PeaceSigns - Peace and Justice Support Network E-Zine

Do you have eyes, and fail to see? Do you have ears, and fail to hear? And do you not remember? -Mark 8:18, NRSV

The emphasis of last month's column on Social Security reform was an example of the need for Christians to be aware of the facts of issues in the public arena. An important part of what it means to make peace and to do justice is being aware of unjust policies and structures, particularly those that hurt the most vulnerable, including the elderly. In other words, we need to have eyes to see!

While I do not want to get hung up on current political issues, these are important issues that affect many people. As "ambassadors for Christ," we need to speak truth to the government and advocate for justice and peace. Another issue that promises to be a political hot potato is Medicare reform, in particular the prescription drug benefit that will go into effect in 2006 as a result of the Medicare Modernization Act of 2003.

To give credit where credit is due, the fact that the current administration managed to get a prescription drug benefit enacted is, in itself, a significant step. At the time, the American Association of Retired Persons (AARP) endorsed the new law because it was a step-albeit a small one-in the right direction, providing some relief from escalating prescription drug prices and some assistance for low-income seniors.

However, the plan has several serious problems, especially when the full plan goes into effect on January 1, 2006. The more problematic provisions are:

There is a monthly premium of approximately $35 for 2006, which will increase each year.
There is a deductible of $250 for 2006, which will also increase each year.
There is a "gap" in coverage between $2,250 and $5,100 spent on prescriptions where Medicare does not pay any of the cost. This is a total of $2,850 that is not covered at all. This gap will also increase annually.
Medigap insurance cannot be used to cover the prescription drug coverage gap.
There is an asset test for low-income eligibility.

The premiums, deductible and "gap" do not affect those with an income of less than 135% of the federal poverty line ($12,123/individual or $16,362/couple for 2004). There is also provision for those between 135% and 150%. This in itself is very good. The difficulty is that to qualify the low-income person must also pass an "asset test." Those under 135% of the federal poverty line must have less than $6,000/individual or $9,000/couple in assets. Limits of $10,000 and $20,000 apply for those between 135% and 150%.

What does all this mean? Consider the following example:

A couple has life savings of $10,000 and Social Security income of $1,000/month. They have no other assets. While they fall below 135% of the Federal poverty line for a couple ($16,362), they will still have to pay premiums and the deductible and will have a coverage gap, because the value of their savings is greater than $9,000. The husband's prescription costs are $250/month and the wife's are $75/month, for a total of $3,900/year. The chart below shows how the Medicare drug plan would cover these costs.

	Drug Cost	Husband Pays	Drug Cost	Wife Pays
deductible	250.00	250.00	250.00	250.00
over $250	2,000.00	500.00	650.00	162.50
over $2,250	750.00	750.00	0.00	0.00
premium	0.00	420.00	0.00	420.00
	-------	------	------	------
TOTAL	$3,000.00	$1,920.00	$900.00	$832.50

The total cost for the couple with the Medicare prescription plan is $2,752.50 compared to the $3,900 without the plan. This is a 29% savings. Notice that the wife saves only $67.50 out of $900 (7.9%).

The bottom line is that many of those who need this benefit the most will not benefit much, if at all. Also, costs paid by recipients will rise steadily. According to the Congressional Budget Office, by 2011-five years after the plan goes into effect-the average monthly premium will be $49 (up from $35), the deductible will be $380 (instead of $250), and the coverage gap will be $4,315, up from $2,850.

Other aspects of the new law which seem particularly harmful for the neediest are:

The law prohibits purchasing Medigap insurance to cover the costs not covered by the plan.
The law prohibits purchase of prescription drugs from Canada.
The law makes no provision for controlling the cost of prescription drugs.

In my January column, I quoted from Isaiah:

"Ah, you who make iniquitous decrees, who write oppressive statutes, to turn aside the needy from justice and to rob the poor of my people of their right, that widows may be your spoil, and that you may make the orphans your prey!" -Isaiah 10:1-2, NRSV

This passage applies here as well as to the Social Security reform issue. The Medicare Modernization Act of 2003, as it stands now, is unjust to those who need it most. The advertised goal was to give significant relief to those who could not afford prescription drugs or health insurance that would include prescription drug coverage. Instead, in many cases, the relief will be minimal.

This is another issue on which Christians need to speak out to the government. The current law needs to be revised to provide better coverage for low-income people. In particular, the asset test needs to be reexamined, as well as the coverage gap. Mennonite Church USA will be discussing health care access at its assembly in Charlotte, N.C., this July (for more information on the MC USA resolution, see <http://www.charlotte2005.org/conventions/delegates/Healthcare_Access_Resolution.pdf>). This would be one opportunity to discuss this issue and to formulate alternatives that are more just. Other denominations should consider taking up the issue as well.

Last month I proposed some ways that Christians could be involved in important national issues. Applied to the issue of the Medicare Modernization Act of 2003, these include:

Become informed. Search news and other sites for information about the Medicare prescription drug plan. One excellent source is the Coalition of Wisconsin Aging Groups at: <http://www.cwag.org/Medicare%20Modernization%20Act.htm>.
Hold a discussion or information session in your church, Sunday school or Bible study to help others become aware of the issue and the facts.
Write a letter to the editor of your local newspaper explaining the facts and calling for all local citizens, especially Christians, to support consideration of alternatives.
Write or e-mail your senators and representatives. Contact information can be found at <http://congress.nw.dc.us/c-span/home/>

I should have included and now add:

Pray for discernment personally and as a congregation, and for guidance and wisdom for our leaders. Issues such as these are complex. Good intentions often misfire. Our representatives are subject to pressures of budget constraints, constituency demands, and political compromises. We should remember Paul's statement in I Corinthians 1:25: "... God's foolishness is wiser than human wisdom, and God's weakness is stronger than human strength" (NRSV).