Republican Rep. Paul Ryan wants to privatize Medicare. He should look instead to drug scams inherent in Medicare Part D.

When it was set up, the government specifically prohibited negotiation of drug costs with drug companies. Why?

I take the prescription drug Nexium for severe gastric reflux. In 2007, when I first obtained Part D coverage, my cost for a month’s supply was $28. The plan paid $106.68, a total drug cost of $134.88. (Once the total drug cost reaches a certain level, changing annually, enrollees enter the coverage gap, aka the “doughnut hole,” after which the enrollee’s costs increase substantially.)

Since 2007, my Nexium costs have risen incrementally. By August 2013, the plan payment increased to $414.06 (total drug cost of $459 a month). I reached the 2013 “doughnut hole” of $2,970.

Later, I got a refill of Nexium. The plan paid $206.17; I paid $146.28; $106.61 was paid by the Affordable Care Act, which provides for a 47.5 percent “doughnut hole” discount.

In January, the plan paid $445.53; I paid $41; my total drug costs this year are only $275 away from the “doughnut hole,” now at $2,850 (note decrease). ACA aid has been negated by the increase in plan cost.

I can obtain Nexium from a Canadian pharmacy where the cost is 100 tablets for $126 (one and two-thirds months’ supply for me), cheaper than buying while in the “doughnut hole.”

On May 27, an over-the-counter version of Nexium became available at $23.98 for 42 20-mg tablets. My cost would be about $70 a month (with no claim to Medicare), yet the insurance company uses a figure of $487 a month for the total drug cost. What is wrong with this picture?

When legislators exhibit outrage over the cost of Medicare, why is there no mention of Medicare Part D?

Polly Shaw

Bath