Medicare drug plans help many.

Byline: GUEST VIEWPOINT By James Whitfield For The Register-Guard

The Register-Guard's Nov. 16 editorial, `Drug plan deja vu,' serves as an important reminder that open enrollment season for people with Medicare has started and runs through the end of the year.

During this time, people may choose to start or change their Medicare coverage, including their coverage for prescription drugs.

This is the time for beneficiaries to decide if their current plan meets their needs or if there is a more suitable one, and we appreciate the editors' having highlighted this important issue.

It's important to note that five surveys over four months (conducted by the Kaiser Family Foundation, JD Power and Associates and WSJournal/Harris Interactive) indicate a very high satisfaction rate among beneficiaries enrolled in the program - almost 80 percent. I'd like to respond to some of the concerns the editors raised. For example:

Fact: According to a PricewaterhouseCoopers study, 92 percent of all Medicare beneficiaries with drug coverage will not reach the coverage gap or will have some coverage within it. The vast majority of people simply will not be affected by this gap. For those who are concerned, there are 17 stand-alone plans in Oregon that offer some coverage in the gap and 33 plans that offer zero deductible.

Fact: Contrary to the editorial's statement, co-pays and deductibles do count toward total drug expenses when calculating whether one has reached the coverage gap at $2,250 out-of-pocket expenses.

Fact: The editorial references a study suggesting that seniors will have difficulty getting brand-name drugs during the gap. Medicare regulations require that every plan cover multiple medications for every category of illness.

By using the brand-name substitutes that are on a plan's formulary and generic drugs where they are available, all beneficiaries can save even more money on the medications they need. Many will save enough that they will avoid entering the coverage gap altogether.

Fact: Finally, a point about negotiating drug prices.

Drug plans have been quite successful negotiating prices with manufacturers - so successful that the average premium is much lower than originally expected (an average of $24 compared to the estimated $37). Both the nonpartisan Congressional Budget Office and Medicare actuaries have said it is unlikely the government will be able to do much better than that and still maintain the range of drug choices currently available.

The Department of Veterans Affairs program, for example, may seem like a model for Medicare, but the department's drug formulary is much more limited than Medicare's. People who are concerned about the availability of brand name medications should understand that the VA's success in negotiating prices is contingent upon excluding a number of brand-name medications.

In addition, the VA relies upon its own pharmacies for distribution - some 75 percent of all VA drugs are by mail order - a restrictive cost-saving measure that people with Medicare certainly would not accept.

The editors seek to hold the federal government accountable to make Medicare prescription drug coverage work for the people of Oregon. We agree, and that is why we have put processes and procedures in place that we believe will make this enrollment period work more smoothly than the first one.

We want people to make the best choices based on their own needs, and it would be a disservice to readers to suggest, as the editorial does, that taking some time to review their current situation is too hard or too cumbersome to do.

If The Register-Guard wants to help make this process work best for people with Medicare, it should urge readers to take an `enrollment check-up' right away, to help them determine if their current plan is satisfactory, and, if not, to identify one that serves their needs better. This is the time to prepare, compare, and decide.

Objective, unbiased information is available 24 hours a day by calling, toll-free, (800) MEDICARE (1-800-633-4227), or online at www.medicare.gov. People can also call on the dedicated volunteers of Oregon's Senior Health Insurance Benefits Program, or SHIBA, at [phone].

Together, we can all insure that people with Medicare get the prescription medicines they need.

James Whitfield is the regional director for the U.S. Department of Health & Human Services, Region 10, which serves Oregon, Washington, Idaho and Alaska.