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Blog About It: Elder Economic Security

May 1st marks the first day of Older Americans month.  Today the Elder Economic Security Initiative team at Wider Opportunities for Women (WOW) is sponsoring a blog day to spread the word on the importance of elder economic security. We all know economic times are tough but for millions of American seniors living on fixed incomes the volatility of this recession is especially frightening.  Far too many have seen their savings evaporate in the market, housing values plummet, and healthcare costs continue to skyrocket. That's why it's so important that, as our nation considers economic policies designed to turn things around, we don't ignore America's retirees and their families.  At the National Committee, we believe reforming health care is vital to our nation's long-term economic health.  We've written about this a lot here at Entitled to Know but today we've also added our voice to a long list of aging issues bloggers at the National Elder Economic Security Initiative.  Aging in America is more than just a personal issue.  It's also an economic issue...a quality of life issue...and a political issue.  Here are just a few of the blogs we recommend you visit today to join the conversation on Elder Economic Security.

Medicare Overhaul Proposed

It's not surprising that quality control and improving payment processes for Medicare were among the first items tackled by the Senate Finance Committee in their newly unveiled health care reform strategy, entitled "Description of Policy Options."   Chairman Max Baucus told reporters: 
"Almost all health providers agree that the we are taking the right approach...The concerns are implementation."
 The recommendations detailed in the committee's report are designed to hold doctors and hospitals more accountable, slow the growth of Medicare, and improve chronic care for seniors in the program.  The New York Times summarizes the proposals this way: 
  • Medicare would increase payments to doctors who regularly exceed "national benchmarks" for the quality of care. Doctors who did not meet federal standards would be subject to financial penalties.
  •  Medicare would pay bonuses to hospitals that provide superior care for heart attacks, heart failure, pneumonia and selected other conditions. The cost would be offset by cutting Medicare payments to other hospitals. 
  • Doctors could receive extra payments if they hired nurses to manage follow-up care for Medicare patients who were discharged from the hospital after being treated for chronic conditions like diabetes, asthma, depression and coronary artery disease. 
  • The government would set national standards for the appropriate use of CAT scans, magnetic resonance and other diagnostic imaging techniques. Medicare would cut payments to doctors who drive up costs by overuse of imaging services. 
  • In addition, Medicare would make a single "bundled payment" for all the services provided to a hospital patient. The bundle would include payments for any nursing home care or home health services that a person received after leaving the hospital, an idea that made some providers uneasy. 
Senators Baucus and Grassley believe improving the delivery of health care in the Medicare program will help drive the broader effort to overhaul our entire healthcare system. We here at the National Committee applaud these efforts but hope it won't stop there.  Congress should also reinvest at least some of the savings found in Medicare back into the program.

The Medicare = Health care Equation

There is a multitude of factors in the national health care reform equation but one thing is clear, the skyrocketing cost of health care is hurting all Americans, young and old alike.  That's why it's critical that Congress treats Medicare as more than just a cash-cow to pay for system-wide health care reforms.  Some of the savings proposed by the Obama administration should be reinvested to improve care for the nation's 45 million Medicare beneficiaries.  We can't reform health care while ignoring the nation's largest health care provider. We've written a letter to President Obama and Congress suggesting 3 key Medicare priorities: 
On behalf of the National Committee's millions of members and supporters, we propose three priority areas we believe must be addressed.  First, we urge you to eliminate the billions of dollars in subsidies that are being paid to private insurance plans under Medicare Advantage.  Currently, our nation is spending over $1,000 more per individual for those enrolled in Medicare Advantage plans than it would cost to cover those same individuals under traditional Medicare.  There is simply no justification for the wasteful overpayment of private plans participating in the Medicare program.  Second, we urge Congress to enact sorely-needed reforms to the Medicare prescription drug benefit.  Priority improvements in Part D include:  providing seniors the choice of a Medicare-operated prescription drug plan, providing Medicare the authority to negotiate lower drug prices, eliminating the doughnut hole (which does not exist in any private sector health insurance system), and improving assistance to low-income seniors.  We believe these changes will both improve seniors' health and lower costs over the long term.  Finally, as you consider changes in coverage for those under age 65, we urge you to consider parallel improvements in the Medicare program for those aged 65 and older.  For example, most private health insurance plans include a limit on annual out-of-pocket costs for beneficiaries.  We believe a similar cap in Medicare would address some of the issues seniors on fixed, limited incomes face with the unpredictability of annual health care expenditures.
You can see the full letter posted here on the National Committee's website.

Medicare Should Lead Health care Reform

That's the suggestion made by Senate Finance Committee Chairman Max Baucus and echoed by panelists at the first of the committee's health care roundtable meetings.  The Associated Press and Maggie Mahar provide the best reviews of this first Senate session, which focused on reimbursement and delivery reform.  Baucus told attendees: 
"Medicare is the big driver here" and "How to scale it up" will be one of the key questions, he said, but "Medicare will be a big part of that solution."  
His written statement also said: 
"The U.S. health system scores 65 out of 100 on indicators of health outcomes, quality, access, equity, and efficiency. And we know from previous research that adults receive recommended care only about half of the time. [And these are adults who have access to care.] We have the opportunity to modernize our outdated payment systems. Those payment systems encourage the delivery of more care, rather than better care."
The National Committee applauds the Senate's efforts to ensure Medicare is more than just the piggy bank used to pay for system wide health care reform.  Eliminating wasteful industry subsidies to private insurers in Medicare Advantage makes good sense but some of that money must also be reinvested back into improvements for Medicare to:
  • lower drug prices through government negotiation
  • close the prescription drug doughnut hole
  • limit seniors' out-of-pocket costs
Medicare's actuaries predict over one-half of the average senior's Social Security benefit check will be consumed by Medicare out-of-pocket costs by 2025. Containing health care costs is an important goal of national health care reform and we believe seniors in Medicare have a large stake in that ongoing debate.

Health Insurers prefer Astroturf over real Grassroots lobbying

For years, the health insurance industry, led by AHIP, has tried to foment a senior revolt to head off any attempts in Washington to trim back billions in outrageous industry Medicare Advantage subsidies provided by the Bush administration.  AHIP created its own "grassroots" group,  "The Coalition for Medicare Choice" offering free lunches and door prizes at "community meetings" designed to convince seniors that Congress wants to "take away your Medicare".   Now it appears this Astroturf lobbying campaign has reached a new low...sending letters to the editor from seniors without their knowledge.  The New Bedford Eagle-Tribune in Massachusetts reports on three fake letters it received: 
"Some of those seniors are unaware that they have sent any such letters to newspapers. Some of them hadn't even heard of Medicare Advantage. ‘I did not write a letter to the editor. It's not from me,' said Gloria Gosselin, 75, of Lawrence.  Gosselin's name was on one of three strikingly similar letters touting the Medicare Advantage program that were sent to The Eagle-Tribune. Writers of letters to the editor are routinely contacted by newspapers to make sure letters are legitimate. In this case, they weren't. All three of the purported authors of the letters said they had no idea their names were being used to advocate for the health insurance program. The letters were, in fact, composed and sent by the Boston office of a national political consulting firm attempting to create the appearance of a ‘grass-roots' movement for Medicare Advantage."
A quick Google search shows a number of similar letters did make it to print in papers nationwide, large and small.  How many are real?  Who knows.  But when you look at the history of Medicare Advantage's creation, its marketing abuses, rising premiums and out of pocket costs, this Astroturf campaign can't be too surprising from an industry pulling out all the stops to preserve it's profitable government subsidies.  The Obama administration is right to go after these outrageous industry overpayments which will cost Medicare$150 billion over ten years, shave almost two years from Medicare's solvency, and force all beneficiaries (not just those enrolled in MA plans) to pay $36 per year in higher premiums.  These subsidies should be repealed and the savings reinvested in traditional Medicare to improve coverage for 44 million Americans.  That's a true grassroots effort that seniors have supported and will continue to support without free meals, fake letters and Astroturf campaigns.

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