Prescription drug coverage among elderly and disabled Americans: can Medicare—Part D reduce inequities in access?

Abstract

This paper explores the determinants of demand for prescription drug coverage among the elderly population in the United States, using data from the Medical Expenditure Panel Survey (MEPS) and seeks to analyse the impact that the Medicare prescription drug coverage bill (Medicare-Part D) has on Medicare beneficiaries. The results indicate that individuals who are Hispanic, black, or of another race or ethnicity, over the age of 74, not married, in poor health, fall into the low- to middle-income brackets, and have less than a high school degree are more likely to be covered through a public program, more likely to be uninsured for prescription medicine outlays, and less likely to have private prescription drug coverage. The paper concludes that there is cause for considerable concern for low income citizens who have significant prescription drug outlays, and, therefore, the greatest need because their prescription drug costs may not be covered beyond a certain limit unless they reach catastrophic proportions. This continues to raise equity in access concerns among elderly patients.

Association of a Policy Mandating Physician-Patient Communication With Racial/Ethnic Disparities in Postmastectomy Breast Reconstruction

“…In 1998, the Women’s Health and Cancer Rights Act (WHCRA) passed, mandating that insurance companies provide coverage for postmastectomy breast reconstruction (PBR) . Although initial studies questioned the WHCRA’s effectiveness, the legislation was found to increase the rate of PBR .…”

Consider expenditure controls’ impacts on equity

“…During the period of these authors' data, telehealth, which is associated with equity issues, [7] was not nearly as pervasive as it is today [8]. Additionally, the authors did not include Medicare Part D. Uptake of prescription drug coverage through Medicare Part D has been found associated with individuals demographics [9]. Additional analyses including these data could reveal opportunities to control expenditure growth without exacerbating inequities.…”