New York Times Goes Back to Bashing Choice in United States Medicare; All's Right with the Universe

Earlier in August I noted surprise that the New York Times (and other left-wing opinionators) had all of a sudden become big fans of public Part C Medicare Advantage.¹ Thankfully the world righted itself on August 21 as the Times attacked Part D with its usual distortions. The attack comes in an article called "Part D Gains Eroding...," which at least forced the Times to admit that Part D.. at least had some benefits at one point... at least in the Times' opinion.

The author of the New York Times article either has not read the Harvard/UMass report referenced in the article or is misrepresenting it intentionally. I can't tell which because the Harvard/UMass research itself is not done very well. The UMass/Harvard research is supposedly about the subject of seniors not taking their Part D meds because of financial concerns but the research does not analyze the effects of state pharmaceutical assistance programs (SPAPs) on this finding². Not accounting for SPAPs makes no sense given the subject. SPAPs -- along with Social Security Extra Help -- are designed to address low and middle income seniors. Some states do that better than others and it would be very important to the researchers' theory to know if the findings differed in good SPAP states vs. bad SPAP states. For example, if these numbers (see image) applied in Massachusetts where our SPAP is so good that no one making under $70,000 in retirement (90% of retirees) has any financial worries when it comes to Part D drug costs, then the cause would not be finances.

 

But there is even a bigger problem with this article relative to what the UMass/Harvard research shows (see image above). The research says on average financial "hardship"/nonadherence due to finances only affected 10%-15% of seniors in the first place... in 2004 before Part D. Then, according to the research, by 2011 Part D cut those two already low numbers by 33% in one case and by more than 50% in the other. (The image above from the Harvard/UMass report breaks the overall averages out between people with many chronic conditions and those with fewer chronic conditions³. The same trends apply.)

 

The Harvard/UMass researchers admit that their weak findings are inexplicable and that their theory that the Part D donut hole⁴ and the Republicans (and of course George W. Bush) are to blame is just a theory. Instead I would theorize that adherence above 90% with a less-than-10% "hardship" finding is as good as it gets. (Alternately, I would theorize that the movement in these numbers is so minor from 2004 onwards that Part D had nothing to do with them... that they are simply a factor of general TV advertising of drugs).

 

But none of this New York Times attack on Part D is about seniors anyways. All the author cares about is attacking Part D because it was signed under George W. Bush. Whether Harvard/UMass were innocent victims of the Times or willing participants is open to question. The world is back to normal.

 

¹It didn't make sense because the Times is the mouthpiece of the Democratic Party agenda in the United States and the highly sucessful and popular Medicare Parts C (and D) are considered the Republican portions of Medicare (despite the fact that the former was signed by President Clinton and the latter was proposed by him). Part of the Democratic Party platform is to repeal and replace Parts C and D of Medicare.

 

²The UMass/Harvard researchers also should have used much more timely data and added other groupings. For example, their report does not seem to distinguish between beneficiaries in LIS-subsidized public Part C Medicare Advantage plans with drug coverage vs. those "paying full price" for Part C. It lumps all Part C users together, possibly even those on special needs plans that are not techically part of Medicare Advantage.

 

³The UMass/Harvard research never explains why it made the cut at four conditions vs. three or five. I suggest that perhaps it is a statistical trick.

 

⁴The donut hole has no affect on people on Part D Extra Help and little affect on a person on a good state's SPAP. Perhaps the small number of people not taking their meds before and after Part D just don't take meds. I think that explanation is called Occam's something.