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Act Now: Give Thanks for Original Medicare
Medicare Rights Center
November 24, 2004
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As our minds wander to thoughts of biscuits and gravy, and I'm not talking about the turkeys recently pardoned by our President, let's remember that Thanksgiving isn't just about food. When you gather around your tables to eat heartily, remember to give thanks not just for the meal, but also for Medicare. And do not forget that many of the building blocks of Medicare are at risk in the political battles ahead.
There are many reasons to be thankful for this national treasure of a program; here are a few reminders:
1) Medicare helps people live longer, healthier lives. Thanks to Medicare, millions of Americans are able to afford life-saving care and have a better quality of life as they age.
2) Medicare keeps people out of poverty. Medicare is a social safety net that has lifted millions of people out of poverty. In fact, since Medicare was created in 1965, poverty among the elderly has been reduced by nearly two-thirds.
3) Original Medicare is simple, popular and reliable. People with Original Medicare are thrilled with the public-private partnership that allows them to see doctors and receive care at health care facilities throughout the United States this is the type of choice they resoundingly want.
4) Original Medicare is cost-effective. Original Medicare's administrative costs are 2 to 3 percent, while Medicare Advantage plans have administrative expenditures of up to 15 percent.
5) Original Medicare makes market sense. Today there is a trend to reform or privatize Medicare. Why repeat an experiment that has already failed?
Medicare exists because insuring older adults and people with disabilities is a risk insurers didn't (and still don't) want to take. Even today, people ages 55 to 64 struggle to find coverage, and when they do, they struggle to afford it. Insuring older adults and people with disabilities is a financial burden insurers shun (except when they get hefty government subsidies); but isn't it society's moral obligation to bear that burden?
This Thanksgiving, spend a little time thinking just how Medicare has helped you. Maybe you were able to afford surgery to limit your risk for a stroke. Maybe you don't have to worry about paying for a parent's hospital stay that could quickly add up to the thousands of dollars earmarked for your mortgage. Or maybe you can sleep at night, knowing that after working your whole life, you can count on being able to get health care when you are old and sick. That is, as long as we work to strengthen Medicare as we know it.
Medical Record:
1) Medicare helps people live longer, healthier lives:
o 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).
o People with no health insurance are less likely to have a regular doctor. In a survey of people aged 18 to 64 with disabilities, 85 percent of respondents with health insurance had a regular doctor. In contrast, among respondents who also had no health insurance, only 31 percent had a regular doctor. ("Understanding the Health-Care Needs and Experiences of People with Disabilities", Kaiser Family Foundation, December 2003). The same trends are evident in the larger population: people without health insurance are less likely to have a regular source of care and more likely to seek care from health clinics and emergency rooms (Kaiser Commission on Medicaid and the Uninsured, September 2003).
o People with no health insurance forgo needed health care. Nearly half of uninsured adults postpone seeking medical care, and over a third of uninsured adults forgo needed care ( Kaiser Commission on Medicaid and the Uninsured, September 2003).
o Without health insurance, you are more likely to die prematurely. Uninsured non-elderly adults are 20 to 50 percent more likely to die over a five-year period than people who have health insurance ( Kaiser Commission on Medicaid and the Uninsured, September 2003).
o Currently, 78 percent of the Medicare population suffer from one or more chronic conditions that require ongoing medical management. (Vicki Gottlich, "Medical Necessity Determination in the Medicare Program" Partnership for Solutions, January 2003).
2) Medicare keeps people out of poverty:
o Since Medicare was created in 1965, poverty among the elderly has been reduced by nearly two-thirds. (America's Seniors and Medicare: Challenges for Today and Tomorrow: A State by State Status Report" National Economic Council/Domestic Policy Council, The White House, February 29, 2000).
3) Original Medicare is simple, popular and reliable:
o Focus groups reveal that seniors are very satisfied with the Medicare program, with many citing choice of providers as a key reason why. 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).
o 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).
4) Original Medicare is cost-effective:
o In 2002, the administrative costs of government Medicare were projected at 2 to 3%, while those of HMOs were projected at 15% ( Medicare Payment Advisory Commission, "Assessing Medicare Benefits" June 2002).
o 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).
5) Original Medicare makes market sense:
o Health insurers acknowledge that insuring older adults and people with disabilities is a risk they'd rather not take. Allen Schaffer, Cigna's chief clinical officer, speaking of the possibility of providing a Medicare Advantage plan, said, "We had a substantial business six years ago and left the business, we always said we would look at it ... when it makes sense for our shareholders." (Medicare seeks to lure private HMOs back Kim Dixon, Reuters Health, November 16, 2004).
o Securing health insurance is a problem for many people ages 55 to 64. Nearly 3.5 millions of Americans ages 55 to 64 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, Georgetown University, September 2003).
Fast Relief:
Take a moment today to let your senators and representatives know how much you love Medicare. Tell them that rather than propping up private plans with subsidies that benefit the plans more than they benefit the 11 percent of people with Medicare enrolled in these plans, Congress and the Centers for Medicare and Medicaid Services should use these billions to strengthen Original Medicare, a popular and reliable program that has made good on its promise to help older Americans and people with disabilities in their time of need.
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