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View Diary: Six million lost coverage on first day of Bush Medicare drug program (40 comments)

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  •  And my point is that there is no precedent (1+ / 0-)
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    either way.

    This is the first bill this huge -- that affects virtually everyone in the country and alters the structure of a 15 - 20% of the economy when it's fully implemented-- to pass with absolutely no support whatsoever from one political party.  

    A tax hike where you essentially just raise marginal rates takes no implementation.  You don't NEED any cooperation to implement.   You don't have to write a book of regulations.     The ACA was always going be a huge project to (1) write the applicable regulations; and (2) implement.  Not like a tax hike.  Not. At. All.

    The ACA is more on the scale of passing Social Security or Medicare or the prescription drug program.  All of those required implementation (perhaps not even as much as the ACA).  None of those was passed solely on the votes of one political party.

    So, there's no real precedent, one way or the other.

    •  It's to the right edge w/coffeetalk...Squirrel! (1+ / 0-)
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      The diarist has laid out the parallels clearly. Except he has understated how badly botched the transition was of more than SIX MILLION elderly and disabled dual eligibles from nonprofit, single-payer Medicaid drug insurance to for-profit, 45-private-plans-per-state Medicare Part D insurance. Poor people who had medication they needed to live on Dec 31 could not get it on Jan 1. The months leading up to the 'transition' were chaos, with accurate information on how to make choices impossible to get. Which was especially hard for the large percentage of the dual eligible population without HS diplomas, or with dementia and/or severe cognitive disabilities. It is a clear, highly relevant precedent, no matter how many shiny objects and furry rodents you fling to the right of the thread, as per usual.

      The Part D transition was so much more badly botched. Many of the most vulnerable, sick and desperately poor Americans had their health immediately and seriously endangered. Many businesses were thrown into utter chaos, and lost substantial money. The program remains a headache and a boondoggle to this day.

      My pharmacies simply issued me my scripts without charge. They knew I needed my medicine, and that I had no way to pay the retail cost. As far as I know, they were never reimbursed by anyone. I suspect the pharmacist at one place may have lost his job because he chose the lives of his patients over his company's bottom line.

      Oh, and taxpayers continue to get hosed every single year, to the tune of multiple billions of dollars. Medicaid used to pay rock bottom prices for dual eligibles' meds, b/c Medicaid has strong negotiating power. One of the biggest boondoggles in Bush's Part D giveaway: Giving away the now 8 million dual eligibles to Part D. Taxpayers pay the premiums, and the non-negotiable, full retail prices for the same drugs, for a population that needs a lot of meds. Congrats!

      Of course, you know all about all, all the time, coffeetalk. So you knew this already. Right?

      Ho'oponopono. To make things right; restore harmony; heal.

      by earicicle on Sat Jan 04, 2014 at 06:15:20 PM PST

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