Archive for November, 2009
ANSWER to Pop Quiz! Who Said This? About What?
As a spokesman for the AMA, Ronald Reagan said this about the dangers of passing Medicare: “… behind it will come other federal programs that will invade every area of freedom as we have known it in this country. Until one day, as Norman Thomas said, we will awake to find that we have socialism. And if you don’t do this and if I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.”
Ronald Reagan, our beloved Republican president, said this as a spokesman against Medicare. Now Republicans laud Medicare, say they are its champion, but say that health care reform must not pass as it will lead to socialism and the demise of Medicare. There is little new under the sun!
Tell your senators to vote for health care reform – with a public option. Like Medicare it is desperately needed and, if passed, it too will become a beloved institution.
Someone, someday, will thank you for fighting for it and will praise your senators’ votes.
Connecticut’s Senators, Health Care Reform, and Lessons From Medicare
The Center for Medicare Advocacy is incorporated and headquartered in Connecticut. People from this state can be proud of the courage our senior senator, Chris Dodd, has shown in leading health care reform. As a leader of the Senate’s efforts, Senator Dodd is once again speaking and fighting for real reform, to include a public option. We urge our other Senator, Joe Lieberman, to review the true costs and principles involved in this historic opportunity to insure all Americans, and to vote along with Senator Dodd for real health care reform.
The Center has been representing people with Medicare since 1986. We know what we’re talking about when we talk about the benefits and costs of public health insurance.
Medicare is public health insurance. It brought basic health coverage to older people in 1965, when 50% of people over 65 had NO insurance because the private market didn’t want to insure them. All the arguments being made now against health care reform and a “public option,” were also made against Medicare before it passed. Medicare was hardly bi-partisan legislation; it barely passed.
Now most everyone appreciates Medicare and the health and economic security it brings to older people and their families. We can only hope Congress, and both of our Connecticut senators, will vote courageously again, as those before them did to enact Medicare. This time we call upon Congress to bring health and economic security to younger Americans by voting for health reform – with a public option.
Private Medicare Costs Too Much – THAT’S Why The Payments Should Be Cut
If Republicans and “conservative” Democrats really want to save money, help taxpayers, and serve Medicare beneficiaries, they will cut the wasteful subsidies to private Medicare plans. Private Medicare plans cost taxpayers about 14% more than would be needed to cover the same services in the traditional, public Medicare program. Private plans should be paid the same rate as original Medicare; we simply can’t afford otherwise. The subsidies to private “Medicare Advantage” plans cost taxpayers about $10 billion a year!
Private Medicare Plans – Bullies On The Playground?
Medicare “Advantage” private plans were created not-equal in 2003. Not equal to “regular Medicare” because the law gave private plans a windfall of about 14% more per covered beneficiary than is paid for the same coverage in regular Medicare. We have all been paying for this – to the tune of about $10 billion a year! So, if paying the private plans the same as the traditional program means they take their balls and go home, so be it. We simply can’t afford to pay for the kind of profit the private plans seem to insist they make at the expense of Medicare and taxpayers.
The Center for Medicare Advocacy has long been concerned about the extraordinary costs of private Medicare. The movement towards fragmenting and privatizing Medicare was advanced by the Medicare Act of 2003.The lessons from privatizing Medicare should be applied when developing health care reform: No matter how much some people may want to believe that the private market is always a more cost-effective model than a public program, it just isn’t so. Medicare proves the point.
• When Medicare private plans were paid 95% of what it costs to provide the same coverage in the public Medicare program, they left the program in droves. They couldn’t make enough profit. (“Medicare+Choice,” enacted in 1997 as part of the Balanced Budget Act of 1997.)
• Under the “Medicare Advantage” program, passed in 2003, private Medicare plans are paid about 14% more than the same coverage would cost in the traditional public Medicare program. And, not surprisingly, private insurance plans have flocked back into the system. The insurance industry is making a windfall from this system – at the expense of all Medicare beneficiaries, including the vast majority of beneficiaries who still choose “regular Medicare.” Taxpayers overpay too. (CBO, MedPAC, Commonwealth Fund.)
• The private Medicare plan program is bleeding the Medicare trust fund, reducing Medicare’s solvency by about 8 years.
If Congress passes a requirement that all Americans have health insurance, but does not provide for a public option, we will have been taken to the cleaners yet again. Private insurance will gain tens of millions of new customers and we taxpayers will all pay a much higher bill than is necessary. Medicare’s experience proves this.
Meeting With The First Lady About Health Reform
Like many of you, I am a mother, a wife, a daughter – and now, amazingly, a grandmother. I am also a lawyer and I run this small business, the Center for Medicare Advocacy. The Center is a non-profit organization founded in 1986. We represent older and disabled people with the focused mission to ensure fair access to Medicare and quality health care. So I know something about advocating for health coverage.
Michelle Obama is hosting a meeting about health care reform and women on November 13th. Wonderfully, the Center has been invited to participate. So tomorrow I’m going to Washington to tell my story to the First Lady.
I’m healthy. I tend not to catch the various viruses that run through my office and community. I exercise, eat a largely vegetarian diet, live an engaged life, and get the recommended medical and dental check ups.
So I was taken by surprise when I was diagnosed with Breast Cancer four years ago. I had a mammogram just a few months earlier. But the bottom line is, stuff happens. We’re all human, and human beings get sick, even if they do “all the right things,” and take care of themselves. From a person who rarely saw doctors, I became a full-time patient. Even now, four years later, I am involved with treatments and tests far more than I like.
It is silly to suggest that people over-utilize health care because they have health insurance. Yes, my insurance covered most of my care. But many of these tests and “procedures” are painful and many of the medications have dreadful side-effects. No one would choose this.
On the other hand, a lack of insurance authorization almost led me to skip important care. However, because I knew how to pursue an appeal, I obtained authorization and proceeded with the treatment – a good decision since I almost needed a transfusion even with them.
I continue to be faced with decisions about follow up treatment and insurance coverage obstacles. I have had to urge my doctors to make their best medical decisions and to leave the insurance battles to me. But if I were not a lawyer who has been fighting for proper health insurance for other people for 30 years, I might not be getting the treatments I need.
My story is only different from everyone else’s because I do have insurance and because I am a professional advocate. We all get sick, we all get injured. But we don’t all have insurance, and we aren’t all health care lawyers.
All women, all people, need health care and we all need help paying for it. This is particularly a woman’s issue because we live longer with more chronic conditions than men and because we are often primary caregivers – for our kids, our spouses, and our parents, all of whom get sick.
I’m telling my story because I’m told it may help. Tell yours too. We need quality health coverage – including a public option – for everyone. I know this as a woman, a patient, and an advocate. As the First Lady suggests, we need to make our voices heard now.
Urge Congress to seize this opportunity to provide health care security for everyone. Pass health care reform this year!
Congratulations America: Healthcare Reform is Moving Forward
The Center for Medicare Advocacy is grateful to those who courageously voted for the Affordable Health Care for America Act, H.R. 3962. This legislation goes a long way towards ensuring for all Americans the peace of mind that was brought to older people and their families with the passage of Medicare in 1965.
Medicare itself is based on the notion of a shared a public/private undertaking and of pooling resources for the common good. In Medicare’s case, the common good is that of older people, people with disabilities and their families. The Affordable Health Care for America Act advances the common good to all Americans by expanding access to health care to America’s uninsured and by implementing private market insurance reforms.
Among other things, the legislation passed by the House of Representatives will:
- Provide affordable health insurance options for those currently without coverage;
- Provide a Public Insurance option to provide competition with private insurance and keep costs down for individuals and taxpayers;
- Prevent insurance companies from denying coverage to those with pre-existing conditions;
- Prevent insurance companies from dropping the coverage of those who get sick;
- Prohibit insurance companies from having life-time limits on benefits;
- Ensure that insurance companies offer real value for premiums paid;
- Strengthen Medicare for the more than 44 million older people and people with disabilities who currently use the program and for future generations of beneficiaries;
- Improve Medicare’s payment to doctors and thus ensure that Medicare beneficiaries can continue, as they do now, to see the doctor of their choice or find a doctor if they need one;
- Require Medicare, as well as private insurance, to provide preventive benefits without application of cost-sharing;
- Promote care coordination in Medicare – especially for those with multiple chronic conditions – through various pilot projects;
- Improve access to Medicare-covered services for low-income beneficiaries by strengthening the programs that serve these individuals;
- Lower drug costs for Medicare beneficiaries by closing the Medicare Part D “Donut Hole” coverage gap
- Lower drug costs for Medicare beneficiaries by allowing the government to negotiate for lower drug prices with pharmaceutical companies;
- Provide benefits to help older people and people with disabilities live in their own homes and communities by establishing the Community Living Assistance Services and Supports (CLASS) program.
The Center for Medicare Advocacy applauds President Obama, Speaker Pelosi and all members of the House of Representatives who have worked so hard to bring this legislation to life. We urge the Senate to follow suit soon!
AARP Endorses “Affordable Health Care for America Act”
“As members of the House gear up for this historic vote, they will hear from older Americans”
Hartford, CT—Today AARP announced its endorsement of the Affordable Health Care for America Act (H.R. 3962) and the accompanying Medicare Physician Payment Reform Act (H.R. 3961). The Association’s support follows nearly two years of work with lawmakers on both sides of the aisle to craft a health care reform plan that meets the needs of AARP’s nearly 40 million members and all older Americans. Among those needs are reforms that strictly curb insurance companies’ discrimination against older Americans and Medicare improvements that strengthen benefits while protecting the program for future generations.
“For more than two years, AARP has been involved in the debate over health reform with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors,” said AARP Connecticut Director Brenda Kelley. “We have thoroughly read the Affordable Health Care for America Act and can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage.”
Today’s endorsement marks the first time in this legislative battle that AARP has put its full weight behind a comprehensive health care reform package. In the coming days, AARP will be educating its members about the health care reform package through its publications, paid advertising and more than five million calls and e-mails to its grassroots activists.
“As members of the House gear up for this historic vote, they will hear from older Americans,” Kelley said. “Our members have told us loud and clear that they want common sense reforms that will protect Medicare for them and future generations, and ensure all Americans have access to affordable, quality health care choices.”
The Affordable Health Care for America Act and the Medicare Physician Payment Reform Act contain critical components AARP has been fighting for on behalf of its members and all older Americans to improve health care for them and their families. They include:
- Protecting and strengthening Medicare for today’s seniors and future generations of retirees;
- Ensuring seniors can see the doctor of their choice or find a doctor if they need one by improving Medicare’s payments to doctors;
- Lowering drug costs for seniors by closing the Medicare Part D “doughnut hole” and allowing the government to negotiate with drug makers for lower drug prices;
- Taking steps to reduce waste, fraud, abuse and inefficiency in the Medicare program;
- Requiring Medicare and insurance companies to provide for important preventive services like screenings for diabetes, cancer and osteoporosis free of charge;
- Preventing insurers from denying you affordable coverage because of your age;
- Preventing insurance companies from denying you coverage if you have a pre-existing condition or dropping your coverage if you get sick;
- Limiting how much your insurance company can make you pay out-of-pocket;
- Providing affordable health insurance options for those who don’t have insurance; and
- Providing benefits to help seniors and people with disabilities live in their own homes and communities by establishing the Community Living Assistance Services and Supports (CLASS) program.
The bill also includes important new provisions that greatly improve funding and access to current and new health care programs for citizens in Puerto Rico and the U.S. Territories, an issue that is of particular interest to Hispanic leaders and residents in Connecticut.
Kelley added: “We cannot continue to let insurers price older Americans out of the market, just as we cannot stand idle while millions of seniors are forced to choose between their groceries and their prescriptions. AARP is proud to endorse the Affordable Health Care for America Act and the Medicare Physician Payment Reform Act, and we urge members of the House to pass this critical package in the coming days to help fix our broken health care system.”
Kaiser Family Foundation Ad Audit: Message Sacrifices Truth About Health Bills And Medicare
AD TITLE: “Greatest Generation”
SPONSOR: The 60 Plus Association
SUMMARY: A conservative advocacy group uses testimony from sympathetic older Americans to warn that a health care overhaul would impair Medicare, the government health care program for the elderly. The ad says older Americans should be shielded from spending cuts because of their great sacrifices for the country. But it’s truth that’s sacrificed here: the ad exaggerates the impact of proposed Medicare cuts and ignores some improvements in Medicare benefits included in the main Democratic bills before Congress.
BACKGROUND: The 60 Plus Association, a nonprofit advocacy group that bills itself as a conservative counterweight to AARP, favors lower taxes and less government. The group says it is has purchased $2 million in airtime in eight states that are homes to key senators: Alaska, Arkansas, Connecticut, Louisiana, Maine, Nebraska, North Dakota and South Dakota. The ads come in 30-second and 60-second versions.
POLITICS: The ad is part of a broader effort to increase concerns among older Americans about pending health care legislation. The insurance industry’s main lobbying group, America’s Health Insurance Plans, made a similar argument in ads last month. Both AHIP and 60 Plus are upset about proposals to create government-run insurance that would compete with private companies in selling coverage to people under age 65. Since many surveys show substantial support for the public option, however, the opponents are focusing on something else: The bills’ potential impact on the popular Medicare program.
ACCURACY: The health bills would reduce Medicare spending, but it’s highly unlikely medical care for the elderly would suffer, many health analysts say. “This ad is clearly intended to frighten people with a great deal of misinformation,” says Judith Stein, executive director of the Center for Medicare Advocacy, a Connecticut-based nonprofit that helps people secure Medicare benefits.
Under the Senate Finance Committee bill, Medicare spending, on net, would be $379 billion less over a decade, or about 5 percent of program expenditures, than under current law. In both that bill and the House proposal, a big chunk of the cuts would involve Medicare Advantage plans that are run by private insurers and often provide additional benefits beyond what traditional fee-for-service Medicare offers. The Finance bill targets Medicare Advantage for $117 billion in cutbacks over a decade; the House bill, $170 billion, according to the Congressional Budget Office.
Congress is eyeing Medicare Advantage plans largely because they spend an average of about 14 percent more on their members than traditional Medicare spends on its beneficiaries. If the cuts are enacted, the number of Medicare Advantage plans might decline. In addition, those that survive might pare back some of the extra benefits they offer, such as low or zero monthly premiums, dental care and free gym memberships. But no one would be denied basic Medicare benefits.
On the other hand, not all the proposed reductions would be painless – especially for the providers who would bear the brunt of other Medicare cuts. Overall, though, the cuts would be substantially less than the reductions approved by Congress in 1997 to balance the federal budget deficit, according to Tricia Neuman, a Medicare expert at the Kaiser Family Foundation. (KHN is a part of the foundation.) Congress ended up restoring some of that money a few years later. Lawmakers were worried some of the reductions, including those for skilled nursing facilities, were too severe. “It’s hard to anticipate changes in the health care system,” Neuman says. “Ongoing tweaks may be necessary.”
The ad’s warning about the rationing of “potentially life-saving drugs” lacks support. The 60 Plus Association tries to back up this claim by citing a few news stories about patients in England and Canada denied drugs by government insurers. But far from restricting access to drugs, “ironically, there are enhancements to the Medicare drug benefits” in the health overhaul bills, says Paul Ginsburg, president of the Center for Studying Health System Change, a Washington research group.
The bills being debated would eliminate co-payments for preventive services. In addition, the House bill would provide a 50 percent discount on brand-name drugs purchased when beneficiaries hit the coverage gap known as the “doughnut hole,” and it would gradually eliminate the gap. The Senate Finance bill would not close the doughnut hole, but it would provide the discount, which was negotiated with the Obama administration and the pharmaceutical lobby earlier this year. The House bill also would require Medicare to cover immunosuppressive drugs for as long as kidney transplant recipients need them, rather than for the current 36 months.
Overall the ad’s argument is built on a logical inconsistency: It raises the specter of “government-run health care” to increase concerns among both young and old. But at the same time it extols Medicare – which is government-run health care for people 65 and older.
Source: Kaiser Health News, Jordan Rau, KHN Staff Writer
CMA Health Policy Blog 