Tom Cooper: An article on Personal Responsibility

From Tom Cooper, February 9, 2007
Subject: Personal Responsibility

To Molly and Kathie;

With our recent commentary turning an eye on Medicare, I wanted to pass along a FREE news letter that I subscribe to concering Medicare Rights Advocacy called "Asclepios". At 63, I am not yet ready to take the time to understand all of the provisions and intricacies, but I am sure there are many who have questions, as I am sure I and my wife soon will.

I am sending the most recent newsletter and asking you you post it on your e-mail list and blog site. Of course many may already also be subscribers, but others may find it interesting and informative, and they may also wish to sign up for regular reception. The enclosed newsletter tells how to join up.

Thanks,

TC

Asclepios

Your Weekly Medicare Consumer Advocacy Update

Personal Responsibility

February 8, 2007 • Volume 7, Issue 6

The Bush administration wants high-and moderate-income people with Medicare to pay higher premiums for Part D drug coverage and expand the number of people having to do so for Part B, which covers doctor visits and other outpatient services.

It is a bad idea that in the long run will undermine the Medicare program.

Starting this year, the same law that gave us Part D forces individuals earning more than $80,000 ($160,000 for couples) to pay higher Part B premiums as Medicare reduces the portion it pays. (Historically, Medicare has paid 75 percent of the monthly cost of Part B for everyone in the program.)

In the budget proposed to Congress this week, the Bush administration recommended extending that policy to Part D.

Worse, the Bush budget would over time raise the monthly Part B and Part D premiums for increasing numbers of moderate-income older adults and people with disabilities. This will happen because the budget proposes to stop indexing the income thresholds to inflation. As the value of the dollar shrinks year-to-year and an $80,000 income that looks ample now buys a lot less food, medical care and housing, the higher monthly premiums will start to hit more and more middle-class people with Medicare.

The problem, however, is not just the pinch that middle-class people with Medicare—who already pay between 15 and 30 percent of their incomes on health care—will feel from higher premiums. It is not just that the proposal would impose a form of double taxation on people who already paid more into the Medicare system because their Medicare and income taxes were higher during their working years.

The problem is that this proposal transforms Medicare from a universal benefit that is the same for all older adults and people with disabilities into a welfare program that helps the poor but provides scant benefits for the middle class and those better off. This will inevitably weaken the near-universal political support for Medicare, making it easier in the future to further reduce benefits and harder to generate support to sustain the program.

The Bush administration describes this plan as an effort to make higher-income people with Medicare more “aware” of their health care costs and more “responsible” for paying their share. In fact, it is an effort to make moderate- and higher-income Americans less aware that, if they want decent health care in their old age or if they get hurt, they need to work to make sure Medicare is around for everyone. It makes them responsible for paying higher Medicare premiums but less responsible for ensuring that Medicare works for everyone.

Medicare embodies a promise from all Americans to ensure that all older adults and people with disabilities have access to high-quality health care. Fulfilling that promise is everyone’s personal responsibility.

Medical Record

One of the budget’s Medicare legislative proposals for fiscal year 2008 is to “Increase high-income beneficiary awareness and responsibility for health care costs.” This proposal seeks to “eliminate annual indexing of income thresholds for reduced Part B premium subsidies” and to “reduce Part D premium subsidies based on the same income thresholds that apply to reduced Part B premium subsidies, including no annual indexing” (President’s Budget for the Department of Health and Human Services, FY 2008 ).

“President Bush has already proposed eliminating the indexing of the income limits for the Part B premium calculation. (Currently, the income limits are set to rise every year according to the consumer price index.) That would mean that 10 years from now, the same $80,000 income will buy a lot less and many more people will be paying higher Part B premiums. From there, other cost-cutting measures could include means testing the coinsurance, deductible and even creating different levels of benefits covered by Medicare” (“Part B Premium Means Testing Undermines the Medicare Program ,” Medicare Rights Center, 2006).

Older adults over the age of 65 who are in “good” to “excellent” health spend around 15 percent of their income on out-of-pocket health expenses; those in “poor” or “fair” health spend around 30 percent of their income (“Beyond 50: A Report to the Nation on Trends in Health Security,” AARP, May 2002).

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Fast Relief: Part D Monitoring Project

The Medicare Rights Center (MRC) needs to hear about all the problems with the Medicare Part D benefit, whether they happen to you or someone in your community. With this information, we will be armed with the needed evidence to push for a Medicare-administered drug benefit. Submit your story at www.medicarerights.org/partdstories.html

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The Louder Our Voice, the Stronger Our Message

Asclepios —named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.

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The Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States. Founded in 1989, MRC helps older adults and people with disabilities get good, affordable health care. Visit our online subscription form to sign up for Asclepios at http://www.medicarerights.org/subscribeframeset.html.