November 15 marks the opening date for seniors to register for “Part D” of Medicare, the prescription drug plan. People over 65 who receive Medicare will have the choice to register for one of many prescription drug plans, all of which will offer some discounts on their medicine. Sounds great, right? America’s elderly population will no longer have to board buses en masse and travel to Canada to get their prescriptions filled or cut their heart medication in half to make their prescriptions last. Medicare represents a step towards federal responsibility for the huge disparity in health care among America’s citizens — not so fast.

As enrollment begins next Tuesday, prescription drug companies will begin slashing their charitable drug programs. Seniors who once qualified for free medications from pharmaceutical companies will now find that they have to pay for their prescriptions. This wouldn’t seem like such a negative event if Medicare would assume the medication cost. But Medicare’s prescription drug plans will not assist seniors whose prescription drugs cost between $2,251 and $5,100 annually; instead, it will offer them discounts on the money they spend in a lower price bracket and leave them responsible to shoulder co-pays that could approach $3,600.

While Medicare may offer savings to some seniors, enrolling in a prescription drug program remains a bureaucratic nightmare. Insurance companies, eager to cash in on a new market, have flooded seniors’ mailboxes with promotional materials. Not all medications are covered by all insurance plans, so seniors will have to pick and choose plans based on the medications they are currently prescribed — and they’ll have to use the Internet to do it.  As of today, the government has not made any provisions for helping seniors without Internet access or skills access the complex formularies that can identify the best plan for their needs.

This leaves the responsibility to non-profits and individuals, just as the Bush administration would like it. If you know a senior, please help him or her access the site and make some sense of this nonsensical program. And while you’re at it, write your senator a letter. Programs designed to address health equity shouldn’t depend on technology access or equality.

llouison