There are 1,400 plans from 50 insurance companies, working closely with drug companies, and making substantial profits from Part D.

The New York Times reported in March, "If things play out the way some big insurers hope, the drug program could prove to be a feeder system into much greater private presence in Medicare - a long-standing goal of the Bush administration."

In  his radio address, George W. Bush claimed

`` Medicare prescription drug coverage is a great deal for seniors.  Even if you do not have significant drug expenses now, you should consider joining a Medicare drug plan to protect yourself against high prescription drug bills down the road.''

There have been complaints about the complexity of the plans, delays in benefits taking effect and in reimbursements.

According to Saul Friedman of Newsday,

"Part D is not a Medicare benefit, and cutting Medicare out of the picture is what keeps drug and coverage prices high."

CMS have announced the Part D deductible and out-of-pocket expenses, including the doughnut hole is going to increase by nearly 7 percent next year.

The Part D annual deductible will increase from $250 to $265. Co-payments for the poor will also increse.

The coverage amount will also increase from $2,250 to $2,400.

The modest good news is that the initial drug coverage will go up from $2,250 to $2,400. But this year's doughnut hole of $2,850, during which you pay 100 percent of your drugs' costs will grow to $3,051.25.

Once in the doughnut hole next year, getting out will cost your account a total of $5,451.25 ($2,400 plus $3,051.25), up from the current $5,100 ($2,250 plus $2,850). Once out of the hole, you'll continue to qualify for catastrophic coverage, when Part D pays 95 percent of drug costs.

Still looking ahead, monthly Medicare Part B premiums for next year are expected to rise from the current $88.50 to $100.40, a 13.4 percent increase. But the same law that gave us Part D also introduced means testing for the first time in Medicare's history. Starting Jan. 1, part B premiums are expected to rise to new highs on a sliding scale for about 2.4 million persons who earn more than $80,000 a year. Their monthly premium could be as high as $173.30 in 2007.

Part D also introduced means testing for the first time in Medicare's history. Starting Jan. 1, part B premiums are expected to rise to new highs on a sliding scale for about 2.4 million persons who earn more than $80,000 a year. Their monthly premium could be as high as $173.30 in 2007.

Some believe that the affluent should pay more. However, means testing changed the universal nature of Medicare as beneficiaries' financial records will be scrutinized. Medicare could become a program for the sick, old and poor, if the affluent decide to leave, rather than have their privacy invaded.

Many are hoping that, as seniors reach the donut hole amount, their anger will translate into votes for candidates who are in support of Part D and   other healthcare reform.  Both the Medicare Rights Center and the Center for Medicare Advocacy are leading the fight for real reform.  

Which side will the AARP take?