MEDICARE ADVOCATES URGE CONGRESS TO REMEMBER MEDICARE’S PURPOSE AND PRIVATE INSURANCE FAILURES WHEN CONSIDERING MEDICARE REFORM PROPOSALS

Medicare advocates from across the country joined the Center for Medicare Advocacy in exhorting Congress to remember certain key concepts when considering proposals to "reform" Medicare. In particular the advocates urged policy makers to remember that equal access to health care and limited out-of-pocket costs for beneficiaries must be key components of any redesign. They also reminded legislators that Medicare was created because private insurance had failed to meet the healthcare financing needs of elders. The concerns and standards expressed are important guides for any future plans to alter the traditional Medicare program. The advocates’ letter is printed below.

_________________________________

June 4, 2002

Dear Member/Senator:

Medicare reflects society’s promise to elderly and disabled persons that neither they nor their families will have to bear the full burden of their health care costs. Since its enactment in 1965, Medicare has dramatically increased access to health care for older adults and persons with disabilities. Yet, the program has not kept pace with changes in the practice of modern medicine, failing to cover prescription drugs, many preventive services, coordinated care and long-term care.

The undersigned organizations that represent Medicare beneficiaries support efforts to enhance the Medicare program to meet the needs of the 21^st century, as long as those efforts build upon, and do not destroy, Medicare’s proven track record in providing access to care for those who are eligible. Any attempts to restructure Medicare should reflect beneficiaries’ paramount needs and concerns, not unproven economic theories.

In evaluating proposals, we urge you to keep the following considerations in mind:

• Reform proposals must maintain and strengthen the traditional Medicare program with its uniform, defined benefit package. Beneficiaries want and need the stable health coverage, predictable costs, and access to providers of their own choosing offered by the traditional program. In contrast, private insurers who participate in the Medicare+Choice program come and go, reduce benefits, increase cost-sharing, and change provider networks depending on their economic interests and market conditions. Private insurance has failed to meet the promise of original Medicare, and so should not be relied upon to improve the current system. In fact, the failure of private insurance to meet the needs of elders was one of the core reasons for the creation of the Medicare program.
  
  

• Reform proposals must promote equal access to health care for all beneficiaries regardless of age, income or where they live. Reform proposals promoting "choice" in health plans undermine the goal of affording universal access to care for eligible individuals and may actually limit choices for beneficiaries. Beneficiaries need improvements to Medicare that are available across the country, and not just in counties where private insurance companies choose to do business. They need prescription drug coverage that is available regardless of income, and not just to those with low income. And beneficiaries who are younger than age 65 should have the same right as older beneficiaries to purchase Medigap coverage when they first become eligible for Medicare.
  
  

• Reform proposals must reduce, not increase, out-of-pocket expenses for beneficiaries. Beneficiaries already bear more of the costs of their care than they did in 1965, when the Medicare program was first established. Reform proposals that impose new and greater co-payments on Medicare covered services will result in decreased access to care and poorer health for many beneficiaries. Other proposals that result in dividing up the risk pool may lead to adverse selection and steep premium increases in the traditional Medicare program. Persons who cannot afford the traditional program may be forced to receive less care from lower cost options, while others may be forced to pay more individually for their own health care.

Policymakers should focus on improving the traditional program to include prescription drugs and other enhancements to the Medicare benefit package, such as preventive health care and coordinated care and long-term care benefits. Such enhancements are essential to promoting good health outcomes and could avoid more costly interventions over time. Increased reliance on the private sector and competition, as advanced in some reform proposals, is risky for the long-term health of Medicare and all Medicare beneficiaries. Private insurance has failed to meet the needs of elders and persons with disabilities, failed to achieve savings for the federal government, and will not fund and make available to all beneficiaries the additional benefits, such as prescription drugs, that they want and need.

Sincerely,

Edward C. King
Kim Glaun
National Senior Citizens Law Center

Judith Stein
Vicki Gottlich
Center for Medicare Advocacy, Inc.

Brian Sawyer
Paula J. McCann
The Senior Citizens Law Project of Vermont Legal Aid

Michael Burgess
New York StateWide Senior Action Council

Clare Smith
Carol Jimenez
California Health Advocates

Andrew Koski
Ellen Rosensweig
Samuel Sadin Institute on Law of the Brookdale Center on Aging of Hunter College

Marcia C. Rachofsky
Texas Legal Services Center

Elyse Politi
Northern Virginia Medicare Managed Care Ombudsman

Diane F. Paulson
Medicare Advocacy Project, Greater Boston Legal Services, on behalf of its clients.

Bonita Kallestad
Western Minnesota Legal Services

Mike Parks
Ellen Leitzer
Senior Citizens Law Office Medicare Rights Project
Albuquerque, New Mexico

© Center for Medicare Advocacy, Inc. 05/02/2008