Asclepios
Your Weekly Medicare Consumer Advocacy Update
Talking Turkey About
Medicare
For
40 years, Medicare has offered older Americans and Americans with disabilities
affordable access to needed health care because the private marketplace is
unable to meet their needs. Yet, defying practical
experience, Congressional ideologues decided to turn the new prescription drug
benefit exclusively over to private insurers and HMOs.
Why
did this happen? What can we do about it? It’s time to talk
turkey about Medicare.
This
Thanksgiving learn from the wisest members of your family why they value
Medicare so much, how it works and what it would be like to live without
it. You will likely find that what they love about Medicare is its
affordability, reliability and vast choice of doctors and hospitals.
Medicare
offers the most cost-effective health care coverage in
Moreover,
Medicare brings everyone together in one insurance pool, protecting everyone
collectively—the healthy and the sick, the poor and the wealthy, people in the red states and those in the blue ones.
Everyone pays the same price regardless of the amount of care they need.
People with heart disease, cancer and diabetes do not have to choose between
critical care and other necessities.
But
President Bush and the Congressional leadership ignored the lessons of
Medicare’s first 40 years and gambled that, with hundreds of billions of
dollars in subsidies, insurance companies could deliver the drug benefit.
They
barred Medicare from using its negotiating leverage to deliver a cost-effective
benefit and got drug prices from the drug plans that are substantially higher
than what the Department of Veterans Affairs or the Canadian government
pay.
They
pushed for a choice of drug plans and got hundreds of profiteering plans all
offering a limited choice of drugs.
They
junked Medicare’s core principles—universal access and a standard benefit—and
got a system that steers healthy people to cheap plans and sicker people to
expensive ones, segmenting the insurance pool and making the sick pay more.
And
they refused to give Americans with Medicare even the choice of a Medicare drug
benefit, forcing people instead to sign up for a private for-profit insurance
plan if they want help with their drug costs.
So
now Americans with Medicare, people who desperately need affordable
medications, are faced with a dizzying assortment of private drug plan options
that are impossible to decipher and provide poor protection from the high cost
of life-preserving and life-saving medications. Unlike Medicare benefits,
this private prescription drug benefit leaves even the experts wondering
whether people will be helped if they enroll in it.
The
turkeys are coming home to roost.
Let
our Congressional leaders know that you value Medicare because it works better
than private insurance and you want a Medicare drug benefit—a
government-administered benefit that is cost-effective, reliable, affordable
and guarantees our parents and grandparents access to the medications they
need.
Moral,
financial and medical imperatives must drive us to strengthen the Medicare that
has worked efficiently and effectively for 40 years, not abandon
Click here to send a letter to your members of Congress telling
them you value Medicare because it’s simple, automatic and reliable, and that
you want a real government-administered Medicare drug benefit.
Medical Record
Medicare
helps people live longer, healthier lives:
- Before Medicare went into
effect, only half of older adults had health insurance ("Testimony:
Regarding Strengthening and Improving Medicare,” Barbara Kennelly, National Committee to Preserve Social
Security and Medicare, U.S. House Energy and Commerce Committee
Subcommittee on Health, April 9, 2003).
- People with no health insurance
forgo needed health care and die earlier. The uninsured are less likely to
receive preventive care than those with insurance and more likely to be
hospitalized for conditions that could have been avoided. Consequently,
uninsured cancer patients are diagnosed later and die earlier than those
with insurance (“The Uninsured and Their Access
to Health Care,” Kaiser Commission on Medicaid and the Uninsured, November 2005).
Medicare
keeps people out of poverty:
- Since Medicare was created in
1965, poverty among older Americans has been reduced by nearly two-thirds
(“
Original
Medicare is simple, popular and reliable:
- Focus groups reveal that older
Americans are “very satisfied” with the Medicare program, with many citing
choice of providers as a key reason. In contrast, notions of changing or
privatizing the Medicare program are “very negatively received.” Focus
group participants have a generally favorable reaction to the concept of
“choice,” but usually define choice in terms of choice of doctors, rather
than choice of plans (Peter D. Hart Research Associates, July 2001).
- Private plans routinely limit
access to care for people with Medicare. Private plans limit choice of
doctors, restrict access to specialists and have a history of leaving
members out in the cold: between 1999 and the beginning of 2003, private
plans ended coverage for 2.4 million members, forcing them to scramble to
find new Medicare coverage (Public Citizen, February 2003).
Original
Medicare is cost-effective:
- In 2003, the administrative
costs of government Medicare were calculated at 2 percent, while those of
Medicare private plans were calculated to be at 11 percent. Administrative
costs for insurers may include marketing, claims processing, reserves and
profit (“Medicare Cost-Sharing and
Supplemental Insurance,” Medicare Payment Advisory Commission, May 2003).
- Medicare pays on average 107
percent more per head for people in Medicare private plans than in the
Original Medicare fee-for-service in 2004. (“M+C Payment Rates Compared with
County Medicare Per Capita Fee-For-Service Spending (Revised),” Medicare Payment Advisory
Commission, April 2004).
- Private plans offer little in
the way of cost containment. Comparing growth in per-enrollee payments for
comparable services by private plans and Medicare, studies have also shown
that private plans are less successful in controlling costs than Medicare:
whereas Medicare per-enrollee spending grew by 9.6 percent per year from
1970 to 2000, private plan per-enrollee spending grew by 11.1 percent per
year (Boccuti & Moon, Health Affairs, March/April 2003).
Original
Medicare makes market sense:
- Securing health insurance is a
problem for many people ages 55 to 64. Nearly 3.5 million Americans in
this age group are uninsured (Kaiser Commission on Medicaid and the
Uninsured, December 2003). Of these uninsured adults, over 1.5 million
have a chronic condition (Center on an Aging Society,
- Private Medicare drug plans
fail to provide meaningful drug cost savings compared to drug prices
negotiated by
Fast Relief
The
If
you need help understanding or explaining the new Medicare prescription drug
benefit to your clients, call RxHelp, a national
hotline dedicated for nonprofit professionals serving the Medicare population,
operated from
Dial 877-RXHELP-0 (877-794-3570) today!
*****
Don’t Let Your Suffering
Go Unnoticed
Are you struggling to pay for your prescriptions drugs or get the
health care you need? Work with the
The Louder Our Voice,
the Stronger Our Message
Asclepios—named for the Greek and Roman god of medicine
who, acclaimed for his healing abilities, was at one point the most worshipped
god in
Medicare
Rights Center (MRC) is the largest independent source of health care
information and assistance in the