From the category archives: healthcare
This was originally posted at The Huffington Post by NCPSSM President/CEO Max Richtman
America’s longest-serving First Lady and social activist, Eleanor Roosevelt, would have celebrated her birthday this week. There have been so many momentous changes in our nation during the fifty-plus years since her death. Even so, one can’t help but wonder if we have truly fulfilled Eleanor’s hope for America, particularly when it comes to equity for women.
In so many ways, women have come a long way; however, American women are still lagging behind their male peers in too many significant measures. Retirement security is one of those areas where women still face a future marked by inequality. That’s why we at the National Committee to Preserve Social Security and Medicare have launched “Eleanor’s Hope,” a national initiative mobilizing women of all ages to advocate for income equality, retirement security and health protection.
“It is better to light a candle than curse the darkness.”
-- Eleanor Roosevelt
The demographic reality facing most American women simply can’t be ignored. Women live longer than men, on average, yet their lifetime earnings are generally lower. They are more likely to work in part-time jobs that don’t qualify for a retirement plan or interrupt their careers to take care of family. The gender wage gap continues, meaning women earn only 78 cents for every dollar paid to their male counterparts. Lower wages mean less is contributed to Social Security for their retirement. The good news is more women are participating in pension and retirement savings plans than ever before. The bad news is that the retirement savings gap persists.
According to the New School for Social Research, 75 percent of Americans nearing retirement have less than $30,000 in their retirement accounts. Almost half of middle-class workers will be poor or near poor in retirement and living on a $5-per-day food budget. The National Institute for Retirement Security reports four out of five working families have retirement savings less than one times their annual income and 45 percent do not have any retirement assets at all. The economic downturn was especially difficult for elderly women. The latest census reports that nearly 2.6 million elderly women are living in poverty and 733,000 of those live in extreme poverty. For women who live longer on lower benefits, America’s retirement crisis is very real. That’s why the financial protection Social Security provides is even more critical for the millions of women who depend on this vital program to keep them from poverty.
Not only do women live longer than men they are also more likely to suffer from three or more chronic conditions including arthritis, hypertension and osteoporosis, making Medicare especially vital for older women. The Kaiser Family Foundation estimated that out-of-pocket spending in 2009 for Medicare beneficiaries 65 and older was $4,844 for women compared to $4,230 for men. As beneficiaries age, out-of-pocket spending consumes a larger share of their income. At age 85, total out-of-pocket spending for women was estimated to be $7,555 compared to $5,835 for men. Clearly, the inequity women face in the workplace continues to follow them even into retirement.
“The battle for the individual rights of women is one of long standing and none of us
should countenance anything which undermines it.” – Eleanor Roosevelt
There are ways to address these inequities if we can find the political will. Our “Eleanor’s Hope” campaign will lead grassroots advocacy and education efforts in our communities and on Capitol Hill to build momentum in Congress to address these critical retirement issues. Our goal is to raise awareness, recruit and train new activists and bolster Congressional leaders who are making a difference on women’s health and retirement security issues. We’ll advocate for legislation that addresses the inequities threatening millions of retired women. Some of our proposals for Social Security and Medicare include:
- Providing Social Security credits for caregivers
- Improving Social Security survivor benefits
- Equalizing Social Security’s rules for disabled widows
- Strengthening the Social Security Cost of Living Allowance
- Boosting the basic Social Security benefit of all current and future beneficiaries
- Building on preventive care provisions in the Affordable Care Act and expanding coordination of care for beneficiaries with multiple chronic conditions.
- Generating greater savings on the cost of prescription drugs by increasing manufacturer discounts, allowing Medicare to receive the same drug rebates as Medicaid for dual-eligibles, and promoting lower drug costs by providing for faster development of generic drugs.
If this sounds ambitious, it’s because it is. However, just under 77 million baby boomers are retiring and more than half of them are women. Too many will face retirement inequity and insecurity. As we honor Eleanor Roosevelt’s legacy this week and into the future, we must continue the work necessary to fulfill Eleanor’s hope for America.
“The future is literally in our hands to mold as we like. We cannot wait
until tomorrow. Tomorrow is now.” – Eleanor Roosevelt
While a flat line in the medical world is usually bad news...when it comes to health care costs in Medicare, this flat line is a good thing. We reported earlier on the latest Congressional Budget Office forecast for Medicare and why that news is being ignored by Washington’s well-financed anti-entitlement lobby and the fiscal hawks they support in Congress.
Today, the New York Times provides even more good news for Medicare and bad news for anti-Social Security and Medicare scolds:
“Medicare spending isn’t just lower than experts predicted a few years ago. On a per-person basis, Medicare spending is actually falling.
If the pattern continues, as the Congressional Budget Office forecasts, it will be a rarity in the Medicare program’s history. Spending per Medicare patient has almost always grown more rapidly than the economy as a whole, often by a wide margin.”
For years now, Wall Street funded fiscal hawk groups have been promising fiscal Armageddon unless Congress immediately cut benefits to middle-class seniors and their families. Contrary to that billionaire-financed bluster, the truth is there are clearly ways to see savings in Medicare through lower health care costs, not just by slashing benefits:
“The recent pattern reflects two main factors. One is that the baby boom generation is entering the program. In the long term, that’s a problem for Medicare’s finances because the number of people it must care for is going to surge. But in the short term, it skews the group enrolled in Medicare toward a younger, healthier population.
The second factor is more surprising and consequential. Over the last few years, Medicare patients have been using fewer expensive medical services, particularly hospital care and prescription drugs. The budget office is increasingly persuaded that such a pattern is going to last for a while.”
And there are even more proposals that could be enacted which don’t single out seniors for benefits cuts. How about allowing Medicare to negotiate for lower drug costs like the VA does for veterans? Or fully allow the proposed reductions in billions of dollars in federal overpayments to MA private insurance companies to be enacted, as proposed by the Affordable Care Act? This CBO report clearly proves there are ways to manage costs beyond the benefit-cutting or privatization schemes preferred by Congress’ self-proclaimed deficit hawks:
Joan McCarter at Daily Kos sums it up best this way:
“Here's what's particularly significant in this: "Reductions made in the last four years alone are responsible for 10-year savings of more than $715 billion, which dwarfs nearly every deficit-reduction measure currently under discussion." Take that, Paul Ryan.
Here's the thing. Medicare is going to be facing issues when the baby boom cohort gets older and sicker. But this trend in shrinking costs gives policymakers time to look at reforms that do not require benefit cuts, that don't require pain for Medicare patients. That means there's no reason for another Paul Ryan budget that slashes the safety net or for another catfood commission calling for raising the Medicare eligibility age or more cost-sharing by patients. Take note, Democrats, and stop with the deficit fetish already.”
In spite of years and years of doom-and-gloom predictions from conservatives that Obamacare will hurt Medicare, the facts just continue to tell another, very different story. Earlier in the month the annual Medicare Trustees report
showed how the ACA continues to extend the program’s solvency. Now, the Congressional Budget Office
has even more to say:
“You’re looking at the biggest story involving the federal budget and a crucial one for the future of the American economy. Every year for the last six years in a row, the Congressional Budget Office has reduced its estimate for how much the federal government will need to spend on Medicare in coming years. The latest reduction came in a report from the budget office on Wednesday morning.
The changes are big. The difference between the current estimate for Medicare’s 2019 budget and the estimate for the 2019 budget four years ago is about $95 billion. That sum is greater than the government is expected to spend that year on unemployment insurance, welfare and Amtrak — combined. It’s equal to about one-fifth of the expected Pentagon budget in 2019. Widely discussed policy changes, like raising the estate tax, would generate just a tiny fraction of the budget savings relative to the recent changes in Medicare’s spending estimates.”
Unfortunately, these fiscal facts will be ignored by those in Washington determined to cut Medicare benefits. Even though he’s on a nationwide book tour, Rep. Paul Ryan is doing everything possible to ignore talking about his plan which would turn Medicare into CouponCare while also repealing the ACA -- stealing years from Medicare’s solvency, eliminating free screenings for seniors, preserving massive subsidies for private insurers in Medicare Advantage and bringing back the costly prescription drug donut hole.
“How to Lie with Statistics” was a handy little guide that used to be required reading for journalism students and economics majors not so long ago. This book came to mind recently as we’ve followed the ongoing debate about the rate of doctors accepting or turning away Medicare patients. Columbia Journalism Review’s, Trudy Lieberman, tackled the issue:
“The (Wall Street) Journal had reported that last year, according to the Centers for Medicare and Medicaid Services, 9,539 physicians opted out of Medicare, up from 3,700 in 2009. It noted an American Academy of Family Physicians survey that found the proportion of family physicians accepting new Medicare patients was 81 percent last year, down from 83 percent in 2010. Furthermore, the Journal reported, reimbursement rates weren’t the only issue: some doctors were dropping out of the system because Medicare is too intrusive in their practices. Mary Jane Minkin, a gynecologist at the Yale School of Medicine, quit when she saw patients’ gynecological records displayed on electronic records which made them available to other providers they consulted. ‘There’s no reason the dermatologist has to know about my patients’ libido issues,’ she told the paper.
Reasonably interesting stuff. But also somewhat incomplete, as Diamond (Dan Diamond of California Healthline) writes: ‘What the Journal didn’t report is that, per CMS, the number of physicians who agreed to accept Medicare patients continues to grow year-over-year, from 705,568 in 2012 to 735,041 in 2013. And other providers aren’t turning down Medicare, either. The number of nurse practitioners participating in the program has only gone up, Jan Towers of the American Academy of Nurse Practitioners told California Healthline.’
USA Today also reports, “More Doctors accepting Medicare patients”.
“The number of physicians accepting new Medicare patients rose by one-third between 2007 and 2011 and is now higher than the number of physicians accepting new private insurance patients, according to a Department of Health and Human Services report obtained by USA TODAY.
In 2007, about 925,000 doctors billed Medicare for their services. In 2011, that number had risen to 1.25 million, according to the report by the HHS Office of the Assistant Secretary for Planning and Evaluation.
‘I think the report comes at a time when people are asking questions about Medicare,’ said Jonathan Blum, principal deputy administrator for the Center for Medicare Services. ‘It provides a more complete picture of how physicians choose to participate in the Medicare system.’
“Ninety percent of office-based physicians accept new Medicare patients, a rate similar to those who take privately insured patients, researchers found. The rate of Medicare patients who say they can find a new doctor in a timely manner is similar to those who are privately insured, the report said.
Medpac found 28% of beneficiaries had a tough time finding a doctor who accepted Medicare last year, but Blum said that's also similar to privately insured rates. “
Threatening that doctors will leave Medicare is an annual rallying cry from physicians forced to fight against hugely unacceptable rate decreases mandated by a flawed formula that Congress simply must fix. For seniors, keeping their doctors is vitally important. It’s unfortunate that they’ve become the pawns in the battle to fix the physicians payment formula – something we agree must happen.
As President Obama continues his August push on the Affordable Care Act, Politico has an interesting look at the ACA compared to the passage of Medicare in 1965. There are a lot of similarities as the GOP fought hard against both:
President Barack Obama says he’s not worried that all the Obamacare fights will kill the law — because people fought the creation of Medicare and Social Security too, and now they’re more popular than ever.
Democrats have always wanted to believe Obamacare would follow the same pattern: Opponents tried to block passage of the new programs, but once they became law, the public saw the benefits and the opposition faded away.
But this time there’s a difference. Political opposition to Obamacare is still as strong as ever, more than three years after it was signed into law.
That means the administration’s task in launching the health care law — the biggest new social program since the creation of Medicare in 1965 — is harder than anything its predecessors had to face.
One problem with this analysis is that opposition isn’t as strong as ever. In fact, a GOP poll designed to give support to Republicans continuing to push for ACA repeal found the American people actually don’t support repeal:
“Americans — including 57 percent of independents in ten critical congressional districts — favor defunding Obamacare,” said Michael Needham, the CEO of Heritage Action. “House Republicans should be much more concerned with the fallout of failing to defund Obamacare than with the imaginary fallout of doing so.”
What Needham fails to mention, however, is that even this push poll that dramatically oversamples Republicans (more on that in a minute) finds respondents are more likely to say that the Affordable Care Act should be kept than scrapped — and that a plurality would blame Republicans if the government were to shut down.
Only 44.5 percent “oppose the health care law and think it should be repealed,” while 52 percent either support the law as is or have some concerns, but say they think implementation should move forward. And asked whom they would blame if “there was an impasse between president Obama and Congress on whether to continue to fund the health care law, and that impasse resulted in a partial government shutdown,” the top response (28 percent) was Republicans in Congress. The next option, Obama, got 21 percent of respondents.”
Seniors in Medicare have a lot at stake in this debate. Thanks to Obamacare, seniors will see an average savings of about $4,200 in their prescription drug costs over the next decade and the Part D coverage gap known as the “donut hole” will be closed. Seniors also receive free preventative visits and health screenings plus the Medicare trust fund has gained a decade of solvency.
These are real-life tangible benefits for millions of seniors they simply don’t want to lose. It’s no wonder the House GOP is feeling the wind dying down in their Obamacare propaganda campaign.
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