Effects of failure to enroll Part D beneficiaries

The US Medicare Part D prescription drug benefit has failed to enroll millions of eligible US residents, despite their lack of alternative  coverage. The program has cost more than 30% less than originally  forecast, largely thanks to competition between private providers,  better-than-expected discounts for drugs from pharmaceutical firms and a  rise in the proportion of patients willing to switch to generic  compounds.

Representative Henry Waxman (Democrat, California) who will assume the  chairmanship of the US House of Representatives' Energy and Commerce  Committee in 2009, argues that the failure to enrol people on low  incomes has helped the image of a cost-effective federal government  program (Marketletters passim).