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Medicare

Debra Grannick won her pharmacist's degree at USC and went on to manage the massive COSTCO pharmacy on Morena Boulevard. But no one at USC could have prepared her for the chaos that now envelops her, and tens of thousands other pharmacists across America.

Their insular world behind high counters and sliding windows has suddenly become a nationwide exercise in human relations. It's created by President Bush's badly bungled Medicare prescription drug plan, known as "Part D." It became effective, although that is not an apt word, at New Year's.

The standard plans was passed by Congress. Private insurers have created their own variations in the hope that we will all sign up with them. For most of us, the soaring cost of medical drugs leads many of us to think of "Part D" as our salvation. But then again, maybe not.

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"The plan is just far too complex," Debra Grannick says. "It's too much for people to handle. There are too many choices to make. This plan has increased the flow of questions from our customers by a factor of two or three to one.?

And that's true for all the other pharmacists she talks to across the nation. Millions of elderly Americans are trying to complete the enrollment forms with nobody around

to help. At our own house, the two of us lumbered through paperwork one night from the close of the Jim Lehrer hour until 1 a.m. To a writer, they seem almost purposefully unfathomable. We read instructions to each other. Finally we shrugged and began to fill in some lines. We eventually signed our names to a piecemeal application, sealed the envelopes and went to sleep. A few days later I dropped off a new prescription at COSTCO. I asked the price.It was a shocking $260. A clerk said she's just put it on my COSTCO card.

My next day's mail brought a strange white AETNA card. I have been accepted as a customer of AETNA. My confirmation number is a mere 14 digits in length, 131-252-263-991-96. The address of my insurer sounded like a fairy tale: 980 Jolly Road at Blue Bell, Pennsylvania. Failing to memorize that number and doubtful about the whole thing, I took the card to COSTCO, hoping to use it to pay for my new prescription. That's when I met Debra. She appeared after a conference behind her glass walls, one of many, I gathered, that pharmacists are having these days.

She came out to the counter with money in her hand. "So now we owe you $80," she said casually, and counted it out. "Don't forget your card next time."Now that part, I understood. I am not alone in noting that the pharmaceutical drug industry is profiting hugely from my business. And that in Washington, each small decision after another tends to entrench their grip over my life. My white card, I assume, is intended to hold down a rebellion.