No one will argue that Medicare Part D met a genuine need at its inception in the mid-2000s – offering Medicare beneficiaries an affordable voluntary health insurance plan that would cover their outpatient prescription needs. Fast forward 10 years. Has Part D met its objective? In terms of the availability of a wide range of plans at an affordable premium in all parts of the nation, yes, definitely. In terms of actual payments made to beneficiaries, this is a question mark.