Hoadley Jack
Health Policy Institute, Georgetown University, USA.
Issue Brief (Commonw Fund). 2008 May;39:1-15.
Many Medicare beneficiaries signed up for the new Part D benefit during the program's first two years. Subsequently, a significant majority of them reported that the benefit was too complicated, and some observers suggest that the complexity may have thwarted some beneficiaries from finding the plan that was best for them. Meanwhile, more than 4 million of those eligible failed to enroll at all. Although some degree of standardization may occur naturally as the market evolves, steps can be taken to simplify the program and make it easier for beneficiaries to make good choices among plans--and for them to enroll in the first place. This issue brief considers specific options for simplifying Part D in several areas: standardizing the benefit descriptions and procedures used by plans and the Medicare program; further standardization of the plan's benefit parameters, particularly the rules for cost-sharing; and changes to the rules governing plan formularies.
许多医疗保险受益人在该计划的头两年报名参加了新的D部分福利。随后，绝大多数受益人表示该福利过于复杂，一些观察人士认为，这种复杂性可能阻碍了一些受益人找到最适合他们的计划。与此同时，超过400万符合条件的人根本没有参保。尽管随着市场的发展可能会自然出现一定程度的标准化，但仍可以采取措施简化该计划，让受益人更容易在各计划中做出明智选择，并首先让他们能够参保。本问题简报考虑了在几个方面简化D部分的具体选项：规范各计划和医疗保险计划所使用的福利描述及程序；进一步规范计划的福利参数，尤其是费用分摊规则；以及修改有关计划药品目录的规则。
