence in the Tuscon Citizen quoting the gentleman from PUTT is possibly misleading (but I don't know if that's PUTT''s fault or the Citizen's). He says:
“Because Medicare turned over Part D to for-profit insurance companies, seniors are at the mercy of those companies without proper oversight. Oversight of Part D is atrocious.”
First, not all Part D insurers are for-profit companies. All PBMs may be for profit and all or some Part D non-profit insurers may turn over the management of their plans to PBMs. But if that's what he means, he should be clearer (consider who he works for in terms of how his wording is colored).
Second although I agree that saying "Medicare turned over Part D to for-profit insurance companies" is partially accurate (some are for-profit and some are not) the sentence might be read to mean that at some previous point in time Medicare did Part D itself and/or used non-profit insurers. That is not the case. Part D is only a half-dozen years old and has been run pretty much the same since it began. PUTT is twisting words a bit for effect (profits is somehow a dirty word these days). But premiums went down on average in 2012 and will supposedly rise only pennies per month in 2013.
Third, there is all kinds of CMS oversight built into Part D. Whether it is effective would also make a good debate for Obama and Romney (ditto for Medicare Parts A and B).
-- Dennis Byron
