The 40 or so Edmond residents who braved Tuesday’s blustery winds to get some information about the government’s new Medicare prescription drug plan at First Presbyterian were grateful that what they heard cleared up some of the confusion surrounding the program.

Not all of the confusion, however.

Some of the uncertainty surrounding the new program, which goes into effect at the beginning of 2006, is unavoidable. Medicare recipients used to a one-plan-fits-all program from the government will not find such simplicity in the prescription drug coverage plan offered by the federal government. Because the program is primarily through private insurance companies, there is no one-size-fits-all plan. Rather, Medicare recipients must carefully hunt and pick among up to 40 different plans in most areas of the country. It’s somewhat better here in Oklahoma, where there are only 16 different options.

Still, Medicare recipients better have a good idea of what they need and what they can afford. Some of the plans offer prescription drug coverage only, others provide more benefits. Some plans cover a wide range of medications, others only a few.

Deciding which plan fits the best will be up to the individual, not the government, part of President Bush’s insistence that the citizens, not government bureaucrats, should make decisions affecting their lives.

The plans, of course, are not free. Most premiums will average about $32 a month, plus a yearly $250 deductible, according to the government. The Medicare recipient will pay 25 percent of drug costs until spending reaches $2,250, then the plan really kicks in and pays all costs — until spending reaches $5,100. After that, the recipient pays 5 percent of all remaining costs.

In many ways, the plan is remarkable in its ability to offer flexibility and relative affordability to senior citizens, most of whom have decent retirement incomes. But in other ways, the program is laden with pitfalls for a person or a couple with multiple prescriptions. Not all plans cover all prescriptions, so some might have to sign up for two or more plans if their prescription coverage requires it.

Involving private companies in a program designed to help poor retirees and the disabled is risky, both for the recipients and the companies themselves. The insurance companies must strike a balance between making the plan affordable while still providing coverage to a group of people whose prescription drug requirements are much greater than other groups of people.

A group of Democratic lawmakers are seeking to give seniors an additional six months to sign up, something that should be seriously considered.

All in all, though, the plan is about what can be expected from government. Hopefully, our elected representatives in Washington will keep their eye on the plan and make needed changes in the future.


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