Fudging on Drug Ads

The government is supposed to protect us from false advertising, and it sometimes does. On Oct. 5 the Federal Trade Commission announced that it was taking action against the makers of CortiSlim, a weight loss remedy that lists for $49.99 a bottle, of which about $48 seems to go for advertising. On Nov. 9, the FTC announced Operation Big Fat Lie, in which the agency targeted the marketers of other products that claimed to offer weight loss without diet or exercise. From the ingredients mentioned in the FTC complaint, algae, green tea and aloe, these products should be only slightly less useful than a package of Chewy Chips Ahoy as part of a weight loss program.

Government can be very useful in protecting vulnerable people from predatory marketers, up to a point. It's less clear what happens when the government has something it wants to market.

On Nov. 6, the New York Times reported that the National Association of Insurance Commissioners, which represents insurance regulators in all 50 states, had complained that the federal Medicare agency has made misleading statements about the new drug benefit in an effort to persuade people to sign up. The insurance commissioners objected to a proposed federal rule requiring insurers to tell policyholders that the Medicare drug benefit provided "greater value'' than did the drug coverage available to people with private Medigap insurance. This is the type of claim that, if made by a commercial insurance company, would be the subject of an FTC complaint.

Medigap insurance is a program designed to help cover the coinsurance and deductibles in Medicare. While the policies are sold by private insurers, there are standardized plans and standardized prices. The plans are designated by letter, A through J, each offering a few more benefits at easy-to-find prices. Plans H, I, and J offer some coverage for prescription drugs -- H and I offer 50% savings up to a maximum of $1,250 per year after a $250 deductible per year. Plan J covers drugs for 50% up to a maximum of $3,000 per year. This is the maximum benefit available, and won't help much for anybody confronted with modern drugs that cost about as much as a Mercedes S class with a navigation system -- but it may help many people, as it's easy to understand and it's very flexible.

But, Medicare has a newer product, and wants to put "NEW AND IMPROVED!" on the label. More than that, the administration wants credit for what President Bush called "the greatest improvement in senior health care since Medicare was enacted in 1965.'' Actually, the Medicare prescription drug plan may be the biggest boondoggle since the Star Wars missile defense system, but let's not let that get in the way of our fantasies. The Medigap policies, for all their limitations, are fairly easy to understand, and the prescription drug benefit applies to all drugs. If you spend $10, you get $5 from insurance, regardless of what the drug is.

The Medicare drug plan is complex. Worse than that, plan selection asks that people over the age of 65 predict what drugs they'll be taking in the year to come. The choice of which plan to join is based on which pharmacies accept the plans and which plans offer the best prices on specific drugs. If your condition changes and you need different drugs, then the plan that seemed best in January may be the worst by March.

The Medicare Prescription Drug Plan is designed for the benefit of corporations, with the administration's typical disregard for people. Some people will be better off with the new plan, there's no question, but the claim "The new Medicare prescription drug coverage clearly offers a much better value to beneficiaries than Medigap, including comprehensive drug coverage at a lower cost to the beneficiary" is just a long winded way of saying "one size fits all." The insurance regulators made the key point that "value" depends on many factors, including medical condition, drug costs and financial circumstances.

The State insurance regulators, who seem to be nonpartisan on this issue, make the point that the "value" claim is the type of thing they would balk at if it were part of an ad from a private insurer.

The federal government helps protect us from deceptive advertising by predatory marketers. It's not clear who protects us from deceptive advertising by the federal government.

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y.

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