Posts filed under ‘Medicare’
Medicare and … the Military?
I read David Brooks’ New York Times editorial yesterday with dismay. It seems Medicare is not only to blame for the federal deficit, but also for Sen. Hagel’s nomination and the end of America’s military might. I have been representing Medicare beneficiaries and studying Medicare since 1977. Even I was surprised by these positions.
The determination to slash Medicare seems never ending. One hardly knows where to begin responding. But we need to try, before it’s too late. Before the next deficit cutting activities get underway, we need to set the record straight.
The basic, public Medicare program was a cost-effective success. Medicare brought access to health care to older people who were refused private health insurance. It dramatically decreased poverty among older people. Unnecessary payments to private Medicare plans, unrestricted payments for prescription drugs and policies aimed at privatizing Medicare increased the program’s costs exponentially. These expensive provisions should be the targets for those whose true goal is to reduce the deficit. If the will exists, there is a way to reduce costs while preserving Medicare’s promise.
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Watch this short video from the Kaiser Family Foundation: http://www.kff.org/medicare/medicare-timeline2.cfm. It will remind you why Medicare matters.
Annual Medicare Payment Limits for Home Health – Even Worse Than Co-Pays for Beneficiaries
The Center for Medicare Advocacy has represented Medicare beneficiaries since 1986. As one of the few advocacy organizations in the nation solely serving Medicare beneficiaries, we strongly oppose home health episodic payment caps or any other such defined payment limits. The counterpart to this notion, caps on outpatient therapy, has created significant barriers to necessary care for thousands of our clients with long-term and chronic conditions. We have no doubt that episode caps would be harmful to some of those in greatest need of home care. Thus, we are adamantly opposed to such limits in the home health context.
The Center has long opposed Medicare home health co-payments, and continues to do so. Like caps, co-payments will limit access to in-home care for those most in need of these services. However, we are increasingly concerned about proposals to introduce home health payment limits. There is no question that home health payment limits would be disproportionately harmful for people with conditions such as traumatic brain and spinal cord injuries, Alzheimer’s, Parkinson’s disease, MS, and other such illnesses and disabilities. Without the possibility for ongoing home health care, these individuals may well need costly nursing home or hospital care.
For example:
• Our client, Mrs. Berkowitz, who is 81 years old and receives skilled physical therapy and home health aide services for her Multiple Sclerosis and related health needs, will require a nursing home if payment caps are instituted for Medicare home health.
Payment caps contradict and undermine growing efforts to promote better care, at lower costs, by encouraging and investing in home and community-based services.
Payment caps would also undermine the settlement just arrived at with the U.S. Department of Health and Human Services in the national class action law suit, Jimmo vs. Sebelius. The Jimmo Settlement makes it clear that Medicare coverage is available for home health patients who need skilled nursing or therapy to maintain or slow deterioration of their conditions. Jimmo holds the promise of continuing care at home for people with long-term conditions who would otherwise often need more intense and expensive institutional care. Medicare home health payment caps, however, would create a barrier to this care and provide a disincentive to home health agencies to offer care to this particularly vulnerable population.
Medicare Helps People With Chronic Conditions Stay Home
Few people understand the value of Medicare’s home health coverage. In fact, many people who qualify for Medicare instead pay out-of-pocket, go without needed care, look to Medicaid for payment, or even enter nursing homes unnecessarily. Learn about Medicare home health coverage from nationally known beneficiary advocates. This Wednesday, September 12th!
Medicare Home Health Coverage for People With Long-term and Chronic Conditions
Presented by: Judith Stein, Executive Director/Attorney and Margaret Murphy, Associate Director/Attorney
September 12 from 2:00 – 3:00 PM EDT
Unknown to most people with Medicare, and contrary to what is often stated by the Centers for Medicare & Medicaid Services (CMS), the Medicare home health benefit can provide long term coverage for those who qualify. This webinar will help advocates understand the potential of this important coverage so that people with long-term and chronic conditions can obtain the nursing, therapy and home health aide care they need to remain at home. The presenters will explain:
* Prerequisites to obtaining Medicare home health coverage;
* Real and imagined limitations to coverage;
* Advocacy tips for obtaining and maintaining coverage;
* How to appeal home health coverage denials.
Register at http://www.naela.org/store/SearchResults.aspx?EventType=WEB
Download Speaker Bios at http://www.naela.org/app_themes/public/PDF/Meeting%20PDFs/Webinar/2012sep12webinarbio.pdf
We Don’t Need the Ryan Plan − Medicare Is NOT Going Broke
According to researchers from the Urban Institute, writing in the New England Journal of Medicine, Medicare’s purported dire financial condition isn’t actually all that dire. Given the aging of our population, increases in enrollment have obviously contributed to spending growth. But, according to the Urban Institute, “in recent years “spending growth per enrollee slowed in Medicare and Medicaid, and per-enrollee growth rates in the next decade are projected to be very close to the expected growth in [Gross Domestic Product] per capita. These data do not support the need for major restructuring of either program.” (emphases added)[1]
In short, contrary to repeated assertions, Medicare is not broke, going “bankrupt” or running out of funds,[2]. Further, Medicare provisions in the Affordable Care Act (ACA) have improved Medicare’s economic outlook − extending the solvency of the Medicare Trust Fund by 8 years.[3]
The real problem that needs to be addressed is rising overall health care costs. Overall healthcare expenditures per capita in the United States are higher than in any other country, and show no signs of slowing.[4] Addressing US health system costs in general is the only real solution to the fiscal issues ahead. The Affordable Care Act addresses many of these pressing concerns. Let it work.
[1] Holahan, J., McMorrow, S. Medicare, Medicaid and the Deficit Debate. Washington DC: Urban Institute, April 2012. Published in the New England Journal of Medicine, August 2012.
[2] See, e.g., “Medicare is Not Bankrupt” by Paul N. Van de Water, Center on Budget and Policy Priorities (April 24, 2012), available at:http://www.cbpp.org/cms/index
[3] See, e.g., CMS Press Release: “Medicare Stable, But Requires Strengthening” (April 23, 2012), available at:http://www.cms.gov/apps/media/press/release.asp
[4] See, e.g. Kaiser family Foundation at http://www.kff.org/insurance/snapshot
Fight for Medicare
The so-called Medicare wars are really a unilateral assault to the community Medicare program by those who favor privatization. Private plans are well known to cost more within and outside of Medicare. For decades, various experiments with private Medicare plans have proved more expensive than traditional Medicare. Nothing in Mr. Ryan’s plan is new or any more likely to save Medicare money. In fact, his plan would reintroduce vast overpayments to private Medicare plans that were rolled back by the Affordable Care Act. If the goal is to save Medicare, provide fair access to health care for its beneficiaries, and reduce spending – defeat efforts to turn Medicare into a private voucher system.
Scary Ryan Medicare Plan
The Center for Medicare Advocacy is a national leader for Medicare and the people it serves. “We have represented Medicare beneficiaries since 1986,” says Judith Stein, founder and executive director of the Center. “We’ve seen Medicare coverage save lives and bring peace of mind to thousands of families. We know how Medicare works and what keeps Medicare strong. Mr. Ryan’s plan sounds the death knell for Medicare,” continues Ms. Stein. “The private plans added to Medicare since 2003 have cost Medicare and all its beneficiaries dearly. Unfortunately, Mr. Ryan’s vision is to privatize Medicare.”
The Ryan plan would provide each beneficiary with a limited amount to purchase an individual private policy. The Ryan plan would gut the community Medicare program. It would reduce coverage and increase costs for seniors – while doing nothing to address the real problem of rising overall health costs.
“Medicare has dramatically increased access to health care and economic security for millions of older and disabled people and their families since 1965. Mr. Ryan’s plan puts all this in jeopardy. He purports to save Medicare – but will actually end the Medicare program as we know it.”
More Information:
CMA Heath Policy Post: “Medicare ‘Reform’ – Beware the Wolf in Sheep’s Clothing” at: https://cmahealthpolicy.com/2011/12/16/medicare-reform-beware-the-wolf-in-sheeps-clothing/
CMA Alert: “So What Would You Do? real Solutions for Medicare Solvency and Reducing the Deficit” at: http://www.medicareadvocacy.org/2011/06/09/so-what-would-you-do-real-solutions-for-medicare-solvency-and-reducing-the-deficit/
We All Lose – If The Supreme Court Strikes Down Health Reform
Millions of people will be left with limited or no access to health care if the Affordable Care Act (ACA) is overturned. This will include people of all ages − older and disabled people with Medicare, middle class families, children with asthma and other pre-existing conditions, and adults with on-going medical needs. At this time, when family incomes are stretched to the max, many people are unemployed, and fewer jobs provide health insurance, individuals and families all over the country will lose if the Court strikes down Health Care Reform.
Older and disabled people with Medicare will lose access to preventive health care, help paying for life-saving medications, and an annual health visit. Taxpayers will resume overpayments to private Medicare plans. Children with preexisting conditions will again be subject to discrimination by private health insurance companies. People who would have gained access to coverage under ACA, beginning in 2014, will lose out. This includes adults with pre-existing conditions, those with high out-of-pocket costs, and families with moderate incomes. Young adults who, thanks to ACA, have health coverage under their parents’ plans will also be in jeopardy.
In short, if the Court strikes down the law we all lose. The number of people with inadequate or no health insurance will rise – but those same people will still get sick and injured, and require care. And we will all pay, in emergency rooms, unpaid hospital bills, higher premiums – or simply by catching their illnesses.
Let’s hope the Supreme Court recognizes the national interest in making basic health insurance available to all. If it does, we will all feel better.
CMA Health Policy Blog 