Perspective               

Sick People In Medicare HMOs Face High Costs

Many Medicare HMO benefit packages for this year are shifting costs to Americans with the highest health care needs. These packages include high copays for hospital admissions, and for care required by men and women who are chronically ill. For example, this year some Medicare HMOs are requiring their enrollees who need hospitalization to pay $600 per admission and enrollees with severe kidney disorders to pay $25 each time they receive dialysis. People with Medicare who are sick will pay much higher costs while enrolled in a Medicare HMO compared to Original Medicare. It's like a "sick tax" imposed by the HMOs: the sicker you are, the more you pay.

Medicare was created to ensure that all older Americans-healthy or sick-could get the health care they need. The purpose of insurance is to spread the risk so people who need costly care can get coverage at an affordable price. For the system to work, it must treat people with costly health care needs and those who are healthy, equally. Cost-shifting to the sickest people with Medicare jeopardizes the ability of many people with Medicare to get life-saving health care.

The Centers for Medicare and Medicaid Services, the federal agency which oversees the Medicare program, should not allow HMOs to engage in this type of cost-shifting. Write to your Senators and representatives and urge them to support legislation that will ensure that Medicare HMOs distribute costs evenly. It is wrong, and it should be illegal, to discriminate against older and disabled Americans who have the costliest health care needs.

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