By Sandy Alexander
WASHINGTON – Mary Muir is 91 years old, but with the help of medications for high blood pressure, arthritis and asthma, she still cooks her meals, does her laundry, goes shopping and cleans her Frostburg home.
But the same medications that bring Muir independence also cost her more than 40 percent of her $700 monthly income. Her daughter, Stella Roth, said Muir manages to pay her bills and buy her medication, but only because her family helps her.
“In a time when so much of my mother’s care is dependent upon prescription drugs, there doesn’t seem to be any feasible option for purchasing coverage,” Roth told lawmakers Wednesday.
Roth, of Rosedale, told her mother’s story Wednesday to the Democratic Policy Committee in the Senate, part of a panel of speakers invited to explain the importance of adding prescription coverage to Medicare.
Muir is one of 559,000 Maryland seniors and 69,000 people with disabilities in the state who receive Medicare, according to a report released Tuesday by the National Economic Council. But Medicare does not cover prescription drugs, and the report said only 22 percent of Maryland firms offer health insurance to retirees.
Enrollees can pay for supplemental Medigap insurance, but advocates say not all Medigap plans cover prescriptions, and the ones that do are expensive. In Maryland, Medicare members can also enroll in basic managed care plans that cover prescriptions, but the plans often cap annual prescription coverage at anywhere from $300 to $1,000.
In addition, most rural areas of the state do not have access to Medicare managed care plans, said Lee Hammond, president of the Maryland chapter of AARP, which advocates for midlife and senior citizens.
Several proposals are currently under discussion in Washington, including President Clinton’s $432 billion plan to modernize Medicare and subsidize a voluntary prescription program for seniors. Sens. John Breaux, D-La., and Bill Frist, R-Tenn., have a plan to restructure Medicare and pay for enrollment in competing drug plans. There are also proposals pending in the House.
When Medicare was created in 1965, prescription drugs were not usually part of health plans, but they have since become an important part of treatment for almost every major illness, said Rebecca Elon, medical director for North Arundel Senior Care in Annapolis, in written testimony for the committee.
In her geriatrics practice, Elon said she sees nursing home patients who take an average of seven medications a day.
While pharmaceutical use is increasing, so is the cost of prescription drugs. Elon said in her statement that one of her patients paid $1,400 for prescriptions in one month. Another went without $150 of pneumonia medication because she could not afford it in addition to her rent and her regular regimen of medications on her pension of $800 a month.
“Seniors in Maryland are having to decide between prescriptions and food,” said Hammond.
The ones in the worst situations do not have medication coverage under Medicare and spend their savings on prescriptions, until they finally qualify for Medicaid, Hammond said.
The problem is not likely to go away: By 2025, there will be 1 million seniors in Maryland alone, according to the National Economic Council study, almost double the current number.
After seeing her mother struggle with prescription bills, Roth is concerned about what her own future holds.
“I believe Medicare is a great program, but it falls seriously short of meeting the prescription drug needs of seniors,” Roth said.