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.

Trouble in Paradise

The Republicans are fighting over who represents the ‘heart and soul’ of the GOP (news to me it had either). Is this a great philosophical debate about where to draw the line between fiscal responsibility and social responsibility? Or about how far the mixing of church and state should be allowed to go in a democracy founded on their separation? Or how much power the Federal govt should have to invade individual privacy in the name of security?

Nah. It’s about–what else?–money. Specifically, it’s about whether they should destroy the govt by cutting taxes for the rich so there’s no money to pay for programs, or being ‘fiscally responsible’ and just cutting the programs themselves.

A small but powerful faction of Senate Republicans is insisting that the fiscal 2005 budget include rules that require any future tax cuts to be offset so their effect on the deficit would be neutralized; that would mean either cutting spending or raising taxes in other areas. The proposal would strike at the core of President Bush’s domestic agenda if he is reelected by making it much more difficult to cut taxes.But House Republican leaders have vehemently opposed the pay-as-you-go requirement as an affront to their party’s credo that, when it comes to taxes, the lower the better. They have kept the requirement out of the budget resolution passed by the House — and have openly questioned the loyalty of Republicans who disagree.

“It is a fight for the heart and soul of the Republican Party: Is it a party about deficit reduction or a party about tax cuts?” said Stanley Collender, a budget expert at Financial Dynamics, a business communications firm in Washington.

To cut taxes is to cut the govt’s income, which means that the pressure will be on to cut ‘unnecessary spending’, and we know what they mean by that; they’ve demonstrated it time and again since Reagan. It means cutting or eliminating any program that isn’t corporate welfare and borrowing for the military expenditures, putting the burden of payment on the backs of the children and grandchildren–and great-grandchildren–of the middle class, assuming there is a middle class by the time they get through with it.

To cut the deficit is to cut the amount of money the govt borrows by cutting the programs it pays for, and we know where they’ll look for their cuts: any program unrelated to corporate welfare will be on the chopping block: environmental protection, consumer protection, poverty programs, education, and the rest of the ‘liberal agenda’.

Either way, guess which group gets it in the neck? The Publicans aren’t arguing over the role of the Federal govt but over which way to destroy it. No matter who wins, if the GOP remains in control of all three branches you can kiss the FDA, OSHA, NMH, Medicare, Medicaid, the EPA, HHS, HEW, HeadStart, and even Social Security ‘Good-Bye’. There will only be money for programs supported by corporate interests, prisons, and the military–and the latter two will be cut to the bone, no frivolous frills like health care and decent food for inmates, or body armor and decent boots for soldiers.

I admit, it’s pleasant to watch the Republicans who are making the country a hell for everybody who makes less than a million $$ a year and are threatening to turn the US into Mexico or Bangladesh, spitting and clawing at each other in public.

An uncharacteristically blunt Speaker J. Dennis Hastert (R-Ill.) recently complained about how House Republicans were “bowing and scraping” to the Senate to get the budget passed, and he questioned McCain’s credentials as a Republican.Grover Norquist, a leading tax-cut advocate and president of Americans for Tax Reform, sees the Senate push to make it harder to cut taxes as the last hurrah of a small faction of moderate Republicans who are a dying breed in the GOP. “This is a problem that electing two more Republican senators will fix,” Norquist said.

It does have a certain…entertainment value. But our enjoyment has to be limited when we understand that they’re like two dogs fighting over who gets to disembowel the chickens–and we’re the chickens.