Barbra Levin -- Medicare Part D: A Model Public Healthcare Program

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By: Barbra Levin 

Nearly 350,000 Marylanders rely on Medicare Part D to cover their prescription drug expenses. Having turned 10 years old in December, Part D has proven to be incredibly effective at expanding  access to needed medications and empowering seniors to get healthy and ward off disease.

But Part D is more than just a boon to patients -- it's also a model for fiscal responsibility. Part D has kept prices low for enrollees and cost taxpayers significantly less than expected.

In the push to rein in federal spending, lawmakers need to avoid tampering with Part D. It's a rare public program that effectively serves millions while keeping a tight lid on costs.

Prior to Part D's implementation, seniors had no coverage for most prescription drugs. Today, their access to needed medications has dramatically improved. Fully 90 percent of Medicare beneficiaries are now covered by Part D.

Yet even as Part D has expanded coverage, total program costs have come in 45 percent under initial budget projects -- not typical for a big government program.

The big reason Part D works so well is that it harnesses market competition to drive down costs for beneficiaries. Private insurers administer the plans offered under the program. These providers have to bid against each other for enrollee dollars, resulting in lower premiums and cheaper medicines.

Part D’s wide range of coverage options ensures that patients can find the plan that best fits their needs. Nationwide, seniors can choose from an average of 35 different plans. Maryland now offers 36. Premiums can run as low as $13 per month. Fourteen plans available in Maryland have no annual deductible.

This combination of choice and affordability earns Part D high marks from the people who use it. On one national survey, 96 percent of participating seniors said their coverage works "very well."

By expanding access to vital medications, Part D also significantly reduces overall health costs. When patients can afford to stick to their doctor’s prescription regimen, they tend to get healthier, reducing the risk of a major medical complication and saving money for Medicare.

The New England Healthcare Institute found that poor compliance with prescription medication is responsible for $290 billion per year in otherwise avoidable medical spending. But when patients take medications properly, they can generate significant long-term cost savings to the health care system – as much as $7,800 per patient annually, according to one study.

By supporting robust demand for prescription drugs, Part D helps fuel medical innovation.

Cancer patients are now living longer and better lives because of new therapies. Cheap statins are helping reduce the risk of fatal heart attacks and strokes. Bone fractures that once would have led to a loss of independence are being prevented by new "biologic" drugs treating osteoporosis.

But there are still hundreds of thousands of patients with unmet medical needs -- and they are hoping that medical research will yet yield a treatment in time to make a difference.

Consider Alzheimer’s, for example. More than 86,000 Marylanders are affected by this disease.  By 2025, that number is projected to reach 100,000, as local Baby Boomers age.

A new treatment that slowed the progression of the disease by five years, however, could reduce new cases by nearly half and save the national healthcare system $447 billion per year by 2050.  Such a breakthrough would also lessen the emotional and physical toll Alzheimer’s takes on caregivers.

Right now, there are nearly 100 medicines in the pipeline for Alzheimer’s. Many will fail -- at a huge cost to their creators. One company lost $700 million alone on a failed attempt. Still, researchers keep working; knowing that if clinical trials pan out for just one, millions of Americans will be spared the slow, painful decline of a loved one.

Medicare Part D helps provide the financial resources to pursue such vital research. And over its first 10 years in operation, it has improved patient access to life-saving medications and keep costs remarkably low. Part D is an unqualified success.

Neurofibromatosis Mid-Atlantic is a 35-year-old patient advocacy organization based in Baltimore for those affected by the genetic disorder Neurofibromatosis. This disorder causes tumors to grow anywhere on the body. NF, as it is popularly known, is a common and extremely variable condition that runs the gamut of manifestations from mild skin disfigurement to malignancy; hearing loss; incessant pain; death and/or lifelong dependence. Two-thirds of people with NF have learning disabilities and may include both dementia, and Alzheimer’s. Our savior has been Medicare Part D to assist our populace to address the myriad of NF related manifestations.

Barbra Levin is Executive Director of Neurofibromatosis Mid-Atlantic. Her email is

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