PRESCRIPTION MEDICATIONS - FREE OR WHAT

I believe that some citizens of the United States should receive some help in paying for some prescription medications. Mssrs. Perot, Bush, Gore, Lieberman, Cheney, and I don't need help in paying for our prescription medications; but my daughter, Abigail, suffered from cystic fibrosis - and she was helped immeasurably by numerous programs of the State of Connecticut. Connecticut has a "means tested" prescription program for seniors in our state.

Currently, CONNPACE is a co-pay program for seniors over sixty-five years of age with incomes below certain maxima. Many advocates recommend that these maxima be raised, and I cannot disagree per se. However, the greatest burden falls to those who require many prescriptions on a daily basis, Some diabetics with complications require as many as 20 prescriptions each month, and at $12.00 each co-pay the costs become very costly. I will discuss solutions specific to Connecticut, but my concepts may well provide insight for the legislatures of other states to create laws and programs for those states.

In Connecticut I recommend that the threshold be raised by out of pocket costs on a two for one ratio. This means that a senior with income exceeding the maximum by $1,000 would still qualify for CONNPACE after he had spent half of that out of his pocket from one provider (pharmacy). Those figures are annual, but I expect they would be administered pro rata on a monthly basis. So -- a pharmacist would be permitted to accept CONNPACE from the aforementioned man after he had spent $42.67 out of his own pocket each month. (That is one twelfth of $500 which is one half of the $1,000 by which his income exceeds his maximum.)

I believe in means testing for government programs. Even Social Security is means tested: if you pay more in, you will receive greater benefits. With CONNPACE I suggest another means test: usage. I suggest that the legislature provide that (say) the first four prescriptions under CONNPACE would require a co-pay of $12.00, but that the next (say) four prescriptions each month from the same provider (pharmacy) would require a co-pay of only $6.00. After eight prescriptions per month obtained from the same pharmacy, CONNNPACE might require a co-pay of only $4.00. This would help those with the greatest needs the most -- but, since there are fewer of those with the greatest needs, the cost to taxpayers would not be nearly as great as a much smaller reduction in co-pay across the board.

Another benefit would be that clients would be encouraged to buy all prescriptions from a single pharmacy which would allow a simpler summary and consideration of interactions among medicines.