Yesterday I posted a bit of media criticism about an article on Bush’s prescription drug plan that left some important questions unanswered. The article reported that many mental-heath patients were unable to get their prescriptions under the new plan. But the article didn’t say how patients were getting their prescriptions before. I thought that was an important piece of information in determining whether this was an “administrative” problem or a “policy” problem. Fortunately, MB readers who know health care policy have written in with some answers:

I am the site director of a community mental health center. These are out patients.
Patients with schizophrenia can almost never pay for their medications. Modern antipsychotics cost upwards of $350 a month. Those with Medicaid alone are home free. Those without have had to use Patient Assistance Programs. These are programs where patients in need can get medication for free from the drug company. The mess of a Medicare program has done two things to stop patients from getting their medications.
1. Those patients who are unlucky enough to have both Medicaid and Medicare now find that Medicaid won’t make any payments until Medicare Part D has made its payments. Of course, Bush’s program is so messed up, such payments are not forthcoming and the patients now do not get their medication.
2. The drug companies, understandably would rather get paid than give medication away, are ending assistance to patients with Medicare. The problem is, of course, that Medicare is not yet really working.
I hope this explains where “they got their drugs from before”. I am a Republican and I voted twice for Bush. This is not media hype, this is not Liberal bias, this is real damage done to real people through the incompetence of the Federal Government.
Bryan G. Stephens, LPC
Director of Douglas Outpatient Services
Douglas, Georgia

In other words, Bush has made this a federal responsibility — thus taking the burden off the states and the drug companies — but the plan isn’t working yet, so there’s a gap where now the mentally ill aren’t getting their medicines. As one reader points out:

The article you linked to doesn’t make that fact explicit, but it does imply it:“Like other Medicare-Medicaid recipients, the mentally ill were to have been signed up automatically for Part D at the start of the year, with responsibility for their prescriptions shifted seamlessly to private drug plans.”“Shifted…to private drug plans” not “…to government funding.” The trope of “the government took control and things went to hell” might be a pretty reliable one, but it doesn’t apply here.

Actually, it seems like it does. The federal government took control from the states and things have pretty much gone to hell. But whether this is an administrative problem or a policy problem remains an open question. Seems like a policy problem to me. If things weren’t broke before the feds took over, why fix them? But obviously, I’m not an expert on health care policy, so keep the e-mails coming. As someone who opposed the prescription-drug benefit, I’d like to get your opinions and your suggestions about how the press coverage of these issues could be better.