Bob Edwards Takes on Medicare's Part D Donut Hole, Pays Tribute to Aretha Franklin

Bob Edwards:

Hello I'm Bob Edwards with an AARP take on today.

High prescription drug costs are a problem even if you have insurance.

Earlier this year, Congress helped those on Medicare Part D with their drug costs.

It passed a law that would finally close the infamous drug coverage gap, known as the doughnut hole, in 2019.

But now that gain is in peril, as drug makers are lobbying to roll it back. Stahis Panagides and his wife Joy know the toll of high drug costs firsthand.

[Begin Interview]

Stahis:

Thank you for the good journalism.

Bob Edwards:

Oh, very nice of you to say that. Thank you.

Stahis:

Yes. A question: Can my wife be on the line also?

Bob Edwards:

Sure. Sure, why not.

Stahis:

Joy my wife of 54 years.

Joy:

Greetings.

Bob Edwards:

Oh, congratulations.

Joy:

One of my favorite voices in the morning.

Bob Edwards:

Thank you so much. Stahis, I understand you were thrown a curveball three years ago. Tell me about that?

Stahis:

Yes, Parkinson's. I was diagnosed with Parkinson's.

Joy:

It started with a tremor.

Bob Edwards:

And how are you dealing with that?

Stahis:

Not too bad really. I am fortunate to have wonderful children and grandchildren.

My concern was, of course, about three months ago that I couldn't afford one of the medicines that my doctor recommended.

I have all the insurance that I can afford and it was a problem. And as you know, the cost of medicine is a main concern for many of us, especially those of us who have no other choice but to take a medicine.

Bob Edwards:

How many medications are you on?

Stahis:

We were just counting that. You know, let's see, I take 23 pills a day.

Bob Edwards:

23?

Stahis:

Yes.

Bob Edwards:

Mercy.

Bob Edwards:

So, how much is this costing you?

Stahis:

I made a rough estimate anticipating your call, our out-of-pocket expenses are about $23,000 a year.

Bob Edwards:

26,000?

Stahis:

23.

Bob Edwards:

23,000. That’s bad enough. Tell me about the medication that's out of your range.

Stahis:

It was a particular one. It was called… [inaudible]. Right here. Right here. let me see here.

It’s a medicine called RYTARY, that my doctor recommended. And when I went to pick it up from the pharmacy, it was to be $410 for a month. And I just couldn’t afford that.

Bob Edwards:

How did your doctor feel about you passing on that medication?

Stahis:

She was concerned actually. She's a wonderful doctor.

She tried to see if we could do something about it, but we couldn't…

Joy:

She selected another type of pill.

Stahis:

Yes, that's correct.

Bob Edwards:

That's not 400 a month?

Stahis:

It was only 80, I think.

Bob Edwards:

Well, facing cost like that, have you had to make any tough choices?

Joy:

We’d like to travel some more. And we have children scattered around the country and it's nice to be able to see them and to plan for their future too a little bit. But, that kind of savings isn't there.

Stahis:

And, of course I'm thinking of those were in much less fortunate economic situation than we are.

Bob Edwards:

But. But you have Medicare. You have Medicare, you have supplemental insurance.

Stahis:

Yes, and I have a Medicare Part A, B and D and that’s right and supplemental.

Supplemental, by the way Bob, is about five thousand dollars a year. The premium.

Bob Edwards:

And yet, you fall through the cracks somehow?

Stahis:

I am pleased that the pharmaceutical sector in our country is doing all kind of good research, but they….  [inaudible] if they produce medicine that we cannot afford, what's the use?

Bob Edwards:

They're doing a lot of research. They're also doing a lot of lobbying with Congress.

Joy:

Indeed. That’s the problem.

Bob Edwards:

… Trying to roll back benefits that have helped people like you.

Stahis:

It’s just so difficult to try to understand that you know. Why… We would like to have neighbors to be healthy people and I just don’t understand why this type of lobbying… Although, I know money talks.

Bob Edwards:

I understand you testified before Congress about your experience?

Stahis:

Yes, I did. It was a couple of weeks ago I was evidence of the problem anyway. You know?

Joy:

It went very well. He did a very nice job.

Stahis:

Thank you, Joy.

They just needed the victim and that was my husband.

Bob Edwards:

I wonder how many people there are out there sharing your experience? Having to forego a needed medication that the doctors feel is important to your health…

Stahis:

I’d guess it’s millions.

Bob Edwards:

Millions.

Stahis:

My guess, of course. I am… I'm sure there must be some…

Bob Edwards:

What would you encourage other people to do?

Joy:

Stay healthy.

Stahis:

Lobby. Lobby for the good, Bob.

I think, I’ve been in Washington since ’71. I unfortunately know that lobbying interests are dominating and the public is neglected at least until there is crisis of some kind.

Bob Edwards:

Well, thank you for sharing your story and I wish you the very best.

Bob Edwards:

Stahis and Joy Panagide of Bethesda, Maryland. Now let's turn to Megan O'Reilly of AARP.

Bob Edwards:

New York Times reports that the rate of bankruptcy for people 65 and older has tripled from three decades ago.

Are high drug prices part of that problem?

Megan O’Reilly:

We know that rising prescription drug prices is an issue that older Americans face. The average Medicare beneficiary on Part D takes about four and a half prescriptions. You know, so, as we're seeing these costs increase… these prices increase, they're feeling it.

We know that in 2015, the price increased about fifteen-point-five percent for the brand-name drugs that are widely used by older Americans.

Bob Edwards:

There was a prescription drug plan passed during the younger Bush administration correct?

Megan O’Reilly:

Yes, about 15 years ago President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act. And what this law did, in part, was for people on Medicare it created the Part D program. And what this was, was a prescription drug benefit for those people on Medicare.

Bob Edwards:

So, now there's a new proposal before Congress. Does this one help or hurt?

Megan O’Reilly:

So, as part of the Part D program there is this thing within it called the doughnut hole. What is known as the doughnut hole. This is a period of time for people in the Part D plan, where they have to pay fully out-of-pocket. The Affordable Care Act closed that doughnut hole over time to reduce the out-of-pocket costs for beneficiaries.

Congress recently, in February, passed some improvements, some important improvements to the coverage gap that further changed the makeup of who pays what in that doughnut hole as it's closed. And as a result, that those improvements will lower beneficiary costs both their out-of-pocket costs as well as their premiums.

Bob Edwards:

What was going on 15 years ago that made this benefit necessary?

Megan O’Reilly:

You know what we had heard is that really, you know, there was this need… there was this need for prescription drug… a prescription drug benefit. And you know as a result Congress enacted the Part D plan. When you look at the numbers of the millions of beneficiaries who are taking part in it, you know, it's been a successful program.

Bob Edwards:

But, it had a design flaw?

Megan O’Reilly:

But, it had a design flaw. Exactly.

We are very pleased to see Congress work in a bipartisan way earlier this year in February, as part of the bipartisan Budget Act of 2018, where they made these additional improvements. First, closing the doughnut hole in 2019. It moved it up from 2020. And second, shifting who pays what in that coverage gap.

What it did was, previously beneficiaries paid 25 percent, health plans or Medicare paid 25 percent, and the drug companies paid 50 percent.

What Congress changed in February, is they shifted more costs on to the drug companies. So, the drug company shares now at 70 percent. Beneficiaries are at 25 percent and the plans and Medicare are at 5 percent.

And why this matters for beneficiaries, is that the amount that the drug companies are paying they get credited for that. They get credited with that with their 25 percent they are paying.

That helps them get out of the donut hole faster. And when you go out of the donut hole, the beneficiary is paying 5 percent out of pocket. So, they go from 25 percent out of pocket to 5 percent out of pocket.

And, as well lowering the amount that the plans have to pay, we should see effect on their Part D premiums. That those should be lowered as well.

Bob Edwards:

So, what can people do?

AARP has been strongly urging Congress to protect these improvements and not reopen them. We've done that through our communications with members of Congress directly. We've also been communicating with AARP’s 38 million members, as well through our social channels, through emails, and grassroots.

To both let them know of these improvements, but also urge them to tell their members of Congress to protect the doughnut hole improvements and not roll them back.

Bob Edwards:

Thank you very much.

Megan O’Reilly:

Thank you.

Bob Edwards:

To access AARP’s advocacy tools, like the ability to find and email your Member of Congress, go to aarp.org/adovacy.

[Transition to next segment]

Bob Edwards:

Here’s what else you need to know this week.

In mid-August, Aretha Franklin, the most influential and celebrated R&B singer of her time, died, at 76, after a long struggle with cancer.

But her reign as the Queen of Soul? That’s forever.

Over the past 62 years, Franklin built an astonishing legacy. She earned the title Queen of Soul with a staggering run of instant classics — including “Respect,” “Chain of Fools,” “I Say a Little Prayer,” “I Never Loved a Man” and “Think.”

Recently, AARP found an original Aretha Franklin recording in its vault – a song called “Stand Up For Yourself,” recorded in 2007.

Franklin was both a music legend and a civil rights icon.  In her six-decade career, she performed at several presidential inaugurations, and she sang at Martin Luther King’s funeral.

President George W. Bush awarded her the Presidential Medal of Freedom.

When she performed at the 2015 Kennedy Center Honors, her rendition of “(You Make Me Feel Like) A Natural Woman” brought President Barack Obama to tears. 

The newly unearthed Franklin recording was made about a decade ago – as an anthem for bipartisanship. I talked with Nancy LeaMond of AARP to learn how and why this recording came about.

Bob Edwards:

So, tell us what you found.

Nancy LeaMond:

Well, in 2007 AARP launched the “Divided We Fail” campaign to advocate for presidential and congressional leadership on health care and retirement security. The “Divided We Fail” coalition included strange bedfellows: the Service Employees International Union, the Business Roundtable and AARP.

And while business, labor and AARP had often opposed each other on issues, our partnership made the point that even these groups could agree on the importance of affordable health care and a strengthened Social Security program. We wanted to bring that to the attention of everybody running for president in the next year.

We immediately looked for clever ways to communicate with both the candidates and our constituency. While we were sitting around one day somebody said: “How about a theme song, or an anthem?”

And we didn't quite know what to do. But, at the time we had a consultant named Tina Clark who said: “I'll write the music and lyrics to ‘Stand Up for Yourself.’” And then to our great delight, the Queen of Soul, Aretha Franklin agreed to perform this original song for the “Divided We Fail” campaign.

She was the perfect messenger for a critical message.

Bob Edwards:

What was the approach? How do you do that? How do you just call up Aretha? Hey, can you come record for us?

Nancy LeaMond:

So, somebody knew her and said: “how about we get Aretha Franklin.” When all of us sat around and said really? And a couple of weeks later somebody said, that she had said, that it was such an important message that she wanted to do it for us. And that was the beginning of the recording of “Stand Up for Yourself.”

Bob Edwards:

How did you feel when you first heard her performance?

Nancy LeaMond:

I think we were all stunned and moved by it. We'd seen so many drafts of the lyrics beforehand. But, actually seeing her and hearing her magnificent voice just put this in a very special place in a campaign that was very special for all of us at the time.

Bob Edwards:

And you recorded the video of her performance and she's really into it.

Nancy LeaMond:

She is, she is. She was deeply committed and if you think about the message, it's the message of her entire life.

Bob Edwards:

One of the lyrics stands out: “Let's make the choice. We stand as one because divided we fall.” I'm from Kentucky, where the state motto as united we stand divided we fall.

Nancy LeaMond:

Right. Right, we had a big discussion about whether the motto should be “United We Stand,” or “Divided We Fail.” And decided “Divided We Fail.” We just wanted to emphasize that this was… Remember in 2007, that was the beginning of hyper-partisanship. We really wanted to send the message that we need to come together, work in a bipartisan way and, especially as we moved into the important 2008 election, that presidential leadership was required.

Bob Edwards:

You don’t hear a lot about bipartisanship anymore.

Nancy LeaMond:

No. No, you don't.

Bob Edwards:

The country is torn apart on so many levels and so many issues.

Nancy LeaMond:

Well, it's interesting. I spend a good part of my day talking to members of Congress and their staff. What I hear from them a lot is that there is a lot of bipartisan activity, but it tends not to be on what I call the kind of white fire issues. It tends not to be on the big controversial social issues, where people can come together.

But, you do see bipartisanship on issues like fraud, waste and abuse; on chronic care management in the health area; on caregiving – family caregiving, a big issue for AARP. But when you get into these broader issues, that at their fundamentals talk about the role of government, it's much more difficult.

Bob Edwards:

Alright. Well, let's let Aretha have the last word.

Music Plays: “Stand Up for Yourself” performed by Aretha Franklin.

[OUTRO]

Bob Edwards:

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Thanks for listening.  I’m Bob Edwards.