Major changes were introduced in Medicare for the first time in thirty years as the Medicare Modernization Act of 2003 offered prescription drug assistance to all Medicare beneficiaries with such assistance also being offered through a large number of private health insurers.A very large number of plans are now being offered and it has to be wondered why the tax cuts that had been announced could not have been used to device a simpler system without a doughnut to better care for the elderly and the disabled. This brief essay presents an examination of why Medicare Part D coverage makes the elderly a vulnerable population.