Guest Contributors: Carroll Estes, Ph.D., Peter Arno, PH.D. and Deborah Viola, Ph.D.
The health care reform bills now before Congress contain an unpleasant surprise for older Americans: Age-based increases in health insurance premiums for those under 65. This is nothing more than a giveaway to the private insurance industry.
At first blush, it might appear that this is justified assuming that as we age, we cost the health care system more. In fact, age is far from an entirely reliable predictor of health care costs, accounting for less than 20% of the variation in costs across age groups. A healthy 55-year-old may well consume fewer health care dollars than a 35-year-old who is obese or has diabetes.
Both the House
bills include provisions to eliminate pre-existing condition clauses, which clearly serve the public interest. Permitting premiums to rise with age contradicts the intent, if not the letter, of that regulation as aging can reasonably be considered an immutable, pre-existing condition. Moreover, the new regulation disproportionately affects Americans between 55 and 64, who already shoulder a financial burden for health care that is higher than any other age group, regardless of insurance status.
The current House bill would allow someone 55 or older to pay premiums that are twice as high as a young enrollee (a 2:1 age rating). The Senate agreed to a 3:1 age rating, which would allow premiums to be three times higher for older people. In a recent briefing, Karen Ignagni, head of the American Health Insurance Plans that represents private health insurers, called for a 5:1 age rating.
Here's a question for policymakers and the public to consider: Will the proposed age-rating of premiums, coupled with the absence of a robust, affordable public option, push more older Americans into the pool of people unable to afford health coverage?
This is not just a numbers game. There is both a human and financial toll to be paid. A recent Harvard study
published in the American Journal of Public Health found that American adults under 65 who lack health insurance have a 40 percent higher risk of death than those who have coverage. Ailing and uninsured people in their 50s and 60s will likely add to the strain on Medicare's budget as they seek care for neglected health problems as soon as they become eligible for this entitlement.
Americans need to seriously consider the implications of stealth budgetary techniques, such as discriminatory, age-related premiums. The private insurance industry stands to make big profits from the millions of new customers it will pick up through health care reform. Adding to its bounty by putting the squeeze on the finances of older Americans is not only unjust, it is poor economic policy.
Carroll Estes, Ph.D
., Chair of the Board of Directors, National Committee to Preserve Social Security and Medicare Professor and Founding Director Institute for Health & Aging University of California, San Francisco
Peter Arno, PH.D
., Professor & Director, Doctoral Program, Department of Health Policy and Management School of Health Sciences and Practice New York Medical College Valhalla, NY
Deborah Viola, Ph.D
., Associate Professor,Department of Health Policy & Management New York Medical College School of Health Sciences & Practice Valhalla, New York
CATEGORY: [Aging Issues], [healthcare], [Medicare]
Thank you to Nicholas Kristoff and the New York Times for providing some desperately needed perspective in the ongoing health care reform debate.
Here's an excerpt but we highly recommend you read the entire piece
"Indeed, these same arguments we hear today against health reform were used even earlier, to attack President Franklin Roosevelt’s call for Social Security. It was denounced as a socialist program that would compete with private insurers and add to Americans’ tax burden so as to kill jobs.
Daniel Reed, a Republican representative from New York, predicted that with Social Security, Americans would come to feel “the lash of the dictator.” Senator Daniel Hastings, a Delaware Republican, declared that Social Security would “end the progress of a great country.”
John Taber, a Republican representative from New York, went further and said of Social Security: “Never in the history of the world has any measure been brought here so insidiously designed as to prevent business recovery, to enslave workers.”
In hindsight, it seems a bit ridiculous, doesn’t it? Social Security passed, and the republic survived.
Similar, ferocious hyperbole was unleashed on the proposal for Medicare. President John Kennedy and later President Lyndon Johnson pushed for a government health program for the elderly, but conservatives bitterly denounced the proposal as socialism, as a plan for bureaucrats to make medical decisions, as a means to ration health care."
CATEGORY: [healthcare], [Medicare], [Social Security]
I've written here before about the fundamentally flawed concept of creating an Entitlement Commission to target cuts in Medicare and Social Security as a way out of our current budget mess. Today, I posted a long look at the latest efforts in the Senate to revive , rename and repackage entitlement commission legislation as a budget deficit commission.
You can read my full Huffington Post article here.
CATEGORY: [entitlement reform], [Medicare], [Social Security]
Fran Garfinkle is a 70-year old retired small business owner from Maryland who understands how quickly retirement dreams can change in our current health care system. Fran, a member of the National Committee to Preserve Social Security and Medicare, joined First Lady Michelle Obama and Director of Health Reform Nancy Ann DeParle at a White House event today urging passage of health reform legislation. Fran’s health care story mirrors that of millions of seniors each year who are trapped in the Medicare Part D coverage gap known as the “doughnut hole”. A provision in the recently passed House legislation would eliminate the coverage gap.
“This past July, the pharmacist told me that I was in the doughnut hole and would have to pay for my medicine on my own. I was floored! To get a 3 months supply of just this one drug costs me $1100. And on top of that, I’d have to pay the full price for the 3 other prescription medications I needed. I couldn’t believe that I was left to fend for myself at the very time that I really could use the help. Our expenses were already pretty hefty. How was I going to pay for this?”...Fran Garfinkle, NCPSSM member
The National Committee to Preserve Social Security and Medicare supports health reform that manages costs, attacks waste, and makes important improvements to Medicare. Closing the Part D doughnut hole, allowing government negotiation of drug prices in Part D and eliminating billions of dollars of wasteful subsidies to private insurers in Medicare are just a few of the vital reforms benefiting seniors included in the House health reform legislation. The status quo is simply not an option for seniors in Medicare or our economy as a whole.
“Not a day goes by that we don’t hear from our members about skyrocketing drug prices, growing out of pocket costs, and even losing Part D coverage entirely after falling into the doughnut hole. Medicare is a lifeline to millions of seniors yet the rising costs system-wide are threatening the program. Older women, like Fran, understand this and we’re proud she added her voice to this debate.”...Barbara B. Kennelly, President/CEO
CATEGORY: [healthcare], [Medicare], [Medicare Advantage], [Part D]
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