The effect of the Medicare “donghnut hole”. “People with high drug costs will have relatively low out-of-pocket expenses for part of the year – say, until next summer. Then, suddenly, they’ll enter the doughnut hole. Their personal expenses will soar. And because the same people tend to have high drug costs year after year, the roller-coaster ride will repeat in 2007.

How will people respond when their out-of-pocket costs surge? The Health Affairs article argues, based on experience from HMO plans with caps on drug benefits, that it’s likely ‘some beneficiaries will cut back even essential medications while in the doughnut hole.’ In other words, this doughnut will make some people sick. For some it will be deadly.”