Posts filed under ‘Public vs. Private Health Coverage’
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.
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!
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
Say It Ain’t So, Joe
We hear that Senator Lieberman is prepared to join Republicans to filibuster against health care reform if it includes a public option. We can’t understand our Senator’s position.
The Center for Medicare Advocacy is a Connecticut-based organization with over 30 Connecticut employees. We have worked for decades to advance fair access to health coverage and care for residents of Connecticut. We have seen the painful ramifications when Medicare private plans came and went from Connecticut – leaving tremendous financial and emotional costs in their wake. In one case, a Medicare beneficiary died at a forum about a private Medicare plan that was leaving Connecticut! We were there.
As Senate Majority Leader Harry Reid said when he announced Monday that the bill he will bring to the Senate floor will include a public option, “I’ve concluded … that the best way to move forward is to include a public option with the opt-out provision for states. .. The public option, with an opt-out, is the one that’s fair.” ( Read more here.)
The public option is necessary to provide fair access to quality health coverage at a price taxpayers can afford. We know that from Medicare. We know that in Connecticut. We urge our Senator to rethink his position.
Dear Senator Dodd
We have avoided adding to the myriad requests we know you must be getting now that you are helping to develop a final Senate health care reform bill. But, it’s quickly becoming now or never, so we write about two of our main concerns:
- The Center for Medicare Advocacy is concerned about the Medicare Commission that the White House seems to envision and that the Finance Committee passed. While we understand the value of a payment commission from some points of view, we, and others who represent Medicare beneficiaries, are terribly concerned about provisions that would essentially empower an unelected Commission to cap Medicare funding. There is no justification for such unilateral Medicare cost-containment. (Except regarding private Medicare Advantage. We have been stating, and will continue to explain, that cuts to the outlandish, wasteful Medicare Advantage subsidies are completely justified.) A Commission empowered to cap overall Medicare funding threatens the future of the traditional Medicare program and is dangerous to older and disabled people. This is sadly ironic since such a Commission could essentially create the very kind of privatized, capped Medicare program that Newt Gingrich envisioned when he said that, “while we may not be able to kill Medicare, we can make it wither on the vine”.
- As you know, the Center for Medicare Advocacy is highly supportive of a real public option in health care reform. We are grateful for your active support for this key component of true reform. We know all too well how private Medicare Part D and Medicare Advantage plans have often abused the system, profited the insurance industry, and endangered the financial well-being of traditional Medicare. To replicate this system by having a private – only – health care reform system is simply to repeat history and to once again give away taxpayer dollars to big industry.
Thank you for all you are doing to bring health care access to all and reason to the health care system. Please let us know if we can help.
Senator Dodd Will “Fight For a Strong Public Option”
Senator Chris Dodd (Dem. Conn) posted this statement on Daily Kos in advance of the meetings he will have with Senator Baucus, Senator Reid, and the White House next week in order to hash out a compromise health care bill to send on to the full Senate. He sent his editorial on to us for CMA’s health policy blog. At the request of the late Senator Ted Kennedy, Senator Dodd chaired the Senate HELP Committee’s work leading to passage of a health care reform bill in July.
“A Moment To Be Bold
By SenChrisDodd <http://senchrisdodd.dailykos.com>
Fri Oct 09, 2009
Next week, I’ll sit down with Majority Leader Reid, Finance Committee Chairman Baucus, and the White House to merge together the provisions of the two health care bills that have been passed by Senate committees.
I’ll be there as the representative of the Senate Health, Education, Labor, and Pensions (HELP) Committee, but I know that I’m also carrying with me the responsibility of speaking up on behalf of millions of passionate activists – without whose efforts we wouldn’t have a President who has made reform a top priority, not to mention enough Democrats in Congress to pass a bill.
I understand that many of you are worried about what that bill will look like. I know first-hand how frustrating it has been to watch good ideas clash with political realities, especially on such an important issue.
The HELP and Finance Committees worked on different pieces of the bigger reform puzzle. My committee passed strong prevention, quality, workforce and long-term services and supports measures. Finance worked to strengthen Medicare and help small businesses afford and purchase health insurance for their workers.
Sometimes, our two committees overlapped. We both agree that insurance companies shouldn’t be allowed to deny coverage for pre-existing conditions, discriminate against women or the elderly, implement annual or lifetime caps on the benefits you can receive, or take away your coverage when you need it most.
That’s something we all agree on – and that’s a pretty good place to start from as we merge our two bills.
But we have come too far, and worked too hard, to settle for “pretty good.” And that’s why I plan to take a stand.
First, and let me be very clear about this: I am going to fight for a strong public option. The simple, undeniable fact is that a public option will save money – and it will introduce more choice and competition into an industry that badly needs both. It is the single best way to keep costs low for middle class families – and keep the insurance companies honest. And I am by no means ready to back down on making that argument.
There are some other issues to hash out, as well. I believe that we should require everyone to get health insurance, just as we require everyone to get auto insurance. But I also believe that it is unfair to burden middle class families with a mandate they can’t afford. I think the HELP bill has especially strong provisions to keep costs low and quality high, and I think they’re worth fighting for.
When we sit down with the White House to merge these bills, it will be an historic moment – one more unprecedented step towards finally overcoming the well-financed special interests and achieving the reform that has eluded us for more than 60 years. It will be a moment to celebrate how far we have come – but also a moment to be bold as we take the final steps towards reform.
It will be a negotiation, and I can’t promise that every disagreement will be resolved in our favor.
But I can promise that I will walk into that room prepared to fight for a strong public option, affordability provisions that protect the middle class, and common-sense protections to keep the insurance companies honest and guarantee that every American family can choose a health care plan that’s right for them.
The finish line is within sight. And I, for one, am ready to hit it running.”
Fiscally Conservative? Support A Public Option!
In the Senate Finance Committee, Arkansas Senator Blanche Lincoln voted against including a public option in health care reform. She explains that her opposition to a public option rests with her knowledge that Arkansas voters are “fiscally responsible”. We hope she will yet realize that anyone whose real concern is fiscal responsibility will support a public plan option.
No matter how much one might want to believe that the private market is always a more cost-effective model than a public program … it just ain’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 program, they left the program in droves. They couldn’t make enough profit. (“Medicare+Choice,” enacted in 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.
- The private Medicare plan program is bleeding the Medicare trust fund, reducing Medicare’s solvency by about 8 years.
If the 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.
Come on, Senator Lincoln, be fiscally responsible – support a public option in health care reform!
CMA Health Policy Blog 