How do you hold down the cost of a govt program aimed at the poor? Don't tell 'em about it

You may remember that the Bush Administration was forced into proposing a drug benefit to help seniors offset the ridiculously high prices for drugs which the pharmaceutical companies claim helps them reclaim their 'development costs' even though they usually develop those drugs on the US govt dime, making those 'costs' minimal. Junior got elected at least in part (the election wouldn't have been close enough to steal, otherwise) by appropriating this Democratic initiative.

But with the BA, as we've come to know, there's a big difference between passing a social program and paying for it. With the No Child Left Behind Act, for example, they passed the law without appropriating the money for it, effectively forcing the costs onto the local tax structure. With the drug benefit, we're seeing a different tactic: don't tell 'em about it.

Bush administration officials say the drug discount card would save Medicare-eligible residents from 10% to 18% on brand-name drugs and from 30% to 60% on generics until 2006, when the government's Medicare prescription drug subsidy kicks in. Many low-income seniors at the complex qualify for an even better deal: a $600 annual subsidy plus substantial savings from some drug manufacturers for individuals who earn less than $12,569 a year and couples who make less than $16,862.

But days before the discount card was set to take effect, no one among 10 Lakeview seniors gathered in the lobby of the complex had enrolled in the program.

None of seniors had received materials from the government or promotional mailings from private card sponsors explaining the program. They were eager to learn more about the card but said they didn't know the government's toll-free information number and didn't have access to the Medicare website. No one had come to the complex to tell residents about the discount card, they said.

"I wish they would," said Rhonda Van Dyke, Lakeview's manager. "For most of our residents, this would really help."

That's why they're not telling them, dear. They have a couple of other little tricks up their sleeves, too.

1) Make the system too confusing to understand.

Democrats and some consumer groups have produced studies showing that seniors could save more money by shopping around on the Internet or buying their prescription drugs from Canada.

Even many Republicans, seniors' groups and private card sponsors acknowledge that the enrollment process, which requires seniors to choose from among 40 national cards and some of the 33 regional ones, is cumbersome and confusing.

Yet nearly everyone, including the harshest critics of the new Medicare law, agrees that the $1,200 low-income subsidy — $600 this year and another $600 in 2005 — would make the discount card a sure-fire winner for most of the 7.2 million poor seniors believed to be eligible.

2) Put the enrollment program on the internet for a target population that has the lowest percentage of computer ownership and internet access.

Earlene Smooth, 76, takes six prescription drugs for hypertension and diabetes. "If it wasn't for my children helping me sometimes, I wouldn't get my medicine," she said.

But the bespectacled widow, sharply dressed in a lime green sweater, floral-print skirt and white moccasins, said she did not plan to sign up for the discount card.

"I read about it but I don't understand it," she said. "They tell you to go on the computer, but everybody doesn't have the computer. There's no way to really find out what's better for me. The government should really have a plan you can understand."

They would if they wanted you to participate, Earlene. They don't, that's the whole point of this exercise. The fewer people sign up, the fewer expensive prescriptions they have to pay for. And these tactics are working.

James P. Firman, chairman of the Access to Benefits Coalition, a network of 68 nonprofit groups working to tell low-income seniors about the discount card, welcomed the federal funds but said new strategies, corporate partnerships and still more money would be needed to achieve the coalition's goal of enrolling 5.5 million poor beneficiaries by the end of next year.

"Most public benefits outreach efforts until now have been to find needles in a haystack," said Firman, who also is head of the National Council on Aging. "We believe the challenge is to find the stacks of needles."

But what about the tv ads the BA paid for? Those are informational, aren't they? Didn't those tell everybody where to go and what to do?

Well, um, not exactly. From an NYT report:

The videos--produced by the Department of Health and Human Services...praising the benefits of the new Medicare law, which would be offered to help elderly Americans with the costs of their prescription medicines--are intended for use in local television news programs. Several include pictures of President Bush receiving a standing ovation from a crowd cheering as he signed the Medicare law on Dec. 8.

The BA used the money that was supposed to be used for informational videos to produce thinly-veiled campaign ads taking credit for the program they don't explain. Result?

John H. Robinson, 71, fished his worn Medicare card out of his pocket and said he got no help in paying for his prescriptions. "I pay across the board, $287 a month," he said, for three prescriptions for his heart, blood pressure and kidneys.

Robinson, who lives on Social Security, probably would qualify for the Medicare card's low-income subsidy but doesn't know how to get it. "I heard something on the TV," he said, "but no one's told me about it."

They don't miss a trick, those Bushies.