There are two kinds of doughnut hole: the kind you eat (yum!), and the kind Republicans (abetted by too many Dems) use to say, "Screw you, old coots!"

I wasn't caught by surprise by the "doughnut hole" in the deceptively innocently named Medicare Part D, the so-called prescription drug benefit. (Well, I suppose you can call it a "benefit" in the sense that the insurance companies selling the policies and the drug companies selling the hard stuff should be making out like bandits.) But knowing about it didn't do me or my 87-year-old mother any good.

Maybe that's because I spent the months between the adoption of the program and the deadline for seniors to sign up without penalty trying to figure the damned thing out, in the increasingly panicky hope of eventually figuring out what the hell to do on behalf of my mother, who takes the typical American senior's laundry list of prescription drugs. (She hates taking all those pills, but her doctor--someone we think we have ample reason to trust--insists they're all necessary.)

I never did figure it out, and as the deadline came and went, I figured, well, somehow we paid for the stuff before, I guess somehow we'll just keep finding the money.

There were all those 800 numbers you could supposedly call, once you were armed with an exact list of all the prescriptions and dosages, and supposedly they would tell you which plan was best for your situation. I never called. One reason was the doughnut hole.

It never for a moment escaped my attention that, as best I could understand it, whichever drug plan you bought, you got your partial coverage up to a certain amount, and above that you got no coverage at all up to another certain amount, and then something else happened--like maybe full coverage? I could never quite get it straight in my head how it all worked, or where those "certain amounts" were going to kick in and out and in, even though it turned out that everybody involved with the plan had a pretty good idea of where: in September-October!

One thing I kind of "got" was that if you called one of those numbers, the people who were going to tell you which plan(s?) were best for you weren't taking the doughnut hole into account. Maybe it's just my natural "glass half empty" temperament, but I could hardly think about anything else.

If you recall, there was a flurry of talk a number of months ago about how the clock was ticking on the doughnut hole, which is how we found out that people in the know had always reckoned it to kick in in September-October. The news seemed to take everyone by surprise.

Well, as surprised as everyone else seemed back then, by some feat of magic they're managing to be surprised all over again now that it's happening.

"Doughnut hole" is of course much too benign a term for the arrangement. The idea was surely that this far into the year there would be no political fallout. In the months when Part D was still controversial, seniors would actually be getting what seemed like real benefits. By this late in the year, the thinking must have gone, the old coots would mutter and grumble, but who listens to old coots muttering and grumbling?

Who knows? Maybe the old coots will be one group of Americans screwed by the policies of the Bush administration who will strike back in the voting booth in November.

If there had been any will to design a fair and affordable prescription-drug benefit program for seniors, it could of course have been done. But since the program was always designed to make seniors cash cows for predatory drug and insurance companies, the thieves and hooligans who designed the program made sure that didn't happen--made sure, for example, that the obvious way of creating a program that would be economically viable and also actually benefit seniors, which is to say using the collective clout of Medicare to negotiate lower drug prices, was expressly, absolutely and unequivocally forbidden in the enacting legislation.

And remember, the AARP provided crucial support to get the program enacted.

It's easy enough to see why most Republicans and shamefully many Democrats went along with the scam. It's what most Republicans and shamefully many Democrats do. In particular under the most recent Republican administrations, the business of America has been warped into the unapologetic robbery, rape and pillage of all groups who can't fight back. However, is it really the AARP's mission to abet the robbery, rape and pillage of America's seniors?

The fringe benefit for Republicans, as Paul Krugman has pointed out repeatedly, is that the debacle provides yet further "proof" that government can't do anything right. What it really proves, of course, is that people who believe that government can't do anything right--like these evil sons of bitches--will always be unable tot do anything right, or fair or decent.

I'd sure like to see every senior citizen, and every American with an elderly relative or friend, and for that matter every American who hopes to live to become a senior citizen, rise up in holy wrath and send these vermin packing for the long, lonely trek to Hell.


UPDATE FROM HOWIE, A NON-DOUGHTNUT HOLE EATER

As you probably know, I interview at least a couple Democrats running for Congress every week in preparation for 2 weekly blog sessions at Firedoglake on Wednesdays and Saturdays. They're from every part of America and, although they are all progressive Democrats, they have been a refreshingly diverse group of men and women. One thing, however, this isn't diverse at all. When I ask them what's the biggest issue troubling the voters in their district the all mention the medical care system either first or second, mostly first, and when they start talking about it the doughnut hole Ken is writing about above comes up... fast. Yesterday I interviewed Angie Paccione whose district encompasses all of sparsely populated eastern Colorado. (Her live blog session will be Wednesday at 5:30 PM EST, 3:30 PM in Colorado.) Angie's district, which has been suffering a 7 year drought, has all kinds of severe economic problems-- including the most mortgage foreclosures of anyplace in America-- but soon after starting to talk about the 200 wells that have been shut down she was talking about health insurance problems and the doughnut hole. The most chilling story came from Congressman Brad Miller (NC) who talked to me about how "hateful" it is for people to have to deal with the largely unnecessary medical bureaucracy.

Today's Washington Post talks about the plight of "millions of seniors" confronting this nightmare, actually, taking Representative Miller's views into account, a dual nightmare. The Post interviewed Robert Hayes, president of the Medicare Rights Center, a nonprofit that helps seniors grapple with the Kafkaesque system. "Virtually everyone who calls to say they've been denied coverage, they're shocked. Trying to explain that this is the way the program was created by Congress angers folks who think it makes no sense. Many people feel blindsided."

Ken mentioned that there were some Democrats that helped the rubber stamp Republicans in Congress and these were the Democrats who also accept huge legalized bribes from Big Pharma in order to buy their votes to screw ordinary Americans who can't pay congressmen big bribes. These people-- along with all Republicans-- would be defeated in November (unless you like doughnut holes and similar nasty little tricks Big Business gets your representative to support from them. The Bill was proposed by Speaker Dennis Hastert (R-IL), who takes more legalized bribes than anyone else in Congress. The co-sponsors reads like a rogues gallery of the most disgusting criminals in Washington: Roy Blunt (R-MO), Tom DeLay (R-TX), Jim McCrery (R-LA), Shelley Moore Caputo (R-VA), Ginny Brown-Waite (R-FL), John Sullivan (R-OK), Devin Nunes (R-CA), Jennifer Dunn (R-WA) for starters. Many of the monsters that have foisted this bill on us have left or are leaving Congress-- Bill Tauzin, Bill Thomas, Porter Goss, Michael Bilrakis, Max Burns-- but there are several who are in vulnerable positions and these are Republican scum who can be and should be defeated. Let's start with New Hampshire rubber stamper Jeb Bradley whose challenger, Carol Shea-Porter, is one of the best Democrats running anywhere. Another slimy Republicrook sponsor for the plight of the elderly Deborah Pryce, Ohio's worst congressperson, and likely to be defeated by Mary Jo Kilroy. Ditto for Bush's two favorite Connecticut congresscreeps, Nancy Johnson and Rob Simmons. The only so-called "Democrat" on this list of shame is Minnesota's Collin Peterson, one of the absolute most reactionary Democrats in Congress. The bill passed by one vote, 216 to 215. The Democrats who acted as honorary Republicans that day were Rodney Alexander (LA)-- who soon after switched parties and made it official-- Leonard Boswell (IA), Bud Cramer (AL), Steve Israel (NY), Ken Lucas (KY), who was soon after defeated by constituents who were sick of his Republican ways and is currently trying to win his seat back (as a right wing Democrat, of course), Jim Matheson (UT), Earl Pomeroy (ND), and the aforementioned co-sponsor Collin Peterson (MN). Keep in mind that when the DCCC asks you for money, it is to keep crooks and traitors like these in office. A much better place to donate is at the Blue America ActBlue Page, where no candidates are sell-outs to Big Business and to the Bush agenda.