Cut Medicare? Cut Medicaid? Why?

kbmgmedicareterms.jpgIn the 1980s, I worked for a health economist named Carl Schramm. His mantra was that the real problem was health care costs, not the cost of insurance. This message landed him a great job with the health insurance industry and he played it forward while leading its lobbying group in the prelude to the Clinton’s health reform efforts.

While I get that health insurers would rather blame providers (hospitals and doctors at that time more than pharmaceutical companies) rather than shoulder the blame for ever-increasing costs, policymakers might want to think about what Schramm was trying to get across nearly 25 years ago.

Here’s my favorite example. In 2006, a Republican-led effort added a prescription drug benefit to  Medicare. The law specifically states that Medicare could not negotiate prices (it was reasoned the market will do that and how is that working exactly?).

Before tearing up the social contract with older Americans and throwing in the towel, let’s empower Medicare and Medicaid to negotiate health care costs across the board. Giving them more control over costs might, just might save these crucial programs for future generations.

Cutting Social Security Will Hurt Low Income Elders

The poll results announced yesterday by the National Committee to Preserve Social Security and Medicare should make members of Congress and others who want to make drastic changes to Social Security think twice.

Proposals to significantly cut benefits or raise the retirement age would hurt older adults with limited income and resources disproportionately. The poll clearly shows that the American people oppose those types of changes.

With the 75th anniversary of Social Security just around the corner, it’s time to strengthen Social Security and not make the most vulnerable in our society suffer.

The poll “U.S. Attitudes Toward Social Security” is now available on the National Committee Foundation’s website.

Elder Justice Act Passes: Part of Health Reform

It is with great pleasure that advocates for the nation’s elderly celebrate the passage of the Elder Justice Act today. It has been a long time coming.

While it will not stop elder abuse, it will help to educate and prevent much abuse and fund those who provide the help and protect our elders. Let’s thank legislators who voted for health reform for their efforts on behalf  of the nation’s elders.

But it doesn’t stop. In order for the legislation to count, there needs to be a renewed effort to fund programs such as adult protective services. Many states have cut programs drastically.

The Elder Justice Now campaign showed how important the work of those advocates is in the lives of elders and their families.

So, get involved and take action through the Elder Justice Now site and stay informed about this important issue through subscribing to updates from the Administration on Aging’s Center for Elder Abuse.

And, write your Democratic Senators and House members today. Thank them and also urge them to not forget to fund the Elder Justice Act so the legislation isn’t just some words on paper. Our elders are counting on us.

What Few Seniors Know about Health Reform

I hope that older Americans and their advocates understand the good that will come from passage of health reform. Closing the Medicare Part D donut hole will help millions of older Americans who struggle to pay for prescription drugs. The Elder Justice Act, which is embedded in the law, will help seniors who are victims of this silent and horrible crisis. Let’s get behind the name calling, the lies and the scare tactics and praise this historic achievement on behalf of the American people, not just the nation’s seniors.

It is truly amazing how well the Republican message machine has worked to discredit health reform. They have even scared most people over 65 into thinking that this effort will mean the death of Medicare.

In musing about this whole thing, I put my memory cap on. When I first came to Washington, I worked for the Blues and then for the health insurance industry. What I learned was that the only reason the for-profit insurance industry got into health insurance in the first place was to sell life insurance. At board and committee meetings, I listened to CEOs and others brag about how they were blowing the Blues out of the water and their group life insurance sales went through the roof as they encroached on what was a non-profit niche.

Honestly, the time for universal coverage being a simple proposition has long past. When Blue Cross and Blue Shield was still only non-profit organizations in every state and covered most working Americans was the time to have taken this action. Now it seems like a hopeless mess which will only enrich private insurers who must make a profit from health care; they consider it a commodity like any other. Not a right.

The private insurers are entrenched. Almost monthly, I have to use my waning knowledge of contracts (I used to write plain language health insurance booklets) to appeal a denied claim from my wife’s for-profit insurer. Most of the time, I win out, but not without a lot of back and forth and making veiled threats. This is no way to run a system.  I’m afraid that health reform will not do anything to stop these expensive, frustrating and often frightening tactics.

I digress. A bright spot in the health reform bill under consideration by the Senate is that the Elder Justice Act is in their bill. The House has deferred including it since the Dems see no political benefit in its inclusion at this point. In fact, it was sponsored by a Republican who will likely vote against the whole bill anyway. Amazing how it all works.

The Act will do much to prevent elder abuse, protect seniors, educate law enforcement and financial institutions, and prosecute sometimes horrendous crimes. So, there is something in health reform for seniors. And, from what I can tell, health reform will not dismember Medicare; in fact it may boot out some of the for-profits who have scammed seniors and the government itself for years under the rubric: Medicare Advantage Plans.

I think the fact that the Elder Justice Act has some life to it in health reform is due in no small part to the Elder Justice Now campaign. I am proud to have been a part of it. Please visit, view a few videos and take action on behalf of older Americans.

Elder Justice Now!

The Elder Justice Act — part of health reform — will not stop the story below from happening to others, but it will give prosecutors and adult protective services nationwide more support for education, prevention and prosecution of such crimes.

Some years ago, my mother was diagnosed with terminal cancer. Like her mother and sister before her, colon cancer attacked her insides and led to debilitating surgery and a painful end.

Both my sister and I lived long distances from her, and long distance caregiving was difficult. Mother did not want hospice care. Having met two nurse assistants at an assisted living facility where she recuperated from surgery, she asked the couple to move in to an extra bedroom rent free.

They were there when she died and we weren’t. They administered pain medicine during her last days — watching and monitoring the drip.  The young man was strong enough to lift mother and carry her to the bathroom for bathing or toileting. The young woman took shifts during the days and nights mother must have suffered with the progressively horrific effects of this disease.

But, after Mother died, a detective informed my sister and me that the couple were forging checks without her knowledge during this period. While the financial damage was not horrendous, they broke the law. Their financial abuse made us question whether they had abused my mother in other ways.

The detective wanted to know if we wished to press charges. We decided not to, mainly because of the care we know they gave and for which they were not paid. Perhaps it was because we both felt a little guilty that we weren’t there and they were — when she died.  At the same time, I have thought many times whether, because of our inaction, they just moved on and abused another elder.

I am sure many families are faced with similar dilemmas, but the fact remains that these two broke the law and took advantage of someone who was frail and dying. It is inexcusable. It is elder abuse.


Long Term Care Too

As you listen to the drum beat of criticism and negative reactions to health reform and hear the loud screams from seniors worried about their Medicare, please note that the health reform law includes an important new benefit covering long term care at home.

Not many years ago, Congress in its wisdom passed what was called the Medicare Catastrophic Act, then rescinded it in lightning speed when certain seniors rebelled and called for its repeal. Sadly, this legislation would have protected millions of American families from the devastating costs of long-term care and was a missed opportunity to solve a vexing issue.

The late Sen. Kennedy sponsored a bill called the “CLASS Act,” which Congress in its wisdom rolled into the final health reform package. This move will mean that over time those who opt to pay a premium to the government will have coverage for long term care at home. It does not include payment for care in a nursing home.

For those like me who purchased long term care insurance, we are waiting to see how insurance companies will react to this. My policy, like so many others, covers home care. It is likely that many companies will develop what is called wraparound policies similar to Medigap, but we will have to wait and see.

For someone who has been involved in more than one national campaign to secure long term care coverage for older Americans, this new benefit is truly incredible. And, like health reform itself, something that I thought I would not live to see.