Medicare Part D--the sea of choices meets the donut hole.

Medicare reform was long overdue when the new prescription drug plan, Medicare Part D, was implemented on January 1, 2006. The Medicare Part D program was developed and written into law in concert with the prevailing conservative political agenda. It is essentially a privatization of public sector Medicare insurance, plus a prescription drug benefit, to private health insurance companies (health maintenance organizations). Unfortunately, the program is fraught with too many choices and options, leading many recipients to consult family, friends, and even attorneys to determine the best plan for their needs. The program began in early 2006, and the deadline for the selection of plans has already passed. For many Medicare D recipients, the next hurdle, dealing with the ramifications of the coverage gap (also called the donut hole), is approaching or is already in effect. Seniors in the donut hole face paying 100 percent out-of-pocket costs for medications while still paying the monthly Medicare premium. The limited coverage provided by Medicare D in this brave new world of innovative and highly effective but expensive drugs coexists with soaring profits in the insurance and pharmaceutical industries.