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John Rother

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Health Reform and a Strong Medicare Program

Posted: 09/05/09 10:49 AM ET

The time to strengthen Medicare is now -- the question is, will Congress have the courage to do it right?

AARP is fighting for a health care reform plan that will protect the Medicare benefits seniors have earned, eliminate waste and put Medicare on more stable financial ground so current and future generations will have the health coverage they need.

After months of being bombarded by myths about death panels, socialized medicine and rationed care, AARP members are asking legitimate questions about how they would be affected by health reform. While we can't predict what Congress will ultimately do, we can tell our members how we're fighting for their health care.

First, we would fight any proposals to cut Medicare benefits or hike out-of-pocket fees or take away their choice of doctor. We would vigorously oppose provisions that would deny care or interfere with the right of patients and doctors to make medical decisions.

Fortunately, no such proposals are under consideration.

We have not yet endorsed any specific health reform legislation. But in our judgment, a number of proposals on the table could improve Medicare in important ways.

Let's start with the drug benefit. Current proposals would reduce costs and significantly narrow Medicare's doughnut hole -- the fast-growing gap in coverage that can cost individuals thousands of dollars a year. Filling in the gap, even gradually, would help millions of seniors afford their prescriptions.

Seniors also would win with better benefits for prevention. Reform legislation would make such services as screenings for diabetes, osteoporosis and prostate cancer free to beneficiaries. Co-pays currently discourage many from getting these screenings, which can prolong their lives.

Also overlooked in the debate is the proposed reinvestment of Medicare savings to improve doctors' payments in Medicare. These changes would help ensure Medicare patients a choice of doctor, provide bonuses to increase the number of primary care providers, and improve care for people with chronic conditions. Such payment reforms hold real promise of improving access to health care for Medicare patients and making a fragmented medical system work better for them.

Older Americans would benefit further from new efforts to root out waste, fraud and abuse in Medicare. One current fraud case involves an alleged $100 million phony-billing scam in five states. Improved efforts to stop this sort of crime and other abuse can save billions of dollars in Medicare and in out of pocket costs each year.

Medical errors, such as life-threatening infections due to poor care, needless use of costly technologies, and excess industry profits all push up costs and undermine Medicare's financial health.

Let's face it: We need to make sure we save Medicare money, as every member of Congress well knows. But we need to protect benefits while at the same time we target waste - and we now have an opportunity to make smart savings that actually strengthen the program.

Take the problem of unplanned readmissions to the hospital. Follow-up care and guidance to help patients after discharge could lower costs as much as $17 billion a year. Reducing readmissions not only would save money, it would spare elderly patients the anguish of returning to the hospital due to poor follow-up care.

Another hunk of savings could come from gradually reducing the billions of dollars of subsidies the government pays to private insurance companies, known as Medicare Advantage. These subsidies cost the government 14% more per patient than traditional Medicare. Those tax dollars should go to helping seniors, not boosting insurance company profits.

AARP believes private Medicare plans should compete by providing better customer service and better quality care, not relying on subsidies from taxpayers. Whether private insurers would modify their benefit packages if they lose the subsidy is a business decision. Nothing in the legislation would require them to do so. And we will encourage lawmakers to include incentives for plans that deliver the highest quality care.

Holding down the growth in future payment increases to health care providers is another way to save money without reducing benefits. About half of the proposed $500 billion in Medicare savings would come from limiting the growth of reimbursements to providers, such as hospitals, nursing homes and home health agencies. Providers that improve their quality and productivity should be able to offset these curbs.

Much of that $500 billion savings, by the way, would be reinvested in Medicare, and the remainder would help make Medicare more financially stable. The net reduction is 3% in projected Medicare spending over the 10-year period. Done right, it is possible to shave 3% and still have a stronger, more effective, and more health-conscious Medicare program.

Some may expect AARP to reflexively protest any changes to Medicare - a program that provides health security for 45 million Americans. But unless we wring out waste and stop insurance companies from profiting on the backs of seniors, Medicare will be under growing financial pressure to provide older Americans with the health coverage they need. We believe eliminating waste and excess insurance company profits is critical to protecting benefits, preserving doctor choice, holding down premiums, and to preserving a strong Medicare for the long term that ensures both current and future generations will have good health care coverage when they are older.

This message is not easy to convey to the public, especially in the current environment. Civil and thoughtful discussion is needed more than ever, and AARP will do what we can to provide accurate information and encourage informed debate.

We seek a common-sense approach to solving the problems of our health care system, problems that we hear about from members every day.

Done right, smart health reforms are surely in the best interest of Medicare and America's seniors who rely on it.


John Rother is AARP's Executive Vice President for Policy and Strategy.

 
 
 
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
12:19 PM on 09/07/2009
"The time to strengthen Medicare is now -- the question is, will Congress have the courage to do it right? "

And the answer is "No". Which is also the follow up to "Will the White House provide leadership?"

And insurance agents like AARP pretending to be advocacy groups are a big part of the problem. Your eager participation in Medicare D is well remembered.

REAL health care reform like Single Payer would save Medicare, Medicaid and the VA. But only a very few people are serious about real health care reform in Washington this go round.
This user has chosen to opt out of the Badges program
11:48 AM on 09/07/2009
The hilarious thing about all this was the large numbers of medicare recipients that were the protesters at the town hall meetings on health care in this country. They made such brilliant comments as: Don't touch my medicare because I don't want government involved in my health care, and other such idiotic statements.

In my area, most of those involved in the teabagger parties were seniors receiving Social Security and Medicare, and they were protesting "government spending". Embarrassing that these idiots are citizens of my country.
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HUFFPOST SUPER USER
John Robert
current actor, producer, director
10:26 AM on 09/07/2009
AARP grew as a front to sell Globe Insurance. Even today, it has a non-profit part and a for-profit division after it paid a large fine to the US government. It is not a honest broker. It gets a referral fee for anything it promotes.
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HUFFPOST COMMUNITY MODERATOR
Teresa201
"Well done is better than well said"
09:35 AM on 09/07/2009
Let's be honest......

AARP has been walking a fine line about reform.
They don't want Public Option.
They are backed by United Health Care....

And they want Medicare to stay the same so that seniors need to pay extra for full coverage...
Never compare Medicare to Single-Payer or Universal Health Care...
Medicare for all would mean that we would have to pay private companies for the coverage that Medicare does not provide.

AARP has been as honest and straight forward as the 'death panels'...........!
08:08 AM on 09/07/2009
See Physician David Himmelstein's comments on AARP.

http://www.pnhp.org/news/2009/may/himmelstein_replies_.php
12:48 AM on 09/07/2009
I just don't understand how countries like France, who has single-payer and private insurance, is not talked about more. France is rated #1 in the world according to the World Health Organization. We could be rated #1 if we had the Public Option and private insurance for those that choose to go that route. If it's working in France, it can work here too.

Insurance companies have had 60 years to do business in good faith. But unfortunately, they have failed the American people by raising premiums and canceling policies of those that dare to get an illness. And now that the President wants the Public Option, now these companies say they won't drop people, want people to have affordable premiums, and want everyone to be covered. What a bunch of morons. We see right through them. They see the writing on the wall. The current status quo is slipping through their fingers, and they're scrambling to get things back into their control.

Single-payer is the best option.
02:56 AM on 09/07/2009
To address your first comment -- "I just don't understand how countries like France, who has single-payer and private insurance, is not talked about more." -- there is an easy explanation. Americans are too drunk on their "America #1" Kool-aid to give a moments consideration that any other country in the world could possible have a superior position on any matter. Most people here would rather live in a cave of pitiful denial, ignorance and arrogance, than admit for a second that we might be wrong about our approach on any issue.

As far as the assumption that private insurance companies have failed the people -- the good of the people, their paying customers, never once factored into the equation. To the contrary, private insurance companies have demonstrated outstanding performance by every measure. The problem is, positive medical outcomes, health and wellbeing, ethics, rule of law, decency, humanity are not the yardsticks by which insurance companies measure success. They are only successful if they have managed to screw you out of every dime you've paid on the way to your grave.
This user has chosen to opt out of the Badges program
10:53 PM on 09/06/2009
AARP is just pitching talking points. The spending plan is clear, $612 billion in medicare cuts. If you are currently entering Medicare, try to get a Dr., "sorry no longer accepting new medicare patients". Yet, AARP takes millions from the seniors in dues and spends it on TV ads. How about starting at home and cutting the costs of AARP insurance and stop spending on TV?
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
09:09 AM on 09/06/2009
The only "common sense" solution to our health care problems including medicare is to get rid of the health insurance industry via a single payer or national health care system.
This user has chosen to opt out of the Badges program
10:55 PM on 09/06/2009
Medicare is broke and AARP is not addressing. Adding more people to a broken system solves nothing. Social Security is broke and AARP is not addressing.
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
12:22 PM on 09/07/2009
Neither Medicare nor Social security are broke. Both suffer from a nation that despises major government successes that saved capitalism from itself.
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HUFFPOST SUPER USER
Lucile Smith
06:30 PM on 09/05/2009
these old people need to stop listen to rush and faux news and listen other station also .But they listen to all the lies and fear tactics and then say Iam scare that stupid cut those messy folks off and stop sitting on your behind saying Iam scared.
03:22 PM on 09/05/2009
No politician this side of sanity is going to cut back Medicare, since it has a large and powerful constituency behind it. It's going to get even more powerful when 70-80 million Baby Boomers are retired.

Now, I am shocked, SHOCKED to learn that politicians might pander to the voters, but on this issue there is no danger of them doing anything else.

Of course, the big question is how it's going to be paid for, especially as more people are retired and those who have no health insurance now are included in some type of government program. This is why I have always suggested letting the Federal Reserve subsidize the Medicare and Social Security Trust Funds, at least through the Baby Boomer retirement phase over the next 30-40 years.
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BlueOnBlue
275 Republicans Voted to Kill Medicare
02:33 PM on 09/05/2009
I'm an AARP member on Medicare and I think the organization should endorse the public option as essential in any real reform of health care insurance.

Too many seniors focus only on themselves when it comes to health care. We're actually doing pretty well. Let's focus on our children and grandchildren and leave them a better health care system than we had until we reached 65. It will help us, too.
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HUFFPOST COMMUNITY MODERATOR
CTtransplant
"We don't stop playing because we grow old; we gro
03:08 PM on 09/05/2009
Thank you!
HUFFPOST SUPER USER
Antifascist-08
02:18 PM on 09/05/2009
Thank you so much.

This is a truly excellent post. Obama has made a serious mistake by not explaining his plans for Medicare in this way. By just saying that he will cut costs instead of emphasizing actual reform and improvement of Medicare, he has left himself open to the fear factor of seniors, and the Reta rdican s have jumped right in and exploited it.

He should emphasize that Medicare savings will make Medicare better and that seniors will get BE TT ER benefits and exactly how and why that will happen.

Everyone agrees that Medicare has serious problems when it comes to abuse and fraud. This has been going on since day one. Obama should create a Medicare watchdog and enforcement agency that would investigate all the possible abuses and insure that the money is being spent properly. That would be change that everyone could believe in.
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HUFFPOST SUPER USER
Larryjk
01:23 PM on 09/05/2009
I'm coming up on my 65th birthday. I've been drawing SSDI and Medicare A, B and D for four years. It's a great system. I'm not concerned about myself and HCR. I want to see affordable HC for my two oldest kids, who have no health insurance because where they work they don't offer HC insurance. And there are a lot of other people in the same boat.
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HUFFPOST COMMUNITY MODERATOR
CTtransplant
"We don't stop playing because we grow old; we gro
01:23 PM on 09/05/2009
I'm getting more than a bit tired of our representatives in Congress who say they don't need to read the bill, they won't sign it regardless of what's in it, etc., etc., etc. These guys make me mad! They are in effect saying to the voters 'we will not do our job'!

We all have - or know of – health care horror stories...things that should not have been allowed to happen.

Well, Our elected officials in Congress receive health care mostly paid for by us tax payers, yet many are trying to make it impossible for us to have an affordable plan of our own :

While many of us are struggling to afford medical insurance/medical bills.
While Congress people try to stop healthcare reform.
While Congress people accept large contributions from lobbyists to prevent health care reform.

Please sign these petitions - and by all means, spread the word! Thank you!
http://www.petitiononline.com/PubOp676/petition.html
http://action.firedoglake.com/page/s/keepthepledge?source=email&subsource=fwd
http://salsa.wiredforchange.com/o/5649/t/4951/content.jsp?content_KEY=2793&tag=pod_auto-email1
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HUFFPOST SUPER USER
Nomccain
01:18 PM on 09/05/2009
Older Americans had better be worried about what's going to happen to them over the next 4 to 5 years IF NO HEALTH CARE REFORM IS ENACTED rather than listen to lies about death panels and socialism.
06:29 PM on 09/07/2009
I really believe most of the concerns of the American people comes down to trust in our federal government. The Obama adminstration has not exactly relieved the American people in these concerns. Trying to rush the health plan before the congressional recess with so many elected officials not having time to read the proposed bills dos not bring confidence in our government that they will be making the right decision concerning our health care. Too often statements by our president doesn't include documentation where he is getting this information from and when he does, I am not sure this stated documentation is not credible. Debate should include arguements based on facts and not merely statements of personal opinions. To have faith in our government, please give me crediable proposals that are believeable!!!!