It mistakenly buys into the philosophy that it’s OK to tax older Americans (make them pay more) and keep them from getting care if they are unable to afford the Medicare deductible or the copays. President Obama proposes to raise the Medicare deductible, impose a copay on home health care services and increase premiums for many older adults already at risk. If that’s not bad enough, he wants people to pay extra for a Medicare supplemental (Medigap) policy that ensures full coverage for their care.
Think again, Mr. President. High deductibles and copays are simply ways to ration care based on people’s ability to pay. They impede access to needed care for the most vulnerable Americans in two sinister ways. First, they keep many older adults from getting care altogether, essentially forcing them to endure a poor quality of life and possibly contributing to their premature death. Second, they undo the larger purpose of insurance, concentrating risk and costs among those who need a lot of care rather than spreading risk among everyone.
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People with Medicare already typically spend a large chunk of their incomes on health care costs Medicare does not cover. The latest data from Kaiser Family Foundation reveals that in 2010 the typical person with Medicare spent almost $5,000 out of pocket. People over 85 spent an average of nearly $6,000. And, people with Alzheimer’s spent an average of $8,305.
There’s a just and fair way to reduce Medicare spending further without shifting more costs onto older adults—insist the government negotiate with pharmaceutical and medical device companies on the prices we taxpayers pay for prescription drugs and devices, now the highest prices in the world. That would save Medicare billions of dollars. Yes, the president proposes giving the Department of Health and Human Services the authority to negotiate prices for biologics and select high-priced drugs. This is good, but the authority needs to be comprehensive and include all drugs.
Imposing additional costs on America’s oldest generation, the overwhelming majority of whom live on small fixed incomes, is unconscionable. Look at the data. It’s time we limited out-of-pocket costs for people with Medicare to ensure they receive needed care. Increasing premiums, deductibles and copays only guarantees that more of them will struggle to get by.