Asclepios
Get Asclepios free by e-mail every week! Click here to subscribe.
Modernize Medicare, Don’t Privatize It
August 23, 2007 • Volume 7, Issue 33“An ounce of prevention is worth a pound of cure,” as the old adage says, but it’s taken a long time for it to apply to the Medicare program. Under current law, only Congress can add preventive care services to Medicare’s coverage. That means it took an arduous legislative process, securing the necessary Congressional votes and the president’s support, to turn the legislation into law just to allow Medicare to cover a screening mammogram.
The Children’s Health and Medicare Protection Act, passed by the U.S. House of Representatives last month, would change that. Among the bill’s many Medicare improvements is a provision that hasn’t received the attention it deserves. It would allow the secretary of the U.S. Department of Health and Human Services to add to Medicare coverage of new services to prevent or detect illness. Best of all, the legislation requires that these services be free for people with Medicare.
The program would allow Medicare to stay up to date with the latest preventive practices as it does for other types of medical coverage. And that’s the way to truly modernize Medicare—not by privatizing it, as supporters of Medicare private plans claim.
Medicare offers some limited preventive care now, including a one-time physical exam that is covered only if performed within the first six months of joining the program. Also covered are flu and pneumonia shots, cardiovascular screenings, several cancer screenings, bone scans to detect osteoporosis, and tests to detect diabetes and glaucoma.
Early detection of disease can save lives. A study released this month by the National Commission on Prevention Priorities found that increased use of just five preventive services would save more than 100,000 American lives every year. Preventive care can also avoid the need for more costly medical treatment.
Yet Medicare officials say only one of 10 people with Medicare takes advantage of the program’s medical screenings. One in three people with Medicare does not get a flu shot.
There may be many explanations for the low interest in preventive care. A study two years ago found that a patient’s copayment is among the possible deterrents for seeking a mammogram. An earlier study published in the Annals of Internal Medicine discovered that financial incentives including reducing or eliminating copayments were “highly effective” in encouraging patients to seek preventive care.
The Children’s Health and Medicare Protection Act goes a long way in making preventive care more accessible to people with Medicare.
There’s just one catch: these provisions do not appear in companion legislation passed by the Senate. While both bills expand health insurance for children, the Senate’s version doesn’t mention Medicare at all.
Let your senators know they should support these important improvements to Medicare.
Ask your senators to add important Medicare improvements to the SCHIP reauthorization bill.
Medical Record
“There is ample evidence to show that increasing the use of proven preventive services will result in fewer people suffering from diseases that could have been prevented or treated with less pain at early stages. Also, preventive services are often more cost effective—meaning they provide better value for the dollar—than waiting to treat diseases, and some preventive services even save more money than they cost. Underuse of effective preventive care is a wasted opportunity” (“Preventive Care: A National Profile on Use, Disparities, and Health Benefits,” National Commission on Prevention Priorities, August 7, 2007).
“[T]he study also found significant reductions in preventive care, such as immunizations for children and pap smears for older women. This raises the important concern that co-insurance plans may adversely impact health while they save money” (“The Role of Consumer Copayments for Health Care: Lessons from the RAND Health Insurance Experiment and Beyond,” Jonathan Gruber, Ph.D., Kaiser Family Foundation, October 2006).
“This spring and summer, as part of the ‘A Healthier US Starts Here’ initiative the US Department of Health and Human Services and CMS will join with local officials and you, our partners, to raise awareness of the importance of preventing chronic disease and illness, promote Medicare preventive benefits and provide information about how beneficiaries can take action to maintain and improve their health” (“A Healthier US Starts Here: CMS Prevention and Wellness Initiative,” Centers for Medicare & Medicaid Services web site).
* * * *Medicare Part D Appeals Help for Advocates is here!
MRC’s new “Medicare Part D Appeals: An advocate’s manual to navigating the Medicare private drug plan appeals process” offers an easy-to-understand, comprehensive overview of the entire appeals process, including real-life case examples, a glossary of important appeals terms, a sample protocol for advocates, and links to important resources.
Register for a FREE copy of this great resource.
* * * *
Medicare Part D Monitoring Project
The Medicare Rights Center (MRC) would like to hear about your experience, or that of someone you know, enrolled in a Medicare private drug plan. With information about what the issues are with Medicare Part D, we will be able to demand that those problems be fixed.
Submit your story at http://www.medicarerights.org/partdstories.html.
* * * *
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.
* * * *
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.