Entitled to Know

43 years ago, President Lyndon Johnson signed Medicare legislation into law not only for the elderly but also for younger generations who care for them. Before Medicare, half of all seniors had no health insurance and nearly 35% lived in poverty. Today senior poverty has dropped by two-thirds and all Americans 65 and older can get health insurance through the Medicare program. Medicare works.

But as Lynda Johnson Robb reminded us at our 25th Anniversary celebration in June, her father knew "Medicare would have to be carefully guarded and improved through the generations".

Unfortuntely, the privatization of Medicare has neither improved nor carefully guarded the program's core mission to provide equitable and dependable healthcare coverage for America's retirees and the disabled. In fact, massive industry subsidies to private insurers, means-testing, higher premiums and the unchecked costs of healthcare threaten the program.

But there have been some signs that the policy and fiscal truths of the Medicare Modernization Act can no longer be ignored. Our President/CEO, Barbara Kennelly hopes next year's Medicare anniversary will be celebrated in a very different political landscape in Washington:

“The Congressional Medicare veto override and vote to delay arbitrary cuts show Congress has the courage to reconsider these destructive privatization provisions written by and for the drug and insurance industries. Our members hope that with a new Congress and President in the White House we’ll be able to celebrate next year’s anniversary and the end of Medicare privatization at the same time.

This privatization, which was accelerated by the 2003 Medicare Modernization Act, has left seniors saddled with rising premiums, growing out of pocket costs and means testing at a time when they are already feeling the effects of an economic downturn. We must reverse the privatization politics of the past in favor of real policy solutions providing healthcare reform nationwide and strengthening our one universal healthcare plan – Medicare.” Barbara B. Kennelly, President/CEO

It's a provocative thought offered in jest at today’s Kaiser Family Foundation discussion on Health Bloggers and the role they play in policy debates.

For those of you who don’t remember (or would rather forget), Harry and Louise were the stars of the infamous television ad campaign launched by the health insurance industry to torpedo President Clinton’s healthcare reform proposals in 1993.

By most accounts, including this study by Duke University, this ad
campaign helped turn the tide of public opinion...leaving us without healthcare reform for going on 15 years. But as the nation finally appears ready to take another pass at reform, today's Kaiser panelists talked about the role “new media”, specifically blogs, will play in future healthcare debates.

Here’s a sampling of what some of today’s panelists opined:

“The one thing the blogs are very good at is getting the media to notice them. They’re going to be very influential...There will be much more careful conversation because so many partisans are waiting to jump so ferociously on any missteps on either side.” Ezra Klein...The American Prospect

“There will be a much better debate with this many eyes and voices.” Michael Cannon, Cato Institute

“I don’t know if there will be better debate just because there will be more debate.” Tom Rosenstiel, Project for Excellence in Journalism

“It will all happen much, must faster.” John McDonough, Senior Advisor to Senator Edward Kennedy and Former Contributor, A Healthy Blog

As we’ve said here many times, we see nationwide healthcare reform and strengthening Medicare as one in the same. There are clearly lessons to be learned from America’s only universal healthcare plan, lessons we hope policy makers will heed in any future reform debate.

You can also link to video of the full Kaiser session (it runs about 90 minutes).

Congress once again did the right thing and cast a vote for seniors in Medicare by setting aside the Bush administration’s flawed Medicare trigger proposal (required in privatization legislation passed in 2003) and the mandatory cuts it requires. Chairman Pete Stark says the trigger was passed solely “to do a hatchet-job on Medicare”. He’s so right.

The 45 percent threshold at which the “trigger” is set is a completely arbitrary limit included in the Medicare Modernization Act. There has never been a public debate on whether it is appropriate to establish a cap on the federal revenue contribution to the Medicare program at any level, nor has any policy rationale been identified for selecting 45 percent as that federal contribution limit. The fact that more than 45 percent of Medicare financing may come from general revenues poses no more of a problem in itself than the fact that 100 percent of the financing for defense, veterans’ benefits, education or most other federal programs comes from general revenues. The problem facing Medicare is the cost of health care, not how the cost is allocated between revenue sources.

Here’s reaction from our President Barbara Kennelly, after last night’s House vote suspending consideration of the Medicare trigger:

"The National Committee applauds Congress for postponing cuts which would have hurt millions of seniors who depend on Medicare while ignoring the real challenges facing our healthcare system nationwide. The 45% financing cap, mandated in Medicare privatization legislation passed 5 years ago, is arbitrary and meaningless in the larger debate of reigning in the high cost of healthcare. This healthcare crisis is crippling our nation and skyrocketing costs affect not only seniors in Medicare but Americans of all ages. This trigger is nothing more than a distraction from the true challenge facing Medicare: how will our nation provide high-quality health care for an aging population in an era of unchecked health care costs? We congratulate Congress for turning the tide away from arbitrary cuts and cost-shifting to seniors in favor of taking the longer view. Our National Committee members look forward to working with Washington to craft meaningful reform which will serve seniors in Medicare, their children and grandchildren as well."

When should I retire?

Sounds like such a simple question...one asked by millions of seniors each year. Yet the answers are as unique as the individual asking them. To help future retirees sort through it all, the Social Security Administration has unveiled a new benefits calculator.

This isn’t a first for SSA but this latest version goes further than earlier models. The Baltimore Sun’s Eileen Ambrose provides a nice breakdown of how it works:

You won't be able to use it if you don't have enough credits to qualify for benefits - 10 years of earnings - or you are already receiving benefits.

You will need to plug in your Social Security number and mother's maiden name. The agency says the site is secure. And when you print out your information, it won't include these identifying details.

The calculator will ask when you plan to stop working and your average future earnings. It combines these with your earnings history so far.

With the click of the mouse, you can see what your monthly benefit will likely be at 62 - the earliest year to receive benefits - and at other ages. You can,for instance, calculate the difference in benefits by working one more year,something the annual paper estimates don't tell you. In my case, retiring at 63 instead of 62 would mean an extra $100 a month.

Our own senior policy analyst, Mary Jane Yarrington, says the more tools available to workers the better. She answers hundreds of questions from seniors and future retirees each year. Do you have a Social Security question? You can reach her at: “Ask Mary Jane”.

Last week’s Medicare votes gave Congress and the President a simple choice: strengthen the Medicare program for seniors and their physicians or support billions in wasteful subsidies the health insurance industry has lobbied hard to protect. Ultimately, even those who’ve supported the billions of dollars of wasteful subsidies to private Medicare Advantage insurers for years realized this was a very important vote to seniors, doctors and their families.

While the major goal was to block scheduled cut in fees to doctors in Medicare there were many other important provisions, which didn’t get as much attention, yet will affect millions of seniors on Medicare, such as:

• Provides lower out-of-pocket costs for mental health services



• Offers new preventive benefits to Medicare beneficiaries



• Some widely used anti-anxiety and sleep drugs will be added to Part D coverage



• Increases funding for low income beneficiaries and extends the program
  until December, 2009



• Eliminates the Part D enrollment penalty for low income seniors



• Provides incentives to doctors to encourage electronic prescribing




For more details, here’s our summary of The Medicare Improvements For Patients and Providers Act (MIPPA).

Barbara B. Kennelly, President and CEO of the National Committee to Preserve Social Security and Medicare, issued the following statement to NCPSSM members and supporters today:

“Thanks to hard won bi-partisan support in the House and Senate, America’s seniors and their caregivers have averted physician pay cuts that would have severely limited healthcare access to millions receiving Medicare. The National Committee’s members and supporters applaud those in Congress who made the right choice today and voted to put seniors’ healthcare needs before insurance industry profits, by overriding President Bush’s veto. I hope this is just the first vote of many to come, which will reverse the destructive and costly privatization of Medicare, begin a serious bi-partisan debate about nationwide healthcare reform and strengthen the Medicare program for future generations.”