Report: Medicare cards confusing

WASHINGTON -- Some seniors are confused by Medicare's new prescription discount card system because early information mailed to them was unclear or incomplete, according to a report by the government's health policy watchdog.

But the government agency that runs the program discounted that survey as unscientific, saying that a more extensive investigation is needed to detect any widespread problems.

The inspector general's office of the Department of Health and Human Services surveyed 59 seniors, many of whom were relatives of agency employees and described the results in a Sept. 29 internal memo obtained by the Associated Press.

"We found that these beneficiaries received very little mail from drug card sponsors that would enable them to make an informed choice among cards," the memo says. The watchdog agency is now conducting a more formal investigation to detect any widespread problems.

HHS spokesman William A. Pierce said his agency will await the results of the second investigation before making any changes.

"If I had presented this in college statistics class, I would have been flunked," Pierce said of the initial survey cited in the memo. "The results, whatever they say, are invalid results because this was a non-random, tiny sample."

The temporary drug discount cards -- a frequent topic on the campaign trail and during the three presidential debates -- are the first wave of a two-phase plan to provide 41 million Medicare recipients with prescription insurance coverage by 2006.

The plan is often touted by President Bush as a domestic policy success as he makes his case for a second term in the White House. His Democratic rival, Senator John Kerry, has argued that the president hasn't done enough to help the elderly with the rising costs of health care.

Both the government and insurers approved for the discount program were permitted this spring to mail seniors information about the cards in an effort to give a discount on prescription prices until the Medicare coverage benefit kicks in two years from now.

"Contrary to expectations, during the initial startup of the drug card program, we found that the 59 selected beneficiaries received little or no mail about the drug card program from sponsors to assist them in making a choice among drug cards," Assistant Inspector General George Grob wrote in the Sept. 29 memo.

"Most of the beneficiaries reported they did not receive adequate information about the drug card program through the mail and further the information they received was not easily understood," Grob reported.

Grob also raised concerns that many of the sample 59 seniors had received mail from other prescription drug programs that offered "competing services" and "which might cause beneficiaries to question whether to enroll in the drug card program at all."

A week after the report, Grob wrote a follow-up memo saying his office wasn't releasing the information publicly because the initial review was designed as a "very quick and early assessment" and that the results couldn't be used to draw conclusions about the rollout of the prescription discount cards.

Mark McClellan, Bush's Medicare chief, wrote a pointed response to the memo last week, arguing it was improper for the independent, nonpartisan inspector general to write about a survey that was "too small to generalize or draw any conclusions."

"What concerns me even more is what I have learned about the nature of who the IG's office recruited to be in the sample -- family and friends of OIG office staff," the Medicare chief wrote. "This is a non-representative sample and not a valid way to conduct a reliable and statistically valid analysis."

HHS officials said the timing of Grob's memo also raised concerns. The review was conducted in May and June and department officials were verbally briefed in July but the memo wasn't issued until Sept. 29, the day before Bush and Kerry debated the first time.

McClellan and other HHS officials said the initial survey did not capture the impact of an advertising program and direct mail effort by the government this summer that resulted in a 10,000-a-day enrollment spurt for the cards and which gave seniors a toll-free number to learn more.

"The report also makes no mention of what beneficiaries find when they call this number -- a simple, three-step process to sign up for the best card for them," the Medicare chief wrote.