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Health: United States
Archives 2006
HEALTHCARE
COVERAGE
Medicare/Medicaid
| Private Insurance/Other
Elder-Care Costs Deplete Savings of a
Generation (December 30, 2006)
In the United States, this writer suggests it is best to be really poor or
really rich. A poor elderly person is eligible for a government-supported
Medicaid and a wealthy older person has enough money to afford a good
retirement and medical care. However, middle class elderly have too much
money to qualify for government support and do not have enough money to
afford ridiculously expensive medical care. As the government fails to
care for elder middle class people, turning to their children to care for
them. The children are forced to empty their retirement savings, including
the 401(k) retirement plans, to support their ailing parents and cover
expensive medical care. This article shares some archetypal examples of
how working children endure this dilemma.
Doctors'
Medicare Pay Cuts Killed; Fund Likely to Shrink (December 20, 2006)
For the fifth time in four years, Congress has erased a pay cut for
physicians, without providing money to cover the $1.8 billion cost. Again,
Medicare officials will tap into an already dwindling reserve fund as it
has done following each of the four previous pay-cut reversals. In another
move, Congress provided funds for a bonus to doctors as an incentive to
provide good care. However,
critics argue that doctors do not deserve a bonus for what they were
already paid once to do. "They're putting a Band-Aid on it
again," states Dr. Colette Willians, a physician concerned about
decreased Medicare reimbursements. "When you take a Band-Aid approach
rather than solving the problem, you get closer and closer to the
cliff."
Medicare Links Doctors’ Pay to Practices (December 12, 2006)
After years of trying to balance the costs of Medicare, Congress has
decided to offer a 1.5 percent bonus to doctors that report how often they
provide quality care. For instance, doctors could be asked to report how
often they prescribe a particular drug after a heart attack or how well
they control blood pressure in patients with diabetes. With these
statistics, Medicare officials say, they will be able to reward doctors
who follow clinical guidelines and perhaps penalize those who ignore such
standards without justification. Some doctors and lawmakers claim that
government defined guidelines could be a step toward cookbook medicine and
will reduce the professional autonomy of doctors.
Study
Finds Senior’s Health and Daily Function Improves(December 7, 2006)
Medicare could save more than $73 billion dollars over three years if
chronic illness in seniors continues declining. The National Institute on
Aging recorded that chronically disabled older persons make up only 19% of
the American population, an 8% difference since 1982. At the same time,
nursing homes have also been on the decline, from 8% to 4%, and the number
of seniors considered "non-disabled" increased from 73% to 81%.
Are American really living healthier lives in old age?
Renewed
Worries on Medicare Drug Plans (December 5, 2006)
As the Medicare sign-on deadline approaches, pharmacists and advocates are
worried that tens of thousands of low-income Medicare beneficiaries will
have trouble getting medications next year. Approximately 600,000 poor
people are losing the guarantee of extra assistance that covered nearly
all their drug costs this year. Many prescription drug plans are changing
benefits. New plans are entering the market. Some beneficiaries will find
they can no longer use the drugstores they have been using or face
increased drug costs. Mark J. Gregory, a vice president of Kerr Drugs
states, “Beneficiaries should be prepared. If you have any doubt, take
action now. Ask questions. Call your plan. Don’t wait till Jan. 1.” Is
this an appropriate request to an aged person who depends on some drugs to
live?
Medicaid Plan Prods Patients toward Health (December 1, 2006)
“We always talk about Medicaid members’ rights, but rarely about
their responsibilities,” said Nancy Atkins, state commissioner of
medical services. Disturbed with people who abuse Medicaid services by not
taking care of their health, West Virginia is considering requiring
recipients to sign a pledge “to have routine checkups and screenings, to
keep appointments, to take medicine as prescribed and to go to emergency
rooms only for real emergencies.” This policy will reward
“responsible” patients with significant extra benefits and punish
those who do not take appropriate preventative care. However, some people,
including doctors, are concerned about the ethics of this policy.
GAO Report: Long-Term Care
Insurance, Federal Program Has a Unique Profit Structure and Faced a
Significant Marketing Challenge (December 2006)
In 2004, about $193 billion was spent nationwide on long-term care
services, including nursing home care and other assisted-living services.
Government programs, primarily Medicaid, paid for this joint federal-state
program that finances health insurance for certain low-income adults and
children. Older people consume about two-thirds of all long-term care
services. The increasing demand for long-term care services will likely
challenge current federal and state resources. This report is the second
of two reports required by the Long-Term Care Security Act to investigate
the competitiveness of the federal program compared with group and
individual plans generally available in the private insurance market.
Voices of Beneficiaries: Medicare Part D Insights and
Observations One Year Later (December 2006)
The Kaiser Family Foundation report explores the experiences of 35
Medicare beneficiaries with Medicare Part D and the voluntary prescription
drug benefit provided by private plans that contract with Medicare. This
report focuses specifically on beneficiary knowledge and understanding
about the drug benefit and their Part D plans. Specifically, researchers
looked at how information and understanding (or lack thereof) played in
people's plan choices in 2006 and how satisfied they are with their
current plan. In addition, the report examines whether beneficiaries
intend to switch plans for 2007.
Different Reasons Suggested for Medicare’s Good News (November 29, 2006)
This year, the Medicare drug benefit cost nearly $13 billion less than
expected. However, more analysis is needed to identify how these savings
are being achieved. While President Bush credits competition among the
private insurance companies, the Centers for Medicare and Medicaid
Services report two other key factors: lower-than-expected enrollment and
drug prices that went up less than expected before the benefit kicked in.
Insurer Scales Back, Widening Medicare Prescription
Gap (November 29, 2006)
Last year, many seniors chose prescription drug plans that cost more but
bridged the break in benefits, known as the "doughnut hole".
However, officials from Humana PDP Complete, the leading national plan
that covers brand and generic drugs in the gap, announced a halt to
payments for brand-name prescriptions. Scaling back coverage raises
more complications for possible reforms in the current program. Although
more plans will offer coverage of generic drugs in the gap next year, the
number covering brand-name medications will drop from 33 to 27. Less than
one-third of Medicare prescription plans offer any sort of coverage in the
gap, according to a recent study for the Kaiser Family Foundation.
Why Medicare Drugs May Be Sticking Point (November 24, 2006)
Democrats want to lower drug prices for senior citizens; however, they are
likely to face obstacles to accomplishing this goal. A narrowly divided
Senate and a Republican president with veto power are two of the
obstacles. Another is that there is no easy solution. It does not mean it
is an impossible task. Virginia has a drug plan that has proven to be cost
effective and successful. Congress may use Virginia’s drug plan, briefly
outlined in this article, as a model when discussing how to improve
Medicare.
Drug Industry Is on Defensive as Power Shifts (November 24, 2006)
With the Democrats winning control of both Houses,
pharmaceutical companies are taking action to prevent Congress from
negotiating lower drug prices for millions of older Americans who are
Medicare recipients. They fear that Congress may overturn a 2003 law that
prohibits the federal government from negotiating on drug prices or making
a list of preferred drugs. They are hiring Democrat lobbyists who could
speak and influence on their behalf. Some Democrats want to establish
stricter regulation of drug safety and also allow imports of drugs from
Canada, where they are often cheaper. Drug lobbyists are aware that it
will be a difficult battle. Will money talk?
Panel Calls for Big Changes in Medicaid (November 23, 2006)
Baby Boomers are retiring and many of them have disabilities of some kind
requiring nursing care which some say risks bankrupting Medicaid. A panel,
the Medicaid Commission, is making suggestions that would resolve this
issue. They include giving states more freedom to determine and manage the
benefits and eligibility, and providing better coordinated care for the
sickest recipients to name a few. However, there are debates on whether
granting states more freedom would result in better care for Medicaid
recipients; more freedom can also mean bigger budget cuts in services.
Medicare Enrollment for Drug Coverage
Set to Get Murkier in '07 (November 19, 2006)
As Medicare drug coverage enrollment begins for next year, an estimated 1
million low income seniors may be randomly assigned to a new plan due to
increased prices and plan cancellations. At the same time, Medicaid
enrollees are also receiving letters that state that they are able to stay
with their current plan. Yet, they may have to pay additional fees. Or
some waivers may be available to them. Advocates fear that conflicting and
confusing information will create the same problems that seniors dealt
with this past year. Many seniors wound up in plans that did not cover
their drugs, were enrolled in two plans or were overcharged.
Administration Opposes Democrats’ Plan for Negotiating Medicare Drug
Prices (November 13, 2006)
One of the Democrats’ top priorities for the new Congress includes
changing legislation so the government can negotiate with drug companies
to secure lower drug prices for Medicare beneficiaries. However,
proponents may face fierce opposition. Those in favor of maintaining
current legislation argue that competing private plans have already
brought down costs more than government price controls would have.
However, Senator Richard J. Durbin of Illinois (D) introduced a bill that
instructs the Secretary of Health and Human Services to offer and operate
one or more government-run Medicare drug plans in addition to those
already available, in order to negotiate prices.
As Drug Prices Climb, Democrats Find Fault with Medicare Plan (November 6,
2006)
National debates persist over the inability for Medicare to negotiate drug
prices directly and the mounting profits made by drug companies. Some of
the biggest windfalls are going to companies that make drugs widely used
by Medicaid recipients. Prior to Medicare Part D, indigent citizens over
65 received drugs through Medicaid at discounted prices.
Drug makers were legally required to give at least a 15% discount
from their list prices. However, these discounts no longer apply since
these recipients are now covered through the new Part D program. As a
result, drug makers are being paid as much as 20 percent more for the same
drugs.
Seniors Shop Early for Medicare Drug Plan (November
4, 2006)
Since open enrollment period begins November 15, Medicare officials are
prompting beneficiaries to look over their options and enroll in a plan by
December 8 if they want to be sure they have coverage under their new
plan. “There are a lot of people who will have a change in drug
needs," said Leslie V. Norwalk, the acting administrator for the
Centers for Medicare and Medicaid Services. "With that change, they
should be taking a look and making sure that their plan still makes the
most sense for them." Approximately 22.5 million seniors and the
disabled are currently enrolled in Medicare plans.
US-Based Medicare Part D Prescription Drug Plan Survey (October 26, 2006)
Global Action on Aging is conducting a survey about the US-based Medicare
Part D Prescription Drug Plan that is in effect in the
US
.
We have posted a Medicare Part D Survey
on our GAA website. The survey is in a Word document format. Please
print the survey and then complete it as soon as possible. Return by
November 20, 2006, to Global Action on Aging, 777 United
Nations
Plaza
, 6J,
New York
,
NY
10017
.
Many thanks for helping GAA learn more about how the Medicare Part D
Prescription Drug Plan is working.
Confident Democrats Draft Broad Health Care Agenda
(October 20, 2006)
Healthcare reform is a top priority for Democrats expecting to gain
seats in Congress. First,
they want federal officials to negotiate directly with pharmaceutical
companies to obtain lower prices for Medicare beneficiaries and close the
gap on coverage. Currently, the 2003 Medicare law passed by Pres. Bush
explicitly prohibits such negotiations.
Even though private insurers already negotiate drug discounts,
Democrats believe the government could get a better deal.
Democrats are also looking for ways to provide more funding for
children’s health insurance and expand embryonic stem cell research.
Medicare
Cuts Could Eliminate Power Wheelchairs for Disabled (October 18, 2006)
Upcoming Medicare cuts in November could mean no more power
wheelchairs for those recipients living with multiple sclerosis, spinal
cord injuries and other conditions. Due to widespread fraud, wheelchair
users are going to have to pay out of pocket by the end of this year.
According to the Centers for Medicare and Medicaid Services, expenditures
for power wheelchairs increased by 2,705 percent between 1995 and 2003 —
from $43 million to $1.2 billion in just over just eight years.
Democrat Disputes Medicare Prescription Drug Plan Calculations (October
13, 2006)
Medicare open enrollment for 2007 starts this November 15th.
Henry A. Waxman (D-California) asserts that the average premium
cost per month for Medicare Part D will rise to $29.
Mark B. McClellan, the head of the Centers for Medicare and
Medicaid Services, stood by the Bush Administration’s estimate that the
average cost will remain at $24, the same as this year. Since 90 percent
ofseniors enrolled in the drug benefit choose stand-alone plans, Waxman
argues that his estimates are more realistic given that his calculations
are based on such plans. McClellan
plans to announce improvements to the CMS Drug Plan Finder, a tool
available on the Medicare Web site to help beneficiaries choose a drug
plan.
Home Health Care Provider Pleads Guilty for Medicare Fraud (October 11,
2006)
Home health care aims to enable people to remain at home rather
than use residential, long-term or institutional-based nursing care.
Medicare can cover the cost of home health care services provided to many
elderly and persons with disabilities. Recently, the owner of the two
largest home healthcare businesses in
California
was charged with defrauding Medicare out of $40 million for work that was
never performed. Lourdes Perez, owner, may serve up to 59 years in prison.
Consumer
Group: Medicare Drugs in Coverage Gap Can Cost More than Retail (October
11, 2006)
Millions
of seniors are suffering from the “gap” in Medicare’s new
prescription drug plan. Consumers now must pay full price for prescription
drugs and some may not emerge out of the $3,600 hole before the end of the
year. A report by Consumers Union, the nonprofit group that publishes
Consumer Reports, found that the regular retail price at the lowest-priced
drugstore beat doughnut hole prices charged by Medicare drug plans,
strengthening the argument that Medicare should be able to bargain
directly with manufacturers to keep prices down for consumers. Why can the
Department of Veterans Affairs negotiate with manufacturers so that
veterans pay 54% less for drugs while Medicare-only beneficiaries are
stuck paying more than the retail price?
Advice on
Social Security, Medicare and IRA Bequests (October 2, 2006)
Prior to retirement, individuals must ask themselves how they will
afford to live out the rest of their lives. They must navigate through the
complex systems of Social Security; Medicare and retirement funds such as
IRA’s in order to have a more comprehensive understanding of their
current situation and whether they will have enough to secure them through
their retirement years. Karen Damato, news editor for the Wall
Street Journal, provides educational information on these issues and
answers questions from concerned readers.
Fewer Drug Options for Medicare Part D? (September 26, 2006)
Last
year, seniors across the country scrambled to enroll in Part D, which
offers
voluntary drug coverage with several insurance companies. However, there
is some speculation that certain insurance companies may drop Medicare
Part D coverage at the end of this year. Therefore, seniors may have to
look for yet another drug plan. Deane Beebe, spokeswoman for the
Manhattan-based advocacy group
Medicare
Rights
Center
, stated:
"People
need to know that your plan might leave, your plan might change your
premium. So now is the time to pay close attention to what it is your plan
is offering and realize that now is the time to switch."
Medicare
Refund Mixup Part of Larger Tangle (September 25, 2006)
Since the
implementation of the new Medicare drug program in January, hundreds of
thousands of beneficiaries have reported problems in getting the
government to start or stop withholding premiums. Over 200,000 persons who
signed up for prescription drug coverage were mistakenly sent premium
refunds and are being asked to send the money back. Federal officials from
Social Security and Medicare have struggled to interconnect their computer
systems so that Medicare premiums are appropriately withheld from Social
Security checks, and low-income people get the assistance to which they
are entitled. Problems are further compounded since this information is
collected and used by many private Medicare drug plans, each with its own
procedures and computer systems.
High-Income Medicare Recipients to Pay Surcharge (September 12, 2006)
The Bush administration announced yesterday that Medicare beneficiaries
will have to pay a higher premium starting in 2007 for Part B of Medicare.
The increase to $93.50 per month, includes a $5 monthly hike to cover
doctors’ services, diagnostic tests and outpatient hospital care. Part B
now covers an estimated 40 million beneficiaries, a 50% increase from 2003
due to a rapid growth in spending for hospital outpatient services. And
for the first time, higher-income beneficiaries will be required to pay a
surcharge. Dr. McClellan, administrator of the federal Centers for
Medicare and Medicaid Services, states that the surcharge would have “a
very positive impact, making Medicare more sustainable in the long
term.” Those individuals with an income of $80,000 or more can expect to
pay surcharges ranging from $12.50 to $68.60 per month.
National Surveys of Pharmacists and Physicians, Findings on Medicare Part
D (September 7, 2006)
During the first year of Medicare’s new drug benefit, 802
pharmacists and 834 doctors were surveyed to assess their views and
experiences regarding Medicare Part D.
In the national survey conducted by Kaiser Family Foundation, many
stated that the new drug benefit can help beneficiaries save money on
their medications. Yet, at
the same time, the majority of pharmacists and doctors also believe that
the prescription drug law can be too complex. They find that many Medicare
beneficiaries experience difficulty in actually getting their medications.
U.S. Government Accountability Office
Report: "Medicare Integrity Program: Agency Approach for Allocating
Funds Should Be Revised” (September 2006)
The Medicare Integrity Program (MIP) provides funds to the Centers for
Medicare & Medicaid Services (CMS)—the agency that administers
Medicare—to safeguard over $300 billion in program payments made on
behalf of its beneficiaries. A recent report by the U.S. Government
Accounting Office (GAO) scrutinizes the Centers for Medicare &
Medicaid Services for their methods on how funding is being used to
prevent fraud, waste, abuse and mismanagement. Also in the report, GAO
examines how major changes in the Medicare program may affect Medicare
Integrity Program funding allocations.
Medicare Part D Digest (August 2006)
Since Medicare Part D’s indroduction last year, certain changes have
occurred
that can have a direct effect on beneficiaries.
For instance, most of the top 20 drugs such as Celebrex and Aricept
have increased in price by an average of 3.7% or more.
However in a more positive development, Hurricane Katrina
beneficiaries will be able to enroll in Part D without the burden of
paying a late penalty through December 31, 2006. In order to keep abreast
of some new developments regarding Medicare Part D, refer to this article
for more up-to-date information.
Who Will Mind Mom? Check Her
Contract (September 7, 2006)
According to a 2004 study by the National Alliance for Caregiving in
Bethesda
,
Md.
, “About 44.4 million adult caregivers--or 21% of the
U.S.
adult population provide unpaid care to seniors or adults with
disabilities.” Yet, as more
people live longer and caregivers find it difficult to balance family
duties and professional careers, formal arrangements may be an answer. A
growing number of families are seeking legal personal-care agreements that
financially compensate family caregivers transporting a loved one to
doctors, the grocery store and taking care of other household
chores. These arrangements, set up by lawyers, can reduce future battles
between relatives, save time and money as well as help a family member
qualify for Medicaid long-term care coverage.
Early Experiences of Medicare Beneficiaries in Prescription Drug Plans
(August 2006)
The Kaiser Family Foundation recently released a report prepared by State
Health Insurance Assistance Plan (SHIP) directors, entitled Early
Experiences of Medicare Beneficiaries in Prescription Drug Plans. Since
directors work closely with the Centers for Medicare and Medicaid
Services, the report explores Medicare beneficiaries’ perspectives on
the new drug benefit. According to the report, some emerging concerns
include data system errors that resulted in beneficiaries being enrolled
into wrong plans; issues with Part D premium payments; limited knowledge
of Medicare Advantage products and uneasiness related to the “doughnut
hole.”
Assembly Approves Universal Health Care (August 29, 2006)
Members of the California State Assembly recently approved a bill that
would establish a statewide health insurance system and eliminate private
medical insurance plans. The
SB840 bill offered by Sen. Sheila Kuehl, D-Santa Monica addresses the
state’s growing health care problem regarding the estimated 7 million
people without insurance. SB840
would provide comprehensive medical, dental, vision, hospitalization and
prescription drug coverage to every
California
resident as well as guarantee individuals the ability to choose their own
doctors and hospitals. The
bill is expected to be approved by the state Senate before going to Gov.
Schwarzenegger. “If he vetoes SB840, the governor will be reminded of
his decision come election day in November,” Kuehl said.
Seniors Flock to Private Medicare Plans (August 29,
2006)
As part of the law that created the new Medicare prescription-drug
benefit, Congress raised the government's reimbursement rates to companies
offering Medicare Advantage plans to about $10,000 per enrollee per year.
Therefore, private insurance companies are enticing Medicare beneficiaries
with lower premiums but often more benefits, such as vision or
prescription drugs. At a time of great confusion over the changes in
Medicare, a large number of seniors are signing up for these privately run
Medicare Advantage plans in the hopes of better managed care. The plan,
also know as private fee for service (PFFS), is a Medicare alternative in
which the federal government pays insurance companies in order to reduce
Medicare spending. Is this a better choice of federal monies?
Medicare Expects Drug Premiums to Hold Steady (August 16, 2006)
Medicare premiums are expected to stay at similar levels for next
year. Currently, seniors pay about $24 in monthly premiums for
prescription-drug coverage, which is an estimated 36% drop from payments
made last year. Intense competition among insurance companies, seniors
choosing cheaper health plans, and the delay in President Bush’s new
premium formula all contributed to price stability. The next enrollment
period starts in November and insurance companies continue to modify
coverage plans to remain competitive and attract more seniors.
A 'Hole' Lot of Frustration: Gap in Medicare
Prescription Drug Plan Leaves some Seniors with a $2,850 surprise (August
15, 2006)
Surviving the “donut hole” has become a way of life for today’s
seniors. The Medicare gap requires most individuals with drug expenses
over $2,250 to pay 100 percent out of pocket before coverage resumes at
the $5,100 level. After that, the beneficiary is covered for all but 5
percent of drug costs. This year, PricewaterhouseCoopers reports that
about 3.4 million beneficiaries, or 8% of those enrolled will be most
directly affected. Next year, even more individuals are projected to fall
into the $2,850 gap since many recipients were not required to enroll
until May of this year.
Planned Medicaid Cuts Cause Rift with States (August 13, 2006)
More
than 330 members of Congress, including 103 Republicans, are
opposed to cutting Medicaid payments to public hospitals and nursing
homes. The White House
administration states that stricter limits on Medicaid payments are
necessary to ensure the program’s “fiscal integrity” as well as
decrease disproportionate payments to health care providers.
Under President Bush’s proposed 2007 budget, the plan would
redefine allowable costs and limit the states’ ability to finance their
share of Medicaid by imposing taxes on health care providers.
A bipartisan group of 50 senators recently urged President Bush to
omit these proposed rules due to the adverse affects on the continuity of
care for Medicaid recipients on top of the huge financial burden the cuts
place on states.
Administration Aims to Set Health Care
Standards, (August 7, 2006)
In a few weeks President Bush will sign an executive order that requires
all federally financed health care providers to implement
quality-measurement tools and standardize requirements for information
technology. Care standards of specific health problems and the development
of uniform methods of measuring and reporting the outcomes of treatments
would be put in place. According to Health and Human Services Secretary
Mike Leavitt, “The goal of the initiative is to reduce health-care cost
inflation while increasing the quality of medical services individuals
receive.” Doctors and hospitals serving the Medicare population and
others in federally financed programs will be directly affected.
Congress Expected to Continue Dodging Mandated Cuts in Doctor Payments
(July 26, 2006
)
Congress set up a 1997 program to limit federal Medicare spending on
annual and cumulative spending for physician reimbursements. Nonetheless,
lawmakers project that billions of dollars will be spent to override these
cuts in Medicare payments to doctors. Lawmakers believe that this solution
is essential to ensuring that patients receive necessary healthcare. They
also fear that any reduction in payments could add to increases in
Medicare premiums and drive doctors from the program. However, the
Congressional Budget Office estimates that allowing doctor payments to
rise in step with medical inflation would increase federal spending on
payments by $218 billion by 2016.
A Windfall
From Shifts to Medicare (July 18, 2006)
With drug companies reporting major US sales increases for popular
Medicaid drugs, the Medicare Part D drug program is proving to be a
windfall for the pharmaceutical industry. According to the program,
Congress cannot negotiate drug prices, which the industry has raised. In
the previous program, states negotiated for the lowest price, receiving
rebates worth billions of dollars each year. The new higher prices will
eventually reach taxpayers, passed on from insurance companies. Moreover,
Washington has asked states to return $5.8 billion in federal Medicaid
funds since the new program began. Some states will fight back, filing
cases against the repayment formula, which they say is unconstitutional.
Bush
Administration Plans Medicare Changes (July 17, 2006)
Changes in Medicare payments to hospitals proposed by the Bush
administration will cut payments 20-30%. The plan will change payment
allocations and hurt hospitals, including nonprofit academic medical
centers. Private insurers, facing higher reimbursements to hospitals, take
issue with the plan. And 3M, the sole government contractor, will profit
substantially from the new system. Though these changes mean to improve
accuracy, critics argue that the system will be less accurate, not
accounting for the costs of new medical technology.
Medicare’s
Hollow Heart (July 13, 2006)
Criticized as a “costly and inefficient failure,” the Medicare Part D
prescription drug program caters to the pharmaceutical industry, not the
citizens for whom the Bush administration created it. In the program, the
government cannot negotiate drug prices for bulk orders, so to offset the
prices citizens must pay for the coverage gap, or “doughnut hole.”
Though still paying monthly premiums, customers pay thousands of dollars
in prescriptions, full price, before they receive the benefits again. This
policy will undoubtedly cost more in the end, with decreased compliance
for medication, increasing emergency and long-term care. And seniors die
earlier without access to drugs: “the annual mortality rate for those
with capped benefits is 22 percent higher than it is for those without
such a cap.”
Investigators Find Medicare Drug Plans
Often Give Incomplete and Incorrect Data (July 11, 2006)
The Government Accountability Organization, a non-partisan investigative
arm of Congress, has found that Medicare drug plans supply faulty
information to people that call. Most insurance company representatives
could not discern the least expensive plan and its annual price. Such
misinformation and mistakes cost beneficiaries thousands of dollars each
year. The Medicare agency reports that there are no performance
requirements beyond answering the phone calls, but even Republican Senator
Olympia J. Snowe asserts that such poor service is unacceptable.
White House to Ease Medicaid Rule on Proof of
Citizenship (July 7, 2006)
In response to a lawsuit challenging the proof-of-citizenship requirement
for Medicaid, the Bush administration announced plans to exempt millions
of Medicaid recipients from the new law. Despite the exemption, critics
argue that many other people will lose coverage, since self-attestation to
citizenship is no longer valid and many people will be unable to prove
their identity.
Medicaid Rule Called A Threat To Millions (June 30, 2006)
Under Bush’s Deficit Reduction Act, people must now provide adequate
proof of citizenship when applying for Medicaid benefits. Although a
federal inspector general reported that non-citizens commit little fraud,
the rule is designed to curb this possibility. Aside from high
administrative costs, another concern is that of harm to millions of US
citizens. For many on Medicaid, it will be extremely difficult to prove
citizenship by the new standards, leaving the most vulnerable without
health care.
How a Hospital Stumbled Across An Rx for
Medicaid (June 22, 2006)
The rising costs of healthcare have created great financial strain for
state governments, specifically in the coverage of poor people under
Medicaid. Because reimbursements are so low, many doctors will not see
Medicaid patients. As a result, patients seek care at the most costly
venue, the emergency room, adding to the state financial burden. Chronic
disease, although affecting a small population, often requires long,
expensive hospitalizations. In a new program, New York’s Mt. Sinai
Hospital provides preventive care to reduce chronic disease symptoms and
complications, reducing ER visits and thus high costs to the state, while
the hospital receives higher Medicaid reimbursements.
States' Changes Reshape Medicaid (June 12, 2006)
Because Medicaid costs are rising faster than state revenues, the federal
government plans to cut spending over the next ten years and has
authorized more control for states. Like changes in the welfare system,
the new principles of Medicaid focus on self-reliance, financial
responsibility, and preventive care. They are modeled on private
insurance, rather than social welfare with centralized governmental
control. Although proposed changes vary by state, the general purpose is
to reduce the burden on state budgets. Advocates explain that paying more
now will prevent total loss of coverage in the future, but others fear
that vulnerable patients and low-income people will lose much needed care.
In Texas
Town, New Drug Plan Baffles Patient and Provider Alike (June 11,2006)
Despite Bush administration reports of the new Medicare
prescription drug program running unhindered, many people are encountering
problems. Difficulties for patients, pharmacists, and doctors compound the
confusion, a result of the variety of plans. Texas has 47 health care
plans with different coverage policies and limitations on drug coverage,
making prescriptions difficult to pay for, assign and fill. Other
frustrations include the gap in coverage, as well as mistakes on social
security withholdings, prescription statement errors, and uncertainty
about eligibility. Though Medicare does make access to drugs easier for
some, “a CBS News/New York Times poll conducted in early May found that,
of people 65 and older, 75 percent said the new program was difficult to
understand.”
Americans Want Universal Health Coverage, Group
Says (June 8, 2006)
In 2003 the United States Congress established and approved funding for
the Citizens’ Health Care Working Group, a committee intended to learn
directly from citizens what they want in terms of health care. Based on
the principle of social responsibility, the committee’s interim report
recommends to the government that all US citizens should have guaranteed
basic health benefits; the recommendation is based on information from
23,000 citizens. However, the report does not suggest strategy or funding
for such a program. Contrary to the view of the Bush administration, which
posits that the government bears less responsibility for health care
funding, universal health coverage would require new laws and financial
resources.
Health
Benefits Ail as Pensions Heal (June 6, 2006)
Though large companies are making progress on funding their pension plans,
“other post-employment benefits” (OPEB), including healthcare, are
still extremely under-funded. Rising interest rates and other factors help
to decrease the pension deficit, but do not affect companies’ healthcare
obligations. Moreover, the tax break incentive for pre-funding pension
plans does not exist for OPEB. US companies complain that the government
should contribute towards healthcare, a large burden as life expectancy
increases and healthcare costs rise. "The light at the end of the
OPEB tunnel is an oncoming train," Standard & Poor's index
analyst, Mr. Silverblatt, says. "Someone is going to have to
pay."
Medicaid
Rules Toughened on Proof of Citizenship (June 5, 2006)
Stemming from political debate about illegal immigration, the Bush
administration will implement strict standards for Medicaid eligibility.
People must prove US citizenship with specific types of documentation,
rated by the government for reliability. The desire to conserve federal
money for citizens will inevitably cause hardship for many people,
including children and older persons. Though politicians assure some
flexibility, the federal government created strong incentives to ensure
state participation.
States Suing Feds
over Seniors' Rx Costs (May 20, 2006)
When the new Medicare D plan started, former senior Medicaid
recipients were automatically transferred to Medicare as dual eligibles.
Until this point, the line between Medicare and Medicaid--as to who pays
for what--was clear. The federal government founded Medicare entirely and
states operated Medicaid using both federal and state money. Now the
federal government plans to make states responsible for the partial
payment of Medicare for dual eligibles. States are concerned that in the
future this may evolve to frequent forcible inclusion of state money for
federally initiated policies.
New Medicare
Drug Plan Is Called a Success (May 17, 2006)
Less than twenty four hours after the Medicare Part D deadline, the Bush
administration declared success saying that 38 of the 42.5 million
eligible beneficiaries (90%) have some kind of drug coverage. These
preliminary numbers are facing criticism since many politicians and
patient rights groups believe the figures are misleading and overly
optimistic. While the administration has been quick to claim success, they
are also swift to avoid questions about removing the late enrollment
penalty. Abolishing the penalty, as many key legislators propose, would
benefit the 4.5 million people on Medicare without drug coverage – of
which 3 million would qualify for low-income subsidies.
The ABCs of Medicare Part D (May 15, 2006)
This article answers common questions about Medicare Part D, such as,
“What is the doughnut hole?”, “What will Medicare Part D cost
taxpayers?”, and “Are seniors satisfied with the program?” The hotly
debated deadline to enroll in Part D was Monday, May 15th. Now that the
deadline has passed, critics and supporters wait to see what will happen
to beneficiaries and those without drug coverage.
Most Medicare Beneficiaries Now in Drug Program (May 10, 2006)
According to new figures, “37 million of 42 million beneficiaries have
coverage under the new Medicare benefit or from other sources.” The 37
million participants includes 8.9 million who signed up for Part D on
their own, 5.8 million who have coverage through a program besides Part D,
and the other 22.3 million who were either automatically transferred to
Part D or have coverage from a former employer. Government officials see
progress, while critics like Robert Hayes, president of Medicare Rights
Center, see a numbers game that distorts the fact that “about half of
Medicare beneficiaries, nearly 51%, who did not have drug coverage before
still lack it.”
Drug-Plan Penalty Is Dropped for Some (May 10, 2006)
On Tuesday, the Bush administration waived late enrollment penalty fees
for low-income seniors and people with disabilities. Participants who
qualify for this waiver can sign up for a drug benefit program until
December 31, 2006. According to the Congressional Budget Office, if the
Bush administration extends the May 15th deadline for all beneficiaries,
the government will lose $100 million in income from late fees this year.
Lawmakers Urge Minority Seniors to Sign Up for Medicare Part D (May 5,
2006)
Lawmakers and clergy in Atlanta, Georgia, are using their respective
pulpits to encourage Medicare Part D enrollment by the May 15th deadline.
Members of the Georgia Legislative Black Caucus pointed out that
“although black seniors are not signing up for Medicare Part D at a
slower rate than other groups, blacks are at greater risk for many health
problems and should enroll in greater numbers.” Local churches are
opening their doors for Part D information sessions and members of
Concerned Black Clergy of Metropolitan Atlanta will encourage enrollment
during Sunday worship services prior to the deadline.
Study Finds Medicare Operators Often Give Bad Information (May 4, 2006)
A recent report from the Government Accountability Office (GAO) found that
operators at 1-800-MEDICARE give faulty information one-third of the time.
The report also observed that Medicare’s written promotional materials
are too technical, call waiting times sometimes close to an hour, and some
people think the website is too confusing. Criticism of Medicare’s
prescription drug program continues as some legislators attempt to push
back the approaching deadline.
Medicare
Surprise (May 1, 2006)
By nature of design, the Medicare Part D drug benefit overlooks middle
ground health spenders. Budget constraints and political decisions led to
what is called “the doughnut hole,” a gap in coverage in which
individuals must pay extremely high prices for their drugs. Many people
who will be affected do not understand the situation; their surprise and
anger will undoubtedly have resounding political repercussions. More
importantly, the circumstances pose dangers to those who cannot afford
medication and will thus skip doses.
Medicare Rule Guarantees Continuity of Drugs (April 27, 2006)
The Bush administration announced a new policy last week to protect
Medicare beneficiaries from the sudden loss of drug coverage. The policy
states that if an insurer removes a drug from their list of covered drugs
beneficiaries are not liable for the changes for the rest of the plan
year, unless the change is due to the drug’s safety or a generic version
becomes available. This policy will also protect recipients from new
restrictions and co-payment increases during their plan year.
Late to Medicare Part D? You'll Pay More (April 27, 2006)
What’s the penalty for enrolling in a drug benefit program after the May
15th deadline? If you’re living in Minnesota you might have received the
wrong information. Beneficiaries were told that the penalty will be 1% per
month of delay based on this year’s national average monthly premium,
which would be a permanent penalty of $2.25 a month; however, the penalty
will change each year depending on the average monthly premium and will
rise accordingly.
Walden Introduces Rural Health Care Bill (April 27, 2006)
Rural communities are hard hit when providing easy access to quality
health care. In order to meet the needs of rural health systems and
isolated citizens, especially older persons, Reps. Greg Walden (R-OR) and
Earl Pomeroy (D-ND) recently introduced the Medicare Rural Health Provider
Payment Extension Act. The bill would “extend Medicare reimbursement
methods for services provided in isolated or underserved areas to help
ensure that such reimbursements are equitable and fair for costs incurred
by rural health providers.”
Deadline Near, Jams Are Seen for Drug Plan (April 24, 2006)
With the Medicare drug plan deadline approaching in less than three weeks,
insurers are expecting a rush for enrollment. Busy phone lines are already
creating long wait times of up to thirty minutes when federal standards
state that “80% of calls must be answered in thirty seconds.”
Beneficiaries are frustrated when requests to have their premiums withheld
from their Social Security checks are rejected, not processed, or set up
incorrectly. Global Action on Aging has been closely monitoring Medicare
Part D and will continue to do so past the May 15 deadline.
Medicaid Hurdle for Immigrants May Hurt Others (April 16, 2006)
In an attempt to restrict undocumented immigrants’ access to health care
benefits, Congress has passed a law that will require recipients of
Medicaid and new applicants to show proof of US citizenship.
Representative Charlie Norwood (R-GA) stated that this new prerequisite
will stop "theft of Medicaid benefits by illegal aliens" and
save the federal government $735 million over 10 years. The law has raised
opposition and concern across the country. A significant number of older
Americans, especially in the South, lack documents confirming their legal
status. Activists fear that minorities, mostly African Americans and
Native Americans, will lose their benefits because of the new requirement.
New Study Captures Variations Across Medicare Drug Plans, Highlighting the
Need for Beneficiaries to Choose Carefully (April 11, 2006)
(Full report available here)
According to a new study by the Kaiser Family Foundation that analyzes
drug costs from different Medicare prescription plans, “Medicare’s new
private stand-alone drug plans vary significantly.” This article
provides highlights from the report. For example, plans covered 64% - 97%
of the 152 sample drugs in the study.
"D" For Disaster (April 7, 2006)
In this article Robert Hayes, president of the Medicare Rights Center,
compares the Medicare prescription drug plan to the rebuilding in New
Orleans and the war in Iraq – “a human tragedy, an administrative
fiasco and a predictable consequence of politicians willing to squander
the national treasury so long as it goes into the pockets of their
mercenary supporters.” Hayes also alludes to the recent release of Secretary’s
Progress Report III on the Medicare Prescription Drug Benefit by
Mike Leavitt, Secretary of Health and Human Services, and criticizes the
report for not explaining the reality behind the statistics.
Confusion on Medicare persists in Texas Valley Region (April 7, 2006)
(Article in Spanish)
Medicare still gives headaches to older persons in Valley region of Texas.
The highly complicated Part D has generated frustration and confusion. Not
able to fully comprehend the guidelines of program, many older persons
have chosen not to enroll. The language barrier—most older persons speak
only Spanish—and lack of outreach volunteers further limits older
adults’ access to vital information. Activists are concerned that many
older persons in the area will miss the May 15 deadline and will have to
pay late penalties.
For Some Who Solve Puzzle, Medicare Drug Plan
Pays Off (March 26, 2006)
Personal experiences show that senior citizens have a lot to gain in
choosing the right Medicare drug plan if they know how to do it.. One
doctor noticed that “the people most likely to benefit have enough
education and perseverance to navigate the system, which is extremely
convoluted and complex. Or they have friends and relatives to help
them.” Satisfied beneficiaries have a couple attributes in common: they
picked one plan and did not change; they got help from experts, family,
and friends to use the plan finder on the Medicare website; they are not
on Medicaid; and they live in states that will now receive financial
support for drug costs. Sadly, not everyone has such access.
This Is Only a Test (March 16, 2006)
Last week, the Senate voted on three different pieces of legislation
concerning Medicare Part D. Despite rejecting an amendment that would
extend the May 15 Part D enrollment deadline, the Senate approved the
Grassley Amendment which “would allow, but not require, the Bush
Administration to extend the enrollment period, waive penalties and allow
an additional plan change.” Although President Bush does not plan on
moving the deadline, many people think an extension is fair considering
the confusion and obstacles of Part D since January 1. Finally, the Senate
passed the Snowe-Wyden Amendment to permit Medicare to negotiate drug
prices under Part D, even though insurance companies will mainly provide
the drug benefit. Uncertainty lingers as legislators try to address
glitches in Medicare’s drug benefit program.
House Republicans Oppose Bush's Medicare Cuts (March 8, 2006)
President Bush plans to cut $36 billion in Medicare over the next five
years and $105 billion over the next ten years. On top of this proposal,
Congress recently cut $39 billion for health and other social programs.
Tension between Bush and Congress rises as legislators from both parties
voice concern over the proposed cuts to Medicare. Another obstacle for
Bush’s healthcare agenda includes a top Senate Republican placing the
expansion of tax-exempt Health Savings Accounts (HSAs) on the back burner.
Debating Health Care, Finally (March 7, 2006)
Maryland’s Fair Share Health Care Act is opening new doors for
discussing state universal healthcare coverage. The act builds on
“existing private-sector coverage, requires all employers and
individuals to contribute a fair share, and sets up a quasi-public health
insurer to cover every resident who is otherwise uninsured.” Dozens of
legislators are taking the lead from Maryland and enacting versions of
Fair Share in their own states. Although Fair Share cannot fix our
national healthcare problems or mandate all companies to provide health
insurance, the solution to our crumbling system of employer-based health
coverage needs to start somewhere.
Bill Would Ease
Home Care for Elderly and Disabled (March 7, 2006)
The New Jersey Assembly will consider a bill called the
"Independence, Dignity and Choice in Long-Term Care Act" that
would allow senior citizens eligible for Medicaid to be receive long-term
care at home rather than in nursing facilities. Fourteen states currently
have a similar legislation. "For too many generations, ironclad
government systems channeled the elderly and the disabled into nursing
homes and other institutions," said state Sen. Loretta Weinberg,
D-Teaneck, co-sponsor of the bill with Assemblyman Jim Whelan, D-Atlantic
City. The measure "will empower seniors and the disabled to decide
what long-term care plan works best for them," Whelan said in a
statement.
Sample
Letter to the Editor on Medicare (March 7, 2006)
The NY StateWide Senior Action Council is circulating Mike Burgess' letter
to the editor about Medicare. In Mike's opinion, although Medicare is not
a perfect program, the new drug benefit has made everything a mess. Mike
says in his letter, "Instead of a universal, comprehensive,
standardized national drug benefit designed for seniors and the disabled,
the Medicare drug benefit was designed as an affirmative action program
for insurance companies and a cash cow to increase the profits of the
pharmaceutical companies." Mike's letter refers to the EPIC drug
program in New York State that contains features that many wanted in a
federal prescription drug plan. Reference is also made to the
Kennedy-Stabenow bill in Congress that is pushing for a Medicare-run drug
plan option.
Democrats Try
to Mend Medicare Drug Program (March 1, 2006)
On February 28, Senate Democrats introduced their solution to strengthen
Medicare Part D’s drug plan, the Medicare-Guaranteed Prescription Drug
Act. This bill plans to address the coverage gap, allow the federal
government to negotiate prices with drug makers, streamline Medicare’s
administration and permit “beneficiaries to remain within traditional
Medicare to obtain drug coverage and not be forced to buy insurance from
private companies.” One of the bill’s authors, Sen. Edward Kennedy,
D-Mass, said “No longer will [seniors] have to rely on a bewildering
array of private plans to meet their need for drugs. In large cities and
small rural areas, from Maine to California, to Alaska and Hawaii,
Medicare will be there for every senior who wants it.”
In Medicare Maze, Some Find They're Tangled in Two Drug Plans (March 1,
2006)
Medicare beneficiaries find they are enrolled in two drug plans and risk
the chance to be charged two premiums or the incorrect co-payment amount.
The Bush administration says know about this problem and is trying hard to
work out the computer glitches. What happened was that enrollment and
disenrollment information was not always sent correctly. This caused great
complications for pharmacists and insurers bacause they do not have a list
of those who are actively enrolled and who is qualified for low-income
subsides.
The Excess Cost of the Medicare Drug Benefit (February 2006)
The Center for Economic and Policy Research and the Institute for
America's Future has recently released a brief report detailing the
unnecessary costs of the new Medicare drug benefit. This report outlines
areas of waste and inefficiencies of the 2003 Medicare Modernization Act
that are predicted to cost Americans and the federal government more than
$800 billion over the next ten years. One area of waste includes excessive
payments to drug companies accompanied by the inability to negotiate the
price of drugs. This occurs despite the fact that almost every other
industrialized nation negotiates prices to lower drug costs. Also, the
confusing, free-market private plans are inefficient compared to
Medicare's simple plan.
Veterans May Face Health Care Cuts in 2008 (February 27, 2006)
The cost of providing health care services to elderly veterans continues
to rise despite projected cutbacks in veterans' medical care starting in
2008. The White House maintains that people should not jump to conclusions
since projected budgets don't necessarily represent policies and decisions
are made on a yearly basis. On the other hand, critics say that if the
White House is proposing cuts, but does not plan to follow through with
them, it "would undermine the administration's argument that they
intend to reduce the deficit in half over the next several years."
And will the veterans get the health care they need in old age?
Drug Plan Sales Tactics Probed (February 24, 2006)
In a time when many seniors are confused and frustrated by the new
Medicare drug benefit program, the Office of the Inspector General at the
U.S. Department of Health and Human Services is now investigating
allegations of fraudulent Medicare marketing practices. This investigation
is going to examine the sales tactics of agents who sell drug-only and HMO
or Advantage plans. Although the inquiry will be industry-wide, certain
insurers have been accused of giving sales agents higher commissions if
they sell HMO plans over drug-only plans.
Medicare
To Cover Obesity Surgeries (February 23, 2006)
(Article in Arabic)
Obese patients now qualify for bariatric surgery under the US Medicare
health insurance plan. Some rules apply. For example, patients must have
tried other weight loss regimens unsuccessfully.
Medicare
May Now Limit Drug Plan Option (February 23, 2006)
The President is considering cutting the Medicare drug coverage for older
persons and those with disabilities. Various employers and insurers are
suggesting how to simplify the program for next year. One proposal would
limit customers to only two drug plans per region instead of the three
that is offered now. Some critics believe that this will not help because
it does not narrow the choices. And, added to that, this procedure may
make it difficult for insurers to negotiate a lower price for drugs.
Confusion With Medicare Drug Benefit Hurts Elderly Clients (February 23,
2006)
In response to the Medicare Part D that took effect on January 1st, older
persons still feel confused and uneasy with the complexity of it. Many
elderly are turning to pharmacists, doctors, social workers, and their
children. The majority has refrained from asking help from their children
because they either do not want to burden them, or fear that they will
lose their independence if they reveal that they can't care for
themselves. For the seniors that still have not enrolled in the plan,
trying to find which option is right for them may be an overwhelming
process. Although Medicare has made a website to make it easier for
elderly to compare the different options, surveys show that only one out
of five people that are 65 years or more have access to internet. As the
program becomes more organized, we will be able to determine if the
outcomes of Medicare Part D will outweigh the negatives.
Medicare Numbers
At Odds With US Claims (February 23, 2006)
How many people have enrolled in the new Medicare drug plan? Well, that
depends on what numbers you want to use. Critics and supporters of Part D
are selectively using data to further their view of the new drug plan.
Officials have also been blurring the line between enrollees and
beneficiaries in what Ron Pollack of Families USA calls "misleading
propaganda."
Market to
Simplify Drug Plans (February 22, 2006)
Instead of narrowing the long list of Medicare drug plan choices,
officials are now relying on financial competition to simplify the benefit
program. Standardization will result when consumers choose certain drug
plans over others and insurance companies and pharmacies promote specific
benefit programs. Will consumer and market driven drug plan
standardization be best for our health and pocketbooks? We'll have to wait
and see.
Health Care
Costs to Keep Rising (February 22, 2006)
By 2015 Medicare and Medicaid spending will likely more than double and
our national health care spending will exceed $4 trillion. Analysts
predict that "within a decade, an aging America will spend one of
every five dollars on health care." Analysts also predict that as
health care costs soar we will increasingly depend on the government for
assistance. But will the government be there to help?
Enrollments in Medicare Drug Benefit Rise (February 22, 2006)
Health and Human Services Secretary Mike Leavitt maintains that the number
of elderly enrolling in a Medicare drug benefit each week proves that
beneficiaries are becoming fonder of the program. Still, critics retort
saying an increase in numbers does not mean people are happy, nor does it
take into account the number of automatic enrollees. In this article,
Leavitt leaves the responsibility to insurers and the market to "make
it easier for beneficiaries to understand the benefit and to reduce the
dozens of plan choices available to them." Finally, Ron Pollack,
executive director of Families USA, points out that the government
originally had higher expectations for enrollment. This means that
"if enrollment is exceeding expectations, it is only because
expectations have been greatly diminished."
Millions Not
Joining Medicare Drug Plan (February 21, 2006)
According to Deane Beede, from Medicare Rights Center, many seniors will
miss out on a "very, very good benefit" if they fail to sign up
for Medicare Part D. The confusion, skepticism, and frustration over Part
D is mainly stemming from the intimidating application. However, other
challenges for enrollment include language barriers, mental impairments,
concern about losing benefits, not knowing their assets, and not wanting
what they perceive as a government handout. Most of the confusion can be
cleared up through explanation and assistance, the article claims.
Despite Medicare Drug Confusion, Many Elderly People Don't Seek Kids' Help
(February 20, 2006)
Even though the best way to compare and select a prescription drug plan is
to go to Medicare's website, surveys show that only one fifth of people
over 65 actually have access to the Internet. Medicare officials thought
that this gap would be bridged by engaging adult children and creating a
family bonding experience. Many older persons say they don't need help,
they don't want to be a burden to their family, they trust pharmacists and
social workers advice over their children's guidance, or they are not
close to their children.
Seniors'
Views More Unfavorable than Favorable on the Medicare Drug Benefit
(February 17, 2006)
According to a recent poll, senior citizens have become less enthusiastic
about the new Medicare Drug Benefit over the past six months. In fact,
seniors are almost two-times as likely to view the benefit program
unfavorably (45%) versus favorably (23%). The poll notes the need for a
multifaceted outreach effort that is not heavily Internet-based,
especially since less than one-third of seniors have ever gone online for
any purpose.
Rules of Medicare Drug Plans Slow Access to Benefits (February 14, 2006)
Although drugs may theoretically be covered by the new Medicare drug
benefit program, restrictions and requirements from insurers are creating
barriers to access medicine. In order to prevent drug abuse, many drugs
require "prior authorization" from doctors and patients. Doctors
may have over twenty-five prior authorization forms for different drugs in
one drug plan, which is a headache for doctors, patients, and pharmacists
alike. John Feather, executive director of the American Society of
Consultant Pharmacists, says that older persons are disproportionately
subject to prior authorization compared to participants in commercial
insurance programs.
New York Health-Care Industry Says It Faces $1.2 Billion in Cutbacks Under
Bush Plan (February 8, 2006)
President Bush's proposed cutbacks are provoking drastic reactions. The
cutbacks will force hospitals, nursing homes and home care providers to
reduce services substantially for older persons and the disabled residents
of New York. The result? More crowded clinics and emergency rooms in
poorer communities and expensive bills for private insurers and patients.
Federal and state officials are putting more pressure on local health-care
industries because they claim local groups have not used funds efficiently
and that they have been too quick to turn to the government for help.
However, even Republicans are skeptical about President Bush's ability to
push through the proposed Medicare cuts.
Report:
Center on Budget and Policy Priorities: Expansion In HSA Tax Breaks Is
Larger- And More Problematic- Than Previously Understood" (February
7, 2006)
Please read the following report on the President's plan of action to
expand Health Savings Account tax breaks. Jason Furman points out that
approximately 46 million people do not have health insurance. Those with
coverage are not receiving the quality care that they are entitled to. The
government's priority should be to provide health care to those who do not
have it. Instead, what the government is proposing will be even more
costly.
Slowing the Growth of Medicare (February 7, 2006)
President Bush has proposed to slow the growth of Medicare and Medicaid
over the next five years. Spending will be cut by reducing annual
inflation updates in Medicare and further shifting Medicaid expenses to
the states. The chief executive of AARP, William D. Novelli, "warned
that the proposals could lead to a crisis in quality and access to health
care for older Americans."
Lawmakers to Override Pataki Veto of Safety Net for Prescription Drugs
(February 6, 2006)
New York lawmakers and Governor Pataki have different ideas about how to
handle the problems with the Medicare benefit program. Pataki has vetoed a
heavily supported bill that would grant a permanent extension in drug
coverage for disabled and low-income seniors until the problems with the
federal program are fixed. The governor feels that the legislation isn't
worthwhile because the U.S. Health and Human Services Department has
promised to reimburse the state of New York through March 8, after which
Pataki pledges to reevaluate the situation.
Democratic Response to Bush's Address (February 1, 2006)
This is the text of the Democratic response to President Bush's State of
the Union address Tuesday, given by Governor Tim Kaine of Virginia. Gov.
Kaine emphasizes a "better way" to do politics through service
and collaboration. He criticizes the Bush administration's "poor
choices and bad management" in healthcare, education, fiscal
responsibility, jobs, and the environment. Kaine offers alternatives to
the current state of the union and foresees a brighter future for the U.S.
if we all work together.
State of the
Union: Affordable and Accessible Health Care (January 31, 2006)
This article outlines President Bush's agenda to make health care in
America more "affordable, portable, transparent, and efficient."
His agenda goes into detail about health savings accounts, making
insurance more portable, improving information on price and quality,
leveling the playing field for individuals and small business employees,
passing medical liability reform, improving access to health information
technology, and assisting vulnerable groups.
'We Strive to Be a Compassionate, Decent, Hopeful Society' (January 31,
2006)
In his State of the Union address, President Bush talks about the impact
of baby boomers and the future of healthcare. He proposes the creation of
a commission to look at the impact of baby boom retirees on Medicare,
Medicaid, and Social Security. Bush also acknowledges the government's
responsibility to provide health care for the poor and elderly. One of his
solutions to ensure affordable health insurance coverage is to strengthen
health savings accounts. Finally, Bush is pressing Congress to pass a
medical liability reform this year.
Medicare Drug Bill Tied to Abramoff (January 25, 2006)
In a letter addressed to the Speaker of the House of Representatives,
Democrat leaders called for an investigation into the process that
produced the Medicare Prescription Drug Act. They ask about the role
played by the Alexander Strategy Group, a lobbying firm linked to Tom
DeLay and Jack Abramoff. They argue that an investigation is deemed
necessary if public faith in the legislative process is to be restored.
The authors of this letter argue that "high drug prices enrich the
pharmaceutical industry at the expense of seniors and taxpayers."
The Great Republican Rip-Off (January 24, 2006)
Froma Harrop, a nationally syndicated columnist, writes this opinion piece
on the Medicare drug benefit program. Calling Washington's performance an
embarrassment, Harrop questions how the party of national security
"would handle an unexpected terrorist attack when they can't even
organize a drug plan with more than a year's lead time." Harrop also
claims that there is profit in confusion and that the elderly are being
ripped-off.
Clinton Criticizes Implementation of Bush's Drug Plan for the Elderly
(January 24, 2006)
Senator Hillary Clinton attacked the new Medicare drug benefit program as
she visited cities throughout New York. She said that the program favors
insurance and drug companies over the elderly. Many Democrats believe that
the problems with this new program may impact Congressional elections in
November. In response to Clinton's criticism, the White House returned the
attack by "contending that her husband's administration had not
produced any significant legislation to help the elderly deal with the
skyrocketing costs of prescription drugs."
New Medicare Program Creates Great Confusion
(January 23, 2006)
(Article in Spanish)
The new Medicare Prescription Drug program has created great confusion
among beneficiaries says AP-Ipsos, a Washington D.C poll agency. Fifty-two
percent of those polled said that they were very confused with the new
plan. The numerous private providers, different plans and the long list of
medications covered make Medicare very complicated. The poll shows that
not only the very old and those with little education find the new
Medicare plan confusing, but also 60 year olds and university degree
holders had difficulties understanding the program. Jean Finberg, from the
National Senior Citizens Law Center, said that impoverished older persons
will be negatively affected by the abstruse nature of the new Medicare
enrollment process.
For GOP, Time
for Soothing, Selling (January 19, 2006)
GOP lawmakers have been pouring effort into outreach towards senior
citizens in hopes of calming the increasing irritation over the new
Medicare prescription drug program. This campaign comes "during a
congressional corruption scandal and a shake-up of the House GOP
leadership," which worries many Republicans during a year of midterm
elections. There are signs of resistance, but also signs of eagerness
among some Medicare recipients.
Medicare
Won't Repay States for Emergency Purchases (January 18, 2006)
The federal government will not reimburse states for the emergency drug
purchases that they made in the past two weeks due to glitches in the new
Medicare Part D program. Medicare administrator Mark McClellen says that
states will have to deal with the drug companies to recover the monies.
Many States, such as California, stepped in to help pay for drugs for the
low-income customers who needed the medications. Now California government
will have a $150 million bill that they must recoup from the litigious
drug companies. A reward for taking care of elderly sick residents?
Bush Adviser Sees Spending Cuts, Health Proposals (January 18, 2006)
White House economic advisor Al Hubbard says that Medicare, Medicaid, and
Social Security are growing at unsustainable rates and may become
increasingly stressed as "baby boomers" begin to retire in 2008.
Hubbard also forecasts that President Bush will address these issues in
his State of the Union address on January 31 and in his 2007 budget
proposal that is going to Congress in February. We may also hear more
about health care cuts as Bush aims to lower costs.
Rolls Growing for Drug Plan as Problems Continue (January 18, 2006)
Over twenty states are stepping in to pay drug claims since the federal
Medicare program started their new prescription drug benefit on January 1.
This effort attempts to aid Medicare recipients who have been overcharged,
turned away, and left without their medications. Dr. Michael J. Sexton
describes the struggles of this new federal program as "like telling
a person who's drowning, 'Hold on; we'll teach you how to swim.' "
Glitches are common in the initial stages of a new program; however,
future disputes loom over how much states will actually be reimbursed.
President Tells Insurers to Aid Ailing Medicare Drug Plan (January 16,
2006)
Now two weeks into the new Medicare program, tens of thousands of people
still are not able to get their medication that Medicare is supposed to
help cover. Several states have declared that the State would help to
cover the costs of prescriptions for their elderly. Other States have
filed for a public health emergency powers. President Bush has ordered
insurers to provide a 30-day supply of whatever drug that the customers
had been taking prior to the implementation of the new system. He said
that the poor must not be charged more than $5 for their drugs. Hopefully,
the new Medicare glitches will be resolved within this 30-day period.
US
Orders Insurers to Supply Seniors' Drugs (January 16, 2006)
Responding to the chaotic functioning of the new Medicare Drug Plan
(Medicare Part D) and well after several states announced they would
declare a health emergency, the Bush administration ordered health
insurers to provide a 30-day supply of prescription drugs to any
beneficiary who previously received them. Acknowledging that many
"dual eligibles" have been overcharged or simply denied
medication, Mark McClellan, administrator of the federal Centers for
Medicare and Medicaid Services confessed he found this behavior
"unacceptable."
Medicare
Meltdown (January 12, 2006)
As the new Medicare Part D program has taken effect, many are still
suffering from the transition. The most vulnerable elderly and disabled
patients face greatest risk. In one case, a man who just had his leg
amputated could not get his prescription of antibiotics to fight off
life-threatening infections because Medicare would not cover the cost of
his medication. Another woman was not able to receive her first treatment
of chemotherapy. Too many elderly and disabled are either not getting
their medication or paying too much for it. All this, when the new system
is supposed to cover drug costs by 50%. Some states are providing
temporary supplies of medication to patients but are concerned because
their emergency supplies are running low.
Drug Makers
Scrutinized Over Grants (January 11, 2006)
A Congressional investigation of the money that drug companies give as
"educational grants" has found that marketing executives push
unapproved uses of drugs with doctors and patient groups. It's hard to
understand why these grants are called "educational." The
committee believes that the use of educational grants to further marketing
aims is widespread in the industry. Some grants were used to train
speakers to advertise and recommend specific products for "off label
uses," during medical presentations. The heavy financing of such
organizations can compromise their independence and result in practices
that damage or harm unknowing patients.
States Intervene After Drug Plan Hits Early Snags (January 8, 2006)
Pharmacies turned away many elderly without giving them their medications
in the first week of Medicare's new drug benefit. Why? Pharmacies could
not verify that the customers had signed up. The situation is even more
complicated for low-income beneficiaries who are being charged incorrect
(high) co-payments. States are now reacting: the Vermont legislature for
instance, passed a bill declaring, "There is a public health
emergency due to the federal implementation of Medicare Part D, which has
resulted in serious operational problems."
Medicare Drug-Coverage Message is Mixed (January 5, 2006)
The government's Medicare health insurance program for the elderly has
been a prime topic of debate for years, especially focusing on cost and
coverage of prescription drugs. The new Medicare Part D offers many
choices to potential subscribers. Less than 10% of Medicare card holders
have signed on. A political scientist from University of North Carolina,
Jonathan Oberlander, says that Congress viewed seniors and those with
disabilities like "computer-linked consumers" and gave them an
overwhelming amount of choices. "It's insanity," said the
professor. Too many choices make people turn away.
Glitches
Mar Launch of Medicare Drug Plan (January 4, 2006)
On January 1 the new Medicare Drug program took effect for those who
signed up by December 31. While over a million customers were able to
obtain their prescriptions under the new plans, many others had great
difficulty. Why? The pharmacy could not verify that they had signed up. As
a result, some pharmacies gave out free 2-3 day's worth of medication
until their Medicare plan could be verified. The timing for the new plan
was bad, considering that New Years Day fell on a Sunday and the following
Monday was also a holiday. Many doctor's offices were closed so that
pharmacists who needed provider information or other verification could
not get help. To add to the overload of customers, many elderly refill
their prescriptions on the first of the month. With the slowdown of the
Medicare verifying system and continuous busy signals due to a high volume
of calls, it was a very frustrating time for seniors and pharmacists. Read
on to get some advice on how to get your medication until you receive your
new Medicare program card.
"Doctors for boomers": Shortage of
geriatricians in the US (January 3, 2006)
The US faces a shortage of geriatricians to care for a tidal wave of older
patients. The leading edge of more than 70 million baby boomers is turning
60, and eventually will need care designed to meet the needs of the
elderly. Already, the US has less than half the elder-care specialists it
needs. Unless there's a change, that will drop to one-third of the
specialists by 2030.
Private
Insurance/Other
US
Health System Not Yet Ready for Disaster (December 12, 2006)
Trust for
America
’s Health (TFAH) recently released the fourth annual "Ready or Not?
Protecting the Public’s Health from Disease, Disasters, and
Bioterrorism." Five
years after the 9/11 and anthrax tragedies, the report says that emergency
health preparedness is still inadequate in the
US
. The report contains state-by-state health preparedness scores based on
10 key indicators to assess emergency preparedness capabilities. All 50
U.S.
states and the
District of Columbia
were evaluated and half scored poorly.
California
,
Iowa
,
Maryland
, and
New Jersey
scored amongst the lowest, while
Oklahoma
was the only state to meet all 10 measured indicators. Half of all
US
states would run out of hospital beds within the first two weeks of a
moderate flu pandemic and 40 states continue to suffer from a shortage of
registered nurses. Click here
for the full report.
Major Visual Disorders
in People Over 40 May Be Costing the US Economy Billions (December 11,
2006)
Millions of Americans have visual
impairment, blindness or other eye diseases such as age-related macular
degeneration, cataracts, and diabetic retinopathy. According to a report
in the December issue of Archives of Ophthalmology, major visual disorders
in Americans older than 40 years may cost the
U.S.
economy an estimated $35.4 billion a year. However, technological
and medical advancements as well as public health efforts to screen for
and treat currently undiagnosed diseases may improve visual outcomes.
These measures may reduce long-term costs, productivity losses and nursing
home placements associated with visual impairment and blindness.
The Last Word on the Last Breath (October 10, 2006)
Healthcare
decisions regarding a patient’s medical treatment is a crucial
discussion among the patient and all parties involved. Since treatment can
become very complicated, end of life measures and quality patient care
have been widely debated in medicine and law. Who gets the final say over
whether CPR should be administered on a gravely ill patient—the doctor,
patient or the patient’s representative? Medical integrity and
patients’ rights play a fundamental role in shaping state legislation.
However, hospitals and state legislature constantly wrestle with balancing
these competing values. Thus, broadening the focus beyond the decisions
regarding the last 15 minutes of a patient’s life and having more open
dialogue around issues of pain management, comfort and closure may assist
in finding this balance.
Panel Urges
Basic Coverage on Health Care (September 26, 2006)
According
to the Census Bureau, since 2001, when President Bush took office, the
number of uninsured has increased by more than 5 million, to 46.6 million
in
2005. To combat this growing number, a federal advisory panel urged
Congress to take steps toward guaranteeing all Americans access to
affordable healthcare by 2012. After soliciting opinions of over
7,000 average Americans and health experts at 98 community meetings in 37
different states, the Citizens’ Health Care Working Group panel advised
Congress to create an independent “public-private entity” to define a
basic set of health care benefits and services for all Americans.
Double Bypass Health-Care Consultants Reap Fees from Those They Evaluate
(September 18, 2006)
Given the competitive market of private health insurance
companies, employers can hire employee-benefits consultants to assist in
choosing the best contract for their employees in terms of health
insurance and prescription-drug coverage.
However, brokers do not often act “in the best interest” of the
employer and often receive hefty financial bonuses from the health vendors
they are supposed to be scrutinizing.
For example, in 2001, employee-benefit consultant Kevin Grady
received $517,138 from UnitedHealth for helping secure the
Columbus
Public
School District
’s business. Once the district found out about the bonus, Mr. Grady’s
license was suspended, district officials canceled his contract, and he
was order to pay $137,000 in restitution and a $25,000 civil penalty. The
incident highlights a prevalent and mostly invisible practice that
increases the cost of health care.
One-year Anniversary of Hurricane Katrina-Survivor Experiences (August
2006)
On the eve of the first year anniversary of the Hurricane Katrina tragedy,
many survivors are still dealing with the aftermath of events that have
led to their displacement. The elderly are amongst the most vulnerable to
the adverse affects of natural disasters since they are least able to
advocate for themselves and seek care. The Kaiser Family Foundation’s
report, Voices of the Storm: Health Experiences of Low-Income Katrina
Survivors, provides vital findings from interviews with low-income
survivors about their health care experiences after the storm. It also
addresses ways to improve the response to this and future disasters. Among
these interviews, the elderly and caregiver survivors share heartrending
stories of their evacuation from New Orleans in 2005.
U.S. Nursing Home Care Found Wanting; Too
Many Facilities are Falling Short of Their Obligations, Survey says
(August 7, 2006)
In 1987, Congress passed a pivotal law to improve nursing home care for
the elderly. But a recent report, titled Nursing Home Quality Monitor, has
made some disturbing conclusions. The report published in the September
issue of Consumer Reports reveals that poor care is still all too common
and many nursing homes have failed to comply with set standards. The
report’s investigators assessed 16,000 recent nursing home inspection
reports and found that many homes were recurring offenders of poor care. A
number of nursing homes repeatedly failed to follow doctors’ orders,
monitor pressure sores or suitably sanitize cutlery. The number may be
even greater since the study also found that many states have become lax
in penalizing bad homes. Many state inspectors are writing fewer
deficiencies for severe violations.
States Stumble Privatizing
Social Services (August 4, 2006)
In the quest to privatize social services, Texas and Indiana were
determined to launch pilot programs in which independent contractors would
replace state employees. The objective was to replace state eligibility
systems with high-tech consulting firms in order to more efficiently
screen thousands of applications, and save taxpayers millions. But early
inconclusive results of a privately run social services project in Texas
and troubles with the bidding process in Indiana have caused both states
to put their plans on hold. Critics of privatization argue that the
problems are actually due to under-funding and understaffing.
Employers
Expand Elder-Care Benefits to Reduce Absenteeism; More Companies Offer
Time Off, Insurance, Home Aides to Caregivers (July 27, 2006)
An increasing number of US employees are becoming caregivers to elderly
family members and relatives. As a result, absenteeism in the work place
is on the rise. According to a recent survey by the National Alliance for
Caregiving, working caregivers cost businesses as much as $34 billion a
year due to absenteeism, hiring replacement workers and other lost
productivity. In order to reduce costs, companies such as KPMG LLP and
Prudential Financial Inc., have begun to provide employees with benefits
that can include extended leaves of absences, subsidized in–home care
and insurance coverage to elderly relatives.
Push For Universal Care (July 18, 2006)
With American companies spending more on health care than any other
expense, some people believe that only the ideology of private sector
superiority prevents corporate action towards a national health care
system. The Service Employees International Union, the most outspoken
group advocating universal healthcare, leads the way in action, but
success demands greater support from all unions. Workers and retirees have
much to gain from such a transition, so advocates for universal care call
for increased pressure on corporate executives.
GM
Chief Urges Congress To Address Health Expenses (July 13, 2006)
An outspoken proponent of health-care reforms, General Motors Corp.
Chairman and Chief Executive Rick Wagoner urged Congress to address rising
health care costs for companies. The high costs create difficulties for US
companies in the competitive global market. Wagoner explained, "We
need to get greater value for our health-care dollar." Though unions
seek a national health-care system, GM promotes other cost reducing
programs, like disease prevention, waste reduction, and information
technology.
After 4 Years, Health Group for the Poor Gets
Started (July 5, 2006)
In the conversion of insurance company Empire Blue Cross Blue Shield to a
profit-making company from a nonprofit, New York State claimed ownership
of some stock after years of granting tax-exemption. With plans to use
these funds for a foundation for New York healthcare, the value increased
from $50 million to $250 million over the four-year delay in action and
the improving economy. Limited to health care in the state, the foundation
can have a great impact, planning to address the obesity and diabetes
epidemics, as well as to support grassroots, local level projects.
Health-Care Costs To Hit Workers, Retirees Harder (July 5, 2006)
The continuing trend of rising health care costs will certainly impact
company policies. Both employees and retirees will have to pay more for
their medical services as companies begin to limit benefits. One study
examines out-of-pocket expenses, noting that these will increase; retirees
in particular will have to spend more or reduce their insured health
coverage.
S.F. Unveils Universal Health Care Plan (June 20, 2006)
The city of San Francisco hopes to enact a universal healthcare plan
available to all adult city residents, independent of citizenship or
employment status; children already have universal coverage. Like many
Americans, thousands of city residents without insurance earn more than
the qualifying cut-off for Medicaid. The mayor, Gavin Newsom, emphasizes
that the preventive and emergency health care will deter emergency room
visits, but will not take the place of private health insurance.
Taxpayers, businesses, and participants will all help shoulder the $200
million cost.
Crisis Seen in Nation’s ER Care (June 15, 2006)
According to three reports presented by the Institute of Medicine, the US
system of emergency medical care is crumbling. Suffering from
overcrowding, a shortage of specialists and instability, emergency rooms
can no longer respond to crises effectively. The system requires reform
measures. Some experts suggested strategies to create regionally planned
networks with a central dispatcher, as well as standardized paramedic
training. To organize reforms, in the next two years Congress will
establish a new organization to undertake the transition.
Try Standardized Health Coverage (May 14, 2006)
This article defends Medicare, promotes a standardized government-run drug
benefit program, and argues that the Stabenow-Kennedy bill, also know as
the Medicare-Guaranteed Prescription Drug Act of 2006, is a good option to
address the problems of Part D. If passed, this bill would create a drug
plan run by Medicare, establish uniform monthly premiums, and allow price
negotiations on drugs.
Ill. Attorney General, 38 Others, Oppose Health Plan in U.S. Senate (April
27, 2006)
Thirty-nine Attorneys General oppose the Health Insurance Marketplace and
Affordability Act of 2006 (HIMMA). Originally designed to help small
businesses provide health insurance, the bill would actually allow
insurance plans to offer “bare-bones” policies that are not required
to provide state-mandated services, such as mammograms, supplies for
diabetes management, mental health treatment, and other protections.
Furthermore, HIMMA takes away state rights by “permitting insurers to
sue states that do not adopt the new federal standards.” If passed,
HIMMA will place patient health and guaranteed state-benefits in jeopardy.
Massachusetts Health Care Reform Plan (April 2006)
The Kaiser Family Foundation created this helpful fact sheet to guide
readers through the newly implemented Massachusetts health care reform
plan.
Unfriendly to Health (April 22, 2006)
For some people, consumer driven health care revolves around the
patient’s needs and prevention programs. For others, such care is based
on the patient’s wealth and health savings accounts. With three million
Americans currently signed up for health savings accounts, promoted
heavily by the current administration, maybe we are missing the larger
problem with our definition of consumer driven health care – the poor
and already uninsured who cannot afford this solution to the US health
care crisis.
Wal-Mart to Offer More Health Coverage (April 17, 2006)
Wal-Mart Stores Inc. is expanding healthcare coverage to part-time workers
by reducing the two year work requirement to one year. Despite this
extension, unions continue to strongly criticize Wal-Mart’s inadequate
health benefits and low wages. According to Chris Kofinis, spokesman for
WakeUpWalMart.com, Wal-Mart’s health care coverage expansion should be
taken with a grain of salt considering “they’re basically expanding
health care coverage to workers who can’t afford it because their pay
[at Wal-Mart] is so poor and the health care deductibles and premiums are
so high.”
A Quiet Push
for State Health Plan (April 11, 2006)
As Massachusetts paves the way for expanding health care coverage, other
states like Wisconsin are working on their own plans for health care
reform. The Wisconsin Health Plan is more extensive than Massachusetts’s
Health Care for All legislation. This plan requires all employers to pay a
payroll tax and further penalizes small businesses who do not spend the
proposed payroll tax amount. The Wisconsin plan would put a tax on
payrolls of corporations and potentially reduce slightly the profits of
the company. While some see this act as redistributing wealth from the
rich to the poor, Rep. Curt Gielow (R-Mequon), one of the bill’s
supporters, says that the Wisconsin Health Plan “will only work when the
will of the people is for the greater good of the people.”
Massachusetts' Mistake (April 7, 2006)
The new “Health Care For All” bill in Massachusetts has many people
claiming victory for universal health care coverage – but not everyone
is convinced. The authors of this article highlight three arguments:
politicians underestimate the number of uninsured, “there is a false
assumption that uninsured people will be able to find affordable health
plans,” and the bill does not provide measures to contain escalating
state health care costs. Despite criticism, Governor Romney plans to sign
the legislation into law on Wednesday, April 12.
Health Coverage Reform Follows State-By-State Path (April 5, 2006)
States are individually acting on health care reform because the federal
government is not. While some states want to expand current government
programs and create new ones, other states prefer individual initiative
through a market-based approach. Reform is necessary because our current
health system “provides health coverage to people based on whether they
are lucky enough to have a job with benefits, old enough to qualify for
Medicare or poor enough to qualify for state aid,” according to former
Oregon governor John Kitzhaber. Current coverage, or lack of coverage,
leaves at least 46 million people in the US vulnerable to poor health and
poverty.
Massachusetts Sets Health Plan for Nearly All (April 5, 2006)
Massachusetts is on the verge of becoming the first state “to provide a
mechanism for all its citizens to obtain health insurance.” By creating
a sliding scale of affordability, the bill will distribute the cost
between businesses, individuals, and the government. Businesses with more
than 10 workers who do not provide insurance will pay $295 per employee
per year. Individuals who can afford private insurance, but do not
purchase it, will be penalized. Individuals who already have insurance
will most likely pay cheaper premiums and government subsidies will make
insurance plans more affordable for the working poor. If the bill is
signed, Massachusetts will be the first state to require its citizens to
have health insurance and also come closest to achieving a semblance of
universal health care coverage in the US.
Coverage, In Pieces (April 3, 2006)
Until recently, a good job used to guarantee decent he |
