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Health

- Archives 2007 - 

United States

Healthcare Coverage | Drugs/Pharmaceuticals | Healthy Living | Trade Unions and Health


HEALTHCARE COVERAGE

Medicare/Medicaid | Private Insurance/Other


Medicare/Medicaid

Reports | Articles 

Reports

Report: Tracking Beneficiaries’ True Out-of-Pocket Costs for the Part D Prescription Drug Benefit (December 2007)
The study reviews how Part D plans and the Coordination of Benefits Contractor ensures the accurate tracking of true out-of-pocket (TrOOP) costs and whether centers of Medicare and Medicaid Services (CMS) conduct an oversight of Part D plans to help to ensure the accurate tracking. Data was collected from TrOOP costs beneficiaries, CMS staff and its contractors. The findings show that a number of requirements were “not carried out consistently” in 2006. 

Report: Medicare Hospice Care: A Comparison of Beneficiaries in Nursing Facilities and Beneficiaries in Other Settings (December 2007)
The report examines the percentage of Medicare hospice beneficiaries residing in nursing homes and defines their characteristics. The researchers then compare these characteristics to those of hospice beneficiaries who reside in other settings. The findings provide a helpful description of the current Medicare hospice care population. 

Report: Changes in the Cost of Medicare Prescription Drug Plans, 2007-2008. (November 2007).
|The Center for Economic and Public Research examines national prescriptions drug plans costs and reports that Medicare Drug Plan Premiums will rise by 20% in 2008. The report also provides an overview of the plans offered by each of the states in 2008 and an average increase in cost. Ironically, the Bush Administration pushed through the Prescription Drug Plan to save seniors’ money. As costs rise, the Plan appears more and more as a way to fuel pharmaceutical companies’ profits. 

Report: Health Insurance and the Labor Supply Decisions of Older Workers: Evidence from the US Department of Veterans Affairs
The report studies the impact of public health insurance on labor supply, focusing particularly on the Department of Veterans Affairs’ health care system (VA). The researchers take male veterans as a target group and report that the VA coverage decreases full-time employment, increases retirement and the probability of a part-time work among the veterans. 

Report: Generic Drug Utilization in the Medicare Part D (November 2007)
In a report from the Health and Human Services Office of the Inspector General, we learn that during the first year of the Medicare Part D program, US pharmacists substituted lower cost generic drugs 88% of the time when they filled Part D prescriptions when generic drugs were available. Generic drugs cost about 71% less than brand name drugs. However some 37% of prescriptions had no generic equivalent and required Part D to pick up the cost. Thanks to the generic drug substitutions, Part D spent $47 billion on drugs in 2006, less than the budgeted $59 billion.

Valuing the Invaluable: a New Look at State Estimates of the Economic Value of Family (November 2007)
What is the economic of caregivers' contributions unpaid in the United States? Whose labor supports long-term care? Experts say $350 billion, as recently as 2006. According to Mary Jo Gibson and Ari N. Houser from the AARP Public Policy Institute, the US government must give better support to family caregivers to maintain the health care system, long-term care system, and economy.

Report: Medicare Part D 2008 Data Spotlight: Premiums (November 2007)

Kaiser Family Foundation looked at premium prices which nearly 2,000 stand-alone Medicare Part D plans will offer to US older persons in 2008.  The average monthly premium will go up from $27.39 in 2007 to $31.99 in 2008, a 17% increase.  Nearly one in five enrolled will face an annual increase of $120 if they stay with the same plan next year. How long will US citizens put up with this organized subsidy to the pharmaceutical industry? 

Report: Medicare Part D Sponsors: Estimated Reconciliation Amounts for 2006 (October 2007)
The US Inspector General reviewed the records of profit-making companies that sponsor Medicare Part D for prescription drugs and found them in arrears, to the tune of $4.4 billion for 2006. This report shows CMS has no procedures in place to require for-profit sponsors to re-pay Medicare until at least 9 months after the 2006 plan year ended. Such procedures leave public monies available for companies to use as cash flow, investments, etc., while the public waits for reimbursement. An outrage!

1-800-Medicare: Caller Satisfaction and Experiences (September 2007)
Customer satisfaction with Medicare telephone customer service has been declining since 2004. “More callers in 2007 than in 2004 reported hanging up before receiving answers to their questions and had concerns about wait times,” and 44 percent of callers in the 2007 evaluation who remained on the line reported having difficulty accessing information. 

Medicare Private Health Plans vs. Medicare Savings Programs: Which Is the Better Way to Help People with Low Incomes Afford Health Care? (September 2007) 
Many private insurance companies claim that the extra payments they receive from Medicare Advantage Plans (a private health plan option), helps lower the out-of-pocket costs for low-income people with Medicare, especially African Americans and Latinos. According to this report, however, low income seniors with Medicare are better off signing up for a Medicare Savings Programs, which subsidize premiums, co-payments and other out-of-pocket expenses, because in private Medicare health plans, they often end up paying more than their wealthier neighbors and get fewer benefits. 

Medicare Prescription Drug Benefit Progress Report: Findings from a 2006 National Survey of Seniors (August 21, 2007)
Based on a random-sample survey of more than 16, 000 seniors in the US , this survey provides “the first in-depth look at experiences in the first year of the drug benefit.” The survey found that low-income seniors skip prescribed medication or stop taking it all together because their out of pocket costs are too high. Although the drug benefit program provides benefits to low-income seniors, the target group is often unaware of the subsidies or find the application too cumbersome.

United Health vs. Uninsured Kids (August 2, 2007)
If the SCHIP funding bill, recently passed by the House of Representatives, were to become law, the government would equalize payments to Medicare Advantage (MA) and traditional Medicare. The readjustment would save $50 billion in overpayments to MA plans which would then be used to fund the children’s SCHIP program. These overpayments currently contribute to the extra benefits offered by MA plans as well as the insurer's administrative costs, marketing, and profit margin. As a result, these insurers are profiting in large part because the government is subsidizing them.  This report describes how MA has become a lucrative business for the private sector and calls for a reduction in the privatization of healthcare.

Off-Base: The Exclusion of Off-Label Prescriptions from Medicare Part D Coverage (August 2007)
Many older persons rely on drugs for treatment of ailments not specifically mentioned on the prescription’s label, so-called “off-label” prescriptions. Medicare Part D, however, refuses to cover off-label prescriptions even if it already covers the drug for “on-label” purposes. Medicaid will only cover drugs specifically excluded from Part D coverage, so again these drugs are not covered. As a result, many low-income seniors are left without relief from conditions that could be treated by available and covered drugs. Should government’s narrow guidelines trump personal physicians’ recommendations on how a drug is used?

The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D (July 2007)
In response to gaps in Medicare Part D, state pharmaceutical assistance programs (SPAPs) are converting to secondary coverage plans. These plans often offer lower eligibility requirements and higher benefits than Medicare Part D. For instance, some states assist disabled persons under the age of 65, cover people with incomes above the Part D low-income subsidy level, or provide beneficiaries with access to drugs that Part D does not cover. 

The Commonwealth Fund/National Opinion Research Center Survey of Retiree Health Benefits, 2005: A Chartbook (July 2007)
This Commonwealth Fund report analyzes the results of a retiree health benefits survey and predicts a significant decline in the level of employer-provided health benefits in the future. In fact, the survey data indicates that a quarter of both public and private firms have increased retirees’ share of healthcare insurance premiums. The report concludes that employers will become even stingier in offering retiree health benefits as these premiums continue to skyrocket. 

Achieving Universal Coverage Through Medicare Part E(veryone) (July 2007)
The Hamilton Project at the Brookings Institution recently released this proposal designed to provide universal healthcare insurance by expanding traditional Medicare. The authors of this report state that a program intended to provide health coverage should be simple and understandable, and they believe that Medicare, as an existing program, will be simplest to implement. Medicare provides “sufficient coverage … without imposing excessive costs,” according to the report, and is therefore an appropriate option for achieving universal healthcare. 

Use of Health Services by Previously Uninsured Medicare Beneficiaries (July 12, 2007)
A longitudinal study examining data from 1994 to 2004 suggests that for those who had healthcare insurance coverage before obtaining Medicare at age 65, the cost and intensity of care required once covered by Medicare was lower than if they had not been insured prior to 65 years. This was especially true for those who had been diagnosed with cardiovascular disease or diabetes before reaching 65.

Why Has Longevity Increased More in Some States than in Others? The Role of Medical Innovation and Other Factors (July 2007)
Although the average life-expectancy of US residents has been increasing steadily over the past century, there are notable discrepancies in life-expectancies by state. Many southern states trail northeastern and west-coast states, in some instances by significant margins. Authors of this report, released by the Center for Medical Progress at the Manhattan Institute, claim that this effect is attributable mostly (63%) to a State’s coverage of newer prescriptions through Medicaid and access to drug treatments through Medicare. Poor older persons appear especially vulnerable when Southern State officials decide on the kind, quality and access to Medicaid and Medicare medications. GAA must ask whether Black or poor older residents of Southern states face persistent race and class discrimination in their access to Medicaid and Medicare drug coverage.

Changes in Characteristics, Needs, and Payment for Care of Elderly Nursing Home Residents: 1999 to 2004 (June 2007)
Kaiser Foundation researchers found that the proportion of older persons over 65 living in nursing homes has actually decreased over the past twenty years, but the nursing home population itself is becoming more disabled. While seniors now have an increase in care options available to them, families of the sickest and most disabled residents still turn to nursing homes for necessary care.

Medicare: Past, Present, and Future (June 2007)
Federal spending on Medicare is projected to double within the next three decades and already the “experts” are devising ways to ration health care to older persons. Authors of this report argue in favor of rationing to slow healthcare spending growth. One “promising reform” would replace “first-dollar insurance coverage” with Health Savings Accounts (HSAs) along with a high deductible policy that has catastrophic coverage. Advocates of older persons must stay alert to such pernicious policies that appear helpful but would assist the early exit of older persons, especially the poor, from this earthly life.

A Proposal to Finance Long-Term Care Services through Medicare with an Income Tax Surcharge (June 2007)
Older persons often can’t take care of themselves if they get chronic diseases or acquire disabilities. Unfortunately, they can’t access long-term benefits in either the private or public sector or find existing programs too expensive. This report proposes collecting an income tax surcharge to expand Medicare services to include home care and custodial nursing home care. The revenue generated by the surcharge would be placed in a Medicare trust fund to finance the future of long-term care. Since the rich of the US find ways to avoid income tax, would this proposal only add to the tax-load of those least able to pay it? 

Consecutive Medicare Stays Involving Inpatient and Skilled Nursing Facilities (June 2007)
According to this report released by the Department of Health and Human Services, 35% of situations in which an elderly person is consecutively placed in multiple nursing facilities are associated with quality-of-care concerns. In 2004, Medicare paid $1.4 billion for stays involving medically unnecessary admissions, unnecessary or incorrect treatment, and inappropriate care setting. The report recommends that quality insurance organizations better monitor the appropriateness of services and collaborate with healthcare providers to improve admission and treatment systems. Will it happen?  Or can we expect more health providers ignoring older patients and turning a deaf ear to monitoring agencies?

Factors Underlying the Growth in Medicare’s Spending for Physicians’ Services (June 2007)
The Congressional Budget Office has looked into Medicare’s expenditures documenting their steady growth over the years. Surprisingly, it is not due to Medicare’s payment rates for physician services. Rather “increases in the volume and intensity of services provided” explain Medicare’s high expenditures, according to a report’s authors. Between 1997 and 2005, physician payments actually declined by 14 percent. The fast-paced technological innovation combined with people living longer has had significant impact on the costs of healthcare. 

Facing the Problems of Providing Long-Term Care for the Oldest Old (June 11, 2007)
The “oldest old,” or those of age 85 and above, is currently the fastest growing segment of the US population. This report focuses on their problems, recommending education about the need for lifelong preventative care, increased research on Alzheimer’s disease, greater oversight of nursing homes, and development of an alternative to nursing homes. To help pay for the care for the oldest old, the authors encourage a Medicare-like social insurance program for long-term care and expanding tax credits available to family caregivers. 

Racial and Ethnic Disparities in Influenza and Pneumococcal Immunization Rates among Medicare Beneficiaries (June 2007)
Although Medicare completely covers the costs of obtaining influenza and pneumonia vaccines, immunization rates for those above 65 are well below the target level of 90%. Racial disparities are apparent within these statistics as well. Only 45% of older African-Americans and 55% of older Hispanics reported receiving the vaccine, while 65% of white adults over 65 were vaccinated. Researchers blame low immunization rates on consumers’ lack of awareness or the fear that the vaccines will cause severe illness. The report also says that health officials may not be savvy to seniors’ worries about immunizations. Are these excuses for racial and economic bias in the US health system? 

Long-Term Care Financing: Policy Options for the Future (June 2007)

This report, produced by a group of Georgetown University researchers, proposes several options for changing the current formula for funding long-term care. The authors recommend a public long-term care insurance which will spread the costs across a broad population of those at risk for needing care. They also note that “planning for the future and caring for one’s family members will, as they should, remain critical to an effective long-term care system.”

A Blueprint for Action: Developing Livable Communities for All Ages ( June 11, 2007 )
The purpose of this Met Life guide, based on a study by the National Association of Area Agencies on Aging and Patterns for Livable Communities, is to provide local leaders with tools to build the collaborations needed to create livable communities for people of all ages. It includes brief descriptions of leading Innovations in communities throughout the USA and a checklist of essential features of an aging-friendly community that will help assess your community’s readiness for an aging population—and enable you to set priorities for improvements.

Private Fee-For-Service Plans in Medicare: Rapid Growth and Future Implications (May 22, 2007)
Some seniors are finding private fee-for-service (PFFS) plans, an option provided through Medicare Advantage, interesting. Of the 8.6 million Medicare Advantage beneficiaries in 2007, 17 percent are enrolled in a private fee-for-service plan. This report suggests that before PFFS grows further, CMS must address the system’s inherent flaws and evaluate whether or not the plan actually offers increased value to Medicare beneficiaries. One such flaw, for example, is that evidence suggests that out-of-pocket expenses increase significantly for enrollees in poor health. Furthermore, contrary to the perception that PFFS offers increased access to healthcare providers, doctors are not always more readily accessible. 

Nursing Homes: Federal Actions Needed to Improve Targeting and Evaluation of Assistance by Quality Improvement Organizations (May 2007)
This report, compiled by the Government Accountability Office, found that Quality Improvement Organizations (QIOs) focus their most intensive assistance to nursing homes based not on the degree to which the care was deficient but rather on a nursing home’s willingness to participate. In fact, “low performing” nursing homes are less likely to receive the most intensive assistance from QIOs. How can the staff from the Quality Improvement Organizations improve the system if the worst nursing homes are excluded from receiving support? Should such homes be permitted to decide not to participate in improvement programs? 

Quality Concerns Identified Through Quality Improvement Organization Medical Record Reviews (May 2007)
The Centers for Medicare & Medicaid Services contracts with quality improvement organizations (QIOs) to oversee the quality of care that Medicare finances. This report, a review of QIO activity from 2003 to 2006, found that QIOs took the two most severe actions (either to start sanctions or to refer the case to its licensing agency) in only two percent of the total cases. Since the QIO program is Medicare’s most serious tool to review how well health institutions are delivering good quality of care, the report suggests that CMS make stronger demands to end substandard care. Without enforcement and changed practices, what point is a review?

Characteristics and Health of Caregivers and Care Recipients --- North Carolina (2005)
A study in the June 5th Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention shows that those who care for elder or disabled relatives have poorer health than non-caregivers. Caregivers were most likely to be older women assisting relatives with various chronic conditions such as stroke, diabetes, and heart conditions. Caregivers experienced poor mental health as a result of stress; some reported that they had sustained some type of injury while caring for their loved ones. Public health initiatives must be designed to promote the health and well-being of both care recipients and caregivers.

The Impact of Part D on Dual Eligibles Who Spend-Down to Medicaid (April 2007)
The report highlights the Part D implications for individuals spending down in order to qualify for Medicaid. Because many senior citizens are not Medicaid-eligible on the federal level, they have often managed to qualify for the state Medicaid program by spending down excess income. In doing so, however, senior citizens have faced many problems with the transition from Medicare Part D. As a result, they experience frequent disruptions in drug and healthcare coverage.  

Interventions that Increase the Utilization of Medicare-Funded Preventive Services for Persons Age 65 and Older (2003)
As Americans over 65 continue to increase and as life expectancy rises, many aging advocates have called for preventive health care services for elder persons. Early detection of conditions such as heart disease, cancer, and many others can prove to be somewhat preventable given the right resources. This will also prove to be cost effective. This particular report is an effort to determine the best possible strategies for early detection and/or prevention of chronic diseases. Specifically, the report looks at interventions aimed at improving influenza and pneumococcal immunization rates, mammography rates, cervical smear cytology rates, and colon cancer screening rates. 

Articles

Doctors Have It Right: Ditch Private Medicare (December 18, 2007)
Privatizing Medicare has failed as today clinics and hospitals decline Medicare Advantage plans and will only treat patients with traditional Medicare plans. Doctors and hospitals themselves are warning and discouraging enrollment in any Medicare Advantage plans and are calling for Congress to eliminate subsidies to private insurers. Experts say that the private plans drain taxpayers who also are clamoring against private plans. In the meantime, the enrollment period to sign people up will soon expire. 

Medicare Battle Stalls Reform (December 7, 2007)
Plans from Congress to pass a Medicare reform bill intended to lower monthly premiums for Medicare beneficiaries have been stalled by threats of a veto from the Bush Administration. The reform bill proposes cuts to Medicare Advantage, a government-subsidized program that provides extra services to beneficiaries through private insurers. The bill is predicated on the argument that government funding is putting too much money into the pockets of private insurers. Without a Medicare reform bill, the Medicare program is not apt to see improvements in the next year.

Hawaii Seniors Struggle with Prescription Costs (December 7, 2007)
A research study by a Hawaiian physician found that a majority of 1,100 senior citizens surveyed indicated they had difficulty paying for medications. Patients pay out-of-pocket for drugs that cost more than the amount covered by their Medicare Part D insurers. Because not all seniors are enrolled in a Medicare Part D plan, those that are not may stop taking medications when they can no longer afford them. The research advises physicians to ask their elderly patients if they can afford the medications they prescribe. Also, health plans should make physicians aware of the patients’ payment options and whether or not they can afford the medications.

Medicare Cuts Payout on 2 Cancer Drugs (December 7, 2007)
New Medicare rules cutting reimbursement for promising cancer drugs are threatening cancer patients’ access to much needed treatments. The drugs, called Bexxar and Zevalin, are used to treat non-Hodgkins lymphoma and may be the only effective therapy for patients. While Bexxar costs $30,000 for one treatment, Medicare will reimburse only $16,000 of the cost. Medicare reimbursements are based on what hospitals have reportedly paid for other drugs, Medicare reimbursing based on a scale informed by the average prices of drugs reported by drug-making companies. Because of high financial losses to hospitals, these medicines may not be as readily offered to patients who really need them.

Debate Heats Up Over Health Care for S.F. City Retirees (December 7, 2007) 
A San Francisco city supervisor is proposing to reduce health care benefits for city government retirees because a large proportion of the budget allocated to cover insurance costs is compromising funding for other city services. The city supervisor’s proposal to amend the City Charter to extend length of service before employees can become eligible for retiree benefits is expected to encounter opposition from organized labor, but is supported by San Francisco Mayor Gavin Newsom. The amendment proposes extending service as much as fifteen additional years before retirees can receive benefits. 

Medicare Drug Costs to Rise in '08 (December 7, 2007) 
For low-income Medicare beneficiaries enrolled in prescription drug plans (Medicare Part D), the federal government has been subsidizing the costs of monthly premiums. But because five plans are raising their premium costs, these plans will no longer qualify for government subsidies. Due to these changes, low-income beneficiaries of these five plans will have to pay the monthly premiums starting next year. On December 31, beneficiaries can either switch plans or be randomly placed in other plans if they cannot afford to pay the premiums. Those opting to switch are advised to check the plan’s drug formulary and choose carefully, sooner rather than later.

Senior Citizens to See High Tech Sensors in Homes, on Bodies to Monitor Health (December 6, 2007)
Park Associates installs 1,500 new digital sensors every quarter in US senior communities to monitor their health.  The sensors detect the normal activity in a home and alert authorities if the pattern changes.  The company also announced the release of reliable light-weight devices such as blood glucose, respiratory rate and activity sensors.  The experts project that by 2012 more than 3.4 million senior citizens in the US will be using digital sensors to monitor and improve their health.

Prescription Abuse Seen in US Nursing Homes (December 4, 2007)
This shocking article reports that Medicaid is buying more antipsychotic drugs for patients than any other drug. These outlays ($5.4 billion in 2005) have produced major profits for the drug companies. Some nursing homes are giving 30% of their patients the anti-psychotic drugs, including some 21% of residents who have not been diagnosed with a psychosis. Nursing home administrators excuse the situation, saying they want to quiet patients living with Alzheimer’s and other forms of dementia. 

Medicare Chief is ‘Secret Shopper’ of Insurers (November 27, 2007)
A large number of misleading and deceitful presentations of Medicare health programs by sales agents prompted the launching of an undercover program called 'The secret shopper.’ Started last year, the program seeks to identify those agents responsible for providing false information to the public. The acting chief of the Medicare program witnessed firsthand how these dishonest explanations were presented. Medicare officials under pressure from Congress and advocacy groups have made several changes requiring sales agents to pass a written exam demonstrating their understanding of Medicare policies. Also, insurers have to list sales events so that Medicare officials can attend. 

Patient Money (November 24, 2007)
The doughnut hole is the nickname for a big financial gap in each person’s Medicare prescription drug coverage. As it becomes bigger every year, some scholars analyze the consequences: many people will struggle to secure a full year’s supply of the drugs they need. But some experts see a positive consequence. Because it potentially forces a Medicare enrollee to pay more than $3,000 from his or her own pocket during the gap period, the hole is helping curb growth in the nation’s drug spending by pushing people toward low-cost generic drugs. Moreover, the popularity of generic drugs is cutting into the profit margins of branded drug companies.

AARP of Two Minds on Private Plans (November 12, 2007)
As the new enrollment period for Medicare prescription drug plans approaches in mid-November, AARP has revealed its dual nature by warning seniors against enrolling in privatized drug plans while at the same time endorsing some of the plans. AARP licenses its brand name to a vast array of products, including some of the new Medicare insurance policies. The Senior Health Insurance Information Program (SHIIP) states that whether endorsed by AARP or any other group, clients must inform themselves about the plan that will be best for them. 

Insurers Target the Elderly: Making the Push into the Pre-Medicare Population (November 10, 2007)
Health insurers say that US baby boomers represent a huge market, with a remarkable increase in the coverage needed for those aged 50 to 64 years. Insurers plan to target this age group, who are not yet eligible for Medicare. As many retirees lose employer-based health care, they need coverage for medical bills. Personal bankruptcies and chronic illnesses are common within this age group that accounts for one-quarter of the US population. The older people are, the harder it seems to be to obtain coverage, thus pushing more and more US citizens to purchase health plans at an earlier stage of life. GAA suggests that a strengthened Medicare and government supported universal health insurance would help more at a lower cost. 

Some Florida Medicare Users May Be Hit with Higher Drug Costs (November 9, 2007)
Starting January 1, 2008 Medicare prescription drug plans are expected to increase in price, thus low-income recipients may have to change their prescription coverage or pay more. In Florida, low-income seniors who join drug plans with premiums under $20 a month do not have to pay the Medicare premiums and co-payments. Due to the increase in drug plan prices, some plans in Florida will not qualify for the exemption and recipients will have to pay more for coverage. It is important for Medicare recipients to be informed of their options in regard to drug plans. 

Medicare Fees Report Blasts Insurers (November 8, 2007)
A government report shows that three of the biggest Medicare drug plan providers—Humana, UnitedHealth and Wellpoint—are required to refund overpayments of $4.4 billion from last year. Medicare’s reliance on private insurance companies to provide coverage to elderly and disabled beneficiaries may need to be scaled back to prevent insurers from acquiring multibillion-dollar loans from Medicare. 

Medicare Drug Plan Bitter Pill for Some (November 7, 2007)
Starting November 15, policyholders can change their current Medicare prescription drug plans—also know as Medicare Part D—during the open enrollment period that ends on December 31. Insurers have increased plan premiums and changed prescription coverage, making it harder for seniors who must select a new plan or choose to stay with their current one. The Centers for Medicare and Medicaid Services (CMS) offer information for policyholders via a toll-free 24-hour hotline (1-800-MEDICARE) and website (www.cms.hhs.gov). 

Elderly Health Costs Growing Slowly (November 6, 2007)
Healthcare spending is increasing quickly for those under 65 years old, but slowly for those 65 and older. The Centers for Medicare and Medicaid Services (CMS) showed modest healthcare spending among the elder cohort in the US. Although the growth in medical costs is lower among the old, compared to the younger cohort, healthcare spending per older person is higher. The CMS also reports that the costs of nursing home care are rising. 

Changes to Medicare are Leaving Some Patients Stuck with the Bills (October 28, 2007)
Due to recent changes to the Medicare billing system, policy holders are being billed excessive amounts for emergency medical services (EMS) not paid by Medicare. The high rate of Medicare claims denial is placing a financial strain on seniors who cannot afford the costs. When a senior receives medical emergency treatment, the new Medicare system reimburses either the transporter or the medical provider, but not both. While states have different policies regarding emergency medical services, Medicare operates under federal standards.

Doctors Making House Calls to the Elderly (October 28, 2007)
Nearly a decade ago, increased Medicare reimbursements for medical home visits gave doctors an incentive to see elderly at home. New medical technology and diagnostic tests helped make house visits possible. Now, with more elderly and declining Medicare reimbursements, doctors do not want to make home visits. The author argues that Medicare should provide financial incentives to geriatricians to make house calls a basic part of elderly health care, as some home-bound elders and those with cognitive problems can benefit greatly from the house calls.

More Medicare Savings Possible (October 15, 2007)
In a report released by the House Committee on Oversight and Government Reform, Democratic legislators said administrative costs totaling $15 million in Medicare prescription drug benefit program spending could be avoided in the future with the elimination of the private insurance plans now subsidized by the federal government. Currently, more than 18 million older beneficiaries receive coverage from 12 leading private insurance companies. Monthly premiums paid out of pocket for the drug benefit plans average about $47 billion for the past year. Taxpayers could save an estimated $3.9 billion per year if private plans received discounts similar to those for Medicaid beneficiaries. Proponents of the prescription drug program argue that private plans save beneficiaries money by ensuring that they take only the medications needed to manage their conditions. Opponents maintain that the government’s traditional Medicare program would cost about 6 times less. 

Fed Up Allies Take on Medicare (October 14, 2007)
Oncologists and drug manufacturers are teaming up to overturn a decision made by The Center for Medicare and Medicaid Services to restrict reimbursement for costly medications used in treating anemia in those undergoing chemotherapy. Drug manufacturers will be affected financially, while patients’ care and safety may be compromised if they cannot obtain medications that their physicians think is appropriate. According to the policy change, the government is only reimbursing physicians for anemia drugs prescribed to patients with hemoglobin levels below a specified level. Research showing the use of anemia drugs causing other serious health problems prompted the government to enact this policy change. Medicare annually spends $5.4 billion on anemia drugs used for cancer patients, kidney patients, and patients with HIV. Currently, Medicare pays for 80% of medication costs. 

After Audit, Insurers Vow to Improve Medicare Service (October 10, 2007)
After a federal Medicare audit revealed that private insurance companies committed serious compliance violations, violators are taking steps to make up for deficiencies. While some companies are retraining their staff, others are hiring more employees to answer phones and to pay claims to beneficiaries. Senator Barack Obama prompted the Government Accountability Office to undertake an investigation into violations of compliance with federal standards, which require that insurers give beneficiaries notice about denial of claims. The audit grew out of Congressional members’ concern about private contractors’ questionable marketing strategies in selling private plans to older persons. Please see Compliance Program Guidance for Medicare Fee-for-Service Contractors for details.

Medicare Audits Show Problems in Private Plans (October 7, 2007)
Audit reports of private insurance companies handling claims for elderly beneficiaries of the Medicare drug benefit program (Medicare Part D) revealed an overwhelming rate of compliance failure and lack of ethical conduct. Major compliance violations included failing to answer calls from patients and doctors, denying claims without explanation, and terminating coverage to those with H.I.V. and AIDS. Violation of ethical conduct concerned marketing practices, which were described as misleading and deceptive efforts by telemarketers and insurance agents preying on the elderly and disabled. Arguing in defense of their practices, some insurers claim a lack of clear federal guidance for program compliance. Despite opposition to the privatization of Medicare, Federal proponents of the drug benefit program argue that allowing private insurers to handle Medicare claims means more market competition and lower drug prices for consumers. However, the Auditors have examined the records and found gross failures. 

Seniors Pay a High Premium for Loyalty to Their Part D Plans (October 5, 2007)
Avalere Health, an advisory firm based in Washington, conducted an analysis of the Medicare Part D plan premiums to reveal that starting in 2008, beneficiaries of stand-alone Prescription Drug Plans (PDP) will see a 21% increase in their monthly premiums. The report issued by Avalere Health used data from the Centers for Medicare and Medicaid Services (CMS) to compute the rate of increase in premiums. According to the analysis, plans with larger numbers of enrollees will increase premiums by more than plans with fewer enrollees. The report suggests beneficiaries remaining loyal to their plans may have to pay more, but will be able to seek alternatively cheaper plans to be offered next year. The CMS plans to offer stand-alone PDP beneficiaries plans with premiums lower than $20-$25 per month starting in 2008.

Premiums for Medicare Drug Plans Jumping 8.7% (October 1, 2007)
Many seniors enrolled in the Medicare drug program are likely to pay more next year. Indeed, the average premium for all stand-alone drug plans will rise 8.7% to $40 a month. As a result, nationwide about 1.6 million older Americans who qualify for both Medicaid and Medicare will be automatically reassigned from their health plans to new carriers. Let’s hope the beneficiaries will be placed in a plan that is right for them, but nothing is guaranteed. 

Shingles Vaccine Proves Painful (September 25, 2007)
The shingles vaccine is efficient but too expensive for older Americans since Medicare does not pay for it. While some Medicare Part D prescription drug plans cover this vaccine, some practices are charging as much as $500 per shot in order to compensate for the delicate procedure surrounding this vaccine. Indeed, the vaccine is a live virus and must be handled with great care. It must remain frozen until shortly before it is injected. For older patients, being told to pick up the vaccine at a pharmacy and bring it back to a doctor's office in half an hour or less is not an easy task. Health officials estimate that 35 to 40 million Americans are candidates for the shot, but only 1 million doses of vaccine have been sold so far. 

Health Care Spending Highest in Northeast (September 18, 2007) 
Newly released government statistics show that staying healthy in the United States is a very costly business, especially in Northeastern states: the highest per capita spending is found in the District of Columbia, $8,295, followed by Massachusetts, $6,683; Maine, $6,540; and New York, $6,535. There are some common characteristics among the states, such as high personal income, a high concentration of physicians, and the lowest rates of uninsured. Other findings showed that Florida, with the highest percentage of people over 65, had the highest Medicare spending per enrollee in the country. Maine, another state with a higher-than-average proportion of older persons, had amongst the lowest individual Medicare spending in the nation. 

U.S. Blacks in Poorer-Quality Nursing Homes: Study (September 11, 2007)
Researchers found that African-Americans in the US are more likely to live in poor-quality nursing homes than their white counterparts. Following up on a study showing that “blacks get poorer care regardless of what kind of health insurance they have,” researchers add that racial segregation also has a “significant impact on the quality of care received by nursing home residents.” In addition, the report found that "blacks were nearly twice as likely as whites to be located in a nursing home that was subsequently terminated from Medicare and Medicaid participation because of poor quality."

Audit Cites Overpaid Medicare Insurers (September 10, 2007) 
Under a federal law, the US government is obliged to audit financial records of “at least one-third” of private insurance companies participating in Medicare each year. A new Government Accountability Office report reveals that the Bush administration has not properly audited companies, resulting in tens of millions of embezzled dollars that “could have been used to reduce premiums or provide additional benefits to older Americans.” While a 2003 audit had already found “significant errors” in 41 out of 49 private insurance companies, the government took no action. Meanwhile, the Bush administration is “vigorously pursuing money that it says is owed to insurance companies by Medicare beneficiaries.” 

Two State Officials Unveil New Effort to Protect Elderly (September 6, 2007) 
The Arkansas’ Attorney General and Insurance Commissioner started informing older persons about the downside of the Medicare Advantage Plans. The Bush administration introduced the Plans as part of the Medicare Modernization Act in 2003, claiming “they help the financially stressed Medicare program provide coverage more efficiently.” However, the Attorney General describes the Plans as a “step toward privatizing Medicare and allow companies to profit while offering slim benefits to senior citizens.”

Seniors Still Face High Costs When It Comes To Medicine (August 28, 2007) 
A recent Milford community meeting of senior service organizations revealed that the high costs of prescription drugs pose the most pressing concern for seniors in the region. Seniors continue to be confused by the Medicare Part D program and often cannot afford prescriptions not covered by the Plan. Seventy-five-year-old Elizabeth McGovern says that her uncovered medication eats up her savings and that one day she will run out of money and won’t be able to afford them.

Medicare D Premiums Up for 2008, but Lower than Expected (August 27, 2007) 
Average monthly Medicare Part D premiums will rise slightly in 2008, from $22 to $25. However, despite the increase, the cost of the program lies about 40% below what federal officials originally estimated. Premiums could stay lower because of “increased generic usage, effective plan negotiation and strong competition," according to the Centers for Medicare & Medicaid Services. 

Amgen Challenges New Medicare Policy for Anemia Drugs for Cancer (August 6, 2007)
Staff at the Center for Medicare and Medicaid Services continue to deny payment for anemia drugs to treat certain cancer patients. Patients and their physicians, along with companies such as pharmaceutical company Amgen, are challenging this policy. Amgen claims that denying payment for these drugs will cause the demand for blood transfusions to increase. 

Medicare Ends Coverage for Hospital Errors (August 12, 2007)
The US Congress is in the process of proposing changes to the Medicare program, and one of the proposals is termination of coverage for hospital mistakes leading to patient infections. Government regulators strongly endorse this modification because it will force hospitals to practice more cautiously. Legislators hope that hospitals will have a greater incentive to improve patient safety in hospitals and create a more trusting environment.

Pharmacists Fear Medicaid Changes (August 6, 2007)
The nation’s most vulnerable citizens, including many older persons, rely on Medicaid for drug coverage. New regulations, however, are putting an increased burden on retail pharmacies. Rural states such as Kansas are affected the most. Over the past six years, Kansas has lost 22 independent pharmacies, and many counties in the state are now serviced by one or even zero retail pharmacies. These pharmacy closings force Medicaid beneficiaries to drive 40-50 miles simply to pick up their medications.

Many Elderly Waive Part D (August 2, 2007)
Over half of older Americans eligible for prescription drug coverage under Medicare Part D did not enroll last year. Experts believe that many Medicare recipients compared their current drug cost with the cost of a Part D plan and decided it was not beneficial to enroll, while many other older persons were simply unaware of the new plans. Experts warn that drug costs can rise very quickly and unexpectedly, and there is also a premium penalty for every month a Medicare beneficiary waits to enroll in a Part D plan. 

Medicare Fraud Leads to Prison (August 1, 2007)
A US District Judge has sentenced an Eastern-European organized crime group to federal prison for engaging in a $20 million Medicare conspiracy to exploit elderly immigrants in California. The conspirators profited as they billed Medicare recipients’ accounts without their knowledge. Konstantin Grigoryan, the ringleader of the group, who immigrated to the US from the former Soviet Union, defrauded hundreds of immigrants, costing these older persons their dignity and taxpayers hundreds of thousands of dollars. 

Maximizing Your Medicare (August 2007)
Medicare has become a very complicated program, and frequent rule changes make it difficult for seniors to navigate the complexities of the options available to them. Stacey L. Bradford from SmartMoney.com recommends that in order to “optimize [seniors’] health-care savings,” Medicare beneficiaries should consider taking advantage of preventative benefits or Medicaid, if they’re eligible. Bradford also warns against abandoning retiree coverage after receiving Medicare, as traditional Medicare still has coverage gaps.

Fate of Medicare Pay Raise Hinges on Contentious SCHIP Negotiations (August 2007)
The SCHIP reform bill has become an opportunity for some lawmakers to address concerns related to Medicare. The US House of Representatives and US Senate recently passed two versions of the proposed legislation, and one key difference between the two is the treatment of Medicare physician reimbursement rates. The House bill changes the 9.9% and 5% physician payment reductions over the next two years into 0.5% increases, while the Senate bill does not change payment rates. Large interest groups such as the AMA and AARP warn that low reimbursement rates could diminish access to care, as it would become less profitable for physicians to treat Medicare beneficiaries.

Medicare Fight Draws in Slew of Industry Groups, Large and Small (July 31, 2007)
Democrats continue to battle for passage of the SCHIP-Medicare bill in the US House of Representatives. The bill proposes an expansion of SCHIP, the national children’s health insurance program, through a reduction in Medicare spending and an increase in the cigarette tax. Powerful lobbyists, such as AARP, the AMA, insurance providers, the tobacco industry, and the medical equipment industry all strongly oppose changes to the existing system and have initiated campaigns to protect their interests. 

CMA Unveils Vision for Future of Medicare (July 30, 2007)
The Canadian Medical Association (CMA) recently proposed that the Canadian government work with private-sector firms to deliver publicly funded health-care services to reduce healthcare wait times. Critics, such as the Canadian Health Coalition, argue that this “dual practice” would permit doctors to bill the public system and then moonlight in the private sector to earn more money. In addition, critics do not think it is necessary to move toward a for-profit health insurance system, considering the gaps and failures in the US system. Focusing on increasing the supply of doctors, nurses, and other healthcare professionals could ease the healthcare wait times more efficiently, without selling out to corporate interests.

$58 Billion Shortfall for New Jersey Retiree Care (July 25, 2007)
For over a decade, New Jersey has neglected to save enough money to pay for public workers’ health care in retirement, creating the “illusion that [the state’s] long-term obligation was zero.” New Jersey currently needs an additional $58 billion dollars to provide retirees their promised health benefits. So the state has decided to shift more of the burden of paying for healthcare to the retirees. New Jersey lawmakers hope a national health plan will takeover the state’s responsibility to provide healthcare for public workers. 

Democrats Press House to Expand Health Care Bill (July 23, 2007)
President Bush, who believes that healthcare is a luxury, not a right, plans to veto Democrats’ recent proposal to expand the public children’s healthcare program. The expansion would involve reducing Medicare subsidies to private health plans, but funding would primarily be raised through an increase in the federal cigarette tax. Democrats face strong opposition to the bill as the White House views this proposal as a “step down the path to government-run health care for every American.” 

Being Elderly and Illiterate Means a Significantly Higher Mortality Rate (July 24, 2007)
Studies indicate that older people who cannot read understandably are confused about directions on prescriptions for taking medications and other medical related information from their doctors. They are far more likely to be hospitalized and/or die. Increasing health literacy is vital to living longer, healthier lives. 

Shortage of Doctors Affects Rural US (July 22, 2007)
Healthcare providers no longer serve rural areas adequately, primarily due to a shortage of foreign physicians. These communities often recruit doctors from abroad in exchange for permanent residency. However, current restrictions on immigration make entry into the country more difficult than in the past. Furthermore, foreign physicians are beginning to become disinterested in practicing in the US, “giving up on the American Dream.” These underserved rural regions have some of the highest rates of diabetes, lung diseases, and other serious illnesses, but the 35 million Americans living in underserved regions need an additional 16,000 physicians to provide them adequate access to care. 

Medicare Terminates Contract with HMO that Serves 12,000 on Treasure Coast (July 20, 2007)
After intense investigation, the Centers for Medicare and Medicaid Services (CMS) have decided to terminate the Medicare Advantage contract with America’s Health Choice for being an “immediate and serious threat to its members.” CMS is immediately transferring patients to SecureHorizons, a healthcare provider offering benefits similar to that of America’s Health Choice. While these members will not be locked into SecureHorizons’ plan, they are being moved to avoid a gap in their coverage. 

If This Is Such a Rich Country, Why Are We Getting Squeezed? (July 18, 2007)
The richest country in the world is facing an “entitlement crisis.” The wealthiest people in the US are getting richer while the government is simultaneously cutting services for the poor. Excluding the top 10% highest-earners, the average US income actually fell by 11 percent between 1973 and 2005 when adjusted for inflation. Yet programs such as Social Security, Medicare, and Medicaid are being downsized. Is it fair that the nation’s overall economic strength is not reflected in all its citizens’ wellbeing?

Study: Uninsured Experience Higher Health Costs Once Enrolled in Medicare (July 18, 2007)
According to a recent Commonwealth Fund report, persons who are uninsured before becoming old enough to qualify for Medicare face high medical costs once enrolled in the program. They entered Medicare in poor health and their medical treatment cost a lot. It is vital, therefore, that healthcare coverage be expanded to uninsured adults before they reach 65 years in order to avoid weighing seniors and Medicare down with health expenses just as they leave the workforce.

Trapped In the Private Medicare Maze (July 17, 2007)
Private insurers continue to engage in the unscrupulous treatment of seniors who are only seeking more affordable, higher-quality healthcare plans. The Medicare Rights Center, for example, frequently fields complaints about fraudulent insurance practices, and this article describes the some of the problems that these commission-hungry salespersons create for our elderly. Some extreme cases include a woman who needed to call 911 just to get a salesman out of her house and insurance agents enrolling deceased people into Medicare Advantage plans. 

Medicare Dilemma Needs a Long-Term Fix (July 14, 2007)
The author argues that keeping the Medicare system alive will require much more than cutting reimbursement rates to doctors. He says that lawmakers must re-order what level of coverage that should be offered to seniors. If the system continues to cover every type of treatment for each beneficiary, the author claims, Medicare will soon reach a dead-end. While making a useful analysis, the author fails to address the high profit margins in the US’ health care system as well the lack of preventive measures throughout the life cycle that can reduce old age health costs. The system needs change! 

Aging Baby Boomers Face Healthcare Shortage (July 2007)
With a growing aging population, the US is facing a geriatrician shortage. Health systems are now encouraging graduating medical school students to get extra training in geriatric medicine. The elderly often have complicated illnesses that require extra attention, an issue discouraging doctors from specializing in geriatrics. In fact, as of 2005, there was only one geriatrician for every 5,000 Americans 65 and older. 

The Medicare Privatization Scam (July 2007)
Congress is planning to reduce overpayments to Medicare Advantage insurers in hopes of improving Medicare’s Part D drug plan and expanding health coverage to some of the country’s 9 million uninsured children. These cuts will hypothetically save about $54 billion over the next four years, and journalist Trudy Lieberman is concerned that without the cutbacks, a traditional Medicare funding crisis could occur. Lieberman argues that traditional Medicare benefits will inevitably shrink as the costs of providing care rise, forcing US seniors to buy into a more privatized healthcare system. She leaves readers with this question: “If the private market doesn’t provide long-term, effective and efficient care, why does the government have $50 billion to subsidize companies while claiming not to have the same $50 billion to pay for care directly?” 

People Misled Into Choosing Medicare Part C Can Bail Out (July 11, 2007)
Congress recently instructed the Centers for Medicare and Medicaid Services to address the recent trend of healthcare fraud related to Medicare Advantage plans. Misinformed beneficiaries can now directly contact the agency at 1-800-MEDICARE to file a complaint and receive advice on how to discontinue an unwanted plan. CMS guidelines emphasize, however, that disenrollment occurs on a case-by-case basis and is permitted only to those who enrolled in a Medicare Advantage plan as a result of misleading or incorrect information presented by an insurer.

U.S. Health Care Ranks Low in Studies (July 11, 2007)
Michael Moore’s latest film, Sicko, has ignited even more discontent with the US healthcare system, a system that ranked a lowly 37th in healthcare services when compared with the other 189 industrialized nations. Moore touts the French, Canadian, and British health systems, but he also overlooks their inherent limitations. Is this film providing a reliable perspective to initiate reform or is it merely exposing us to misleading information and radical socialism?

Funds to Address Long-Term Care Needs (July 10, 2007)
Many older persons living in nursing facilities in Louisiana may soon be able to move back home. As most people in an institution don’t need full-time care, this grant from the Centers for Medicare and Medicaid Services will allow older persons to live by themselves or with their families instead of in a nursing home. According to Kathy Kliebert from the Office for Citizens with Developmental Disabilities, the major focus of the program is to “transition people from the large facilities back into the community.”

Florida May be Hit Hard on Medicare Payments (July 9, 2007)
A recent study found that impending cuts to Medicare’s home oxygen benefit would most adversely affect older persons living in Florida. The proposed 18.8% reduction in reimbursements will likely severely affect a large number of Medicare beneficiaries with chronic lung disease. 

Health Care Terror (July 9, 2007)
In arguing for a universal healthcare system, columnist Paul Krugman asserts that health care is, above all, a moral issue, and he encourages reformers to appeal to Americans’ “sense of decency and humanity” rather than solely their self-interest. Warning against the scare tactics that insurance companies will use in an effort to prevent change, Krugman cites a scene from the new documentary “Sicko” which shows a young Ronald Reagan claiming that Medicare would lead to a totalitarian state. How can we ever trust what these companies tell us when their profit is at stake?

Leaving Medicare Harder Than Joining (July 2, 2007)
One of the largest populations targeted for healthcare insurance fraud is the elderly. This article tells the story of a woman indicted for insurance fraud who faced severe repercussions. Her cheaper health insurance turned out to be misleading because her doctor would not accept the plan and most of her medications would not be covered under her plan. Because she signed a contract with this new plan, she could not return to her other plan until the following year. Thankfully, there are advocacy groups like Medicare Rights Center which alleviate such problems. It is critical for seniors to be cognizant of medical providers and be sure to review insurer’s explanation of benefits. 

Mass. Offers Young Adults Health Plans (July 2, 2007)
Massachusetts launched its new health care law requiring mandatory health insurance for all its residents. In particular, “much of the focus [of this law] was on older residents who typically face larger insurance bills.” However, the state is realizing that a significant number of 19- to 26-year-olds are without health insurance. To reverse this trend, the government is introducing new projects and policies. 

Initiative Aims to Improve Health Care for Elderly Hispanics (July 1, 2007)
The US Department of Health and Human Services invited nine communities throughout the country with large Hispanic populations, including New York, to apply to participate in a yearlong project to determine the best way to close the gap in health care between elderly Hispanics and elderly white persons. The agency is attempting to find ways to encourage Hispanics to take advantage of Medicare benefits and also develop a method for communities to communicate about how to improve health care for their residents.

Michael Moore's Sicko(June 27, 2007)
Michael Moore’s long-awaited documentary is now out in theatres and has the public talking about the pitfalls in the American health insurance industry. In the film, Moore argues that the healthcare system has failed to provide access to everyone. He says "when you share the pie, sometimes you have to wait for your slice. Sometimes you get the first slice, sometimes you get the third slice, sometimes you get the last slice. But the important thing is that you get a slice, everybody gets a slice of this pie. That's not what happens in this country." 

AMA Doctors Tackle Medicare Payment Reform at Meeting (June 27, 2007)
The American Medical Association doctors want to pre-empt Congress’ plan to cut physician payments by 10 percent, saying that doctors will be less willing to treat Medicare patients. As a result, AMA argues that there will not be enough physicians to care for all the new Medicare patients. The government plans to use the cuts in the physician payments to subsidize (at the rate of $65 billion) private health plans administering Medicare Advantage programs that offer huge profits to the health care industry. AMA claims these budget shifts will be a disaster, arguing “the government is putting seniors’ health at risk.” 

Medicare Meet Some, Not All, Needs for Aging Americans (June 26, 2007)
Eligible US citizens can’t find the health care they desire due to the increasingly higher cost of government funded healthcare programs, such as Medicare. Also, many citizens go uninsured. Concerns about Medicare reverberate across the country. The lack of affordable long term care can jeopardize the health of aging baby boomers. 

A Shortage of Doctors is the Biggest Problem for Seniors (June 26, 2007)
(Article in Arabic)
Studies show there are currently 7000 doctors with geriatrics specialties in the United States, or about one for every 2,500 seniors. The number of patients per physician is expected to double by the year 2030, thus increasing doctor-to-patient ratios. It is expected that elder persons will face increasing difficulties when attempting to access medical care. Geriatrics is not a high-income earning field; doctors in geriatrics usually earn about half as much as those in other specialties.

Health-Care Reform, Washington Style (June 26, 2007)
Scott Armstrong, CEO of Health Group, demands “a commitment to a set of agreed principles that will lead to better care,” specifically an increased focus on preventive medicine for older persons. He claims that the government is spending more for fee-for-service plans than on Medicare Advantage plans because of “perverse incentives” to care for people after they become sick rather than helping them avoid becoming that way. If preventive care saves lives and money, writes Armstrong, then it should be available to seniors too, not just children. 

Keeping Early Retirees Afloat (June 23, 2007)
Former employees, ages 55-64, of the some the nation’s largest companies may now get some health insurance, despite their retired status. Today, only 18 percent of the large employers provide health benefits to retirees under the age of 65, a decrease from the 30 percent count in 1993. In response to recent employee layoffs, buyouts, and outsourcing, some large companies will offer more health benefits to retirees to bridge the health insurance gap for early “retirees” until they are eligible for Medicare. 

Seniors Caught in Drug Muddle (June 21, 2007)
A recent study found that many seniors with Medicare prescription plans arrive at the pharmacy only to find that their drug isn’t covered. The reason, according to researchers, is not because of insufficient coverage, but rather because different prescriptions are covered by different plans and it is difficult for physicians to determine which drugs will be covered by a patient’s plan. The authors of the study believe that this problem is one of information rather than coverage, and that technology such as the Internet could help solve the problem.

Part D Consumer Protections (June 21, 2007)
Because Part D prescription drug coverage is conducted through private companies rather than directly through Medicare, Part D plans have a strong incentive to discourage enrollment by people with high drug costs. Congress did establish some basic consumer protections, but testimony from a recent congressional hearing indicates that there are significant gaps in these protections, especially in the process for appealing drug coverage denial. The best way to help seniors, according to this article, is to allow them to buy drug coverage directly through Medicare rather than forcing them to buy coverage through private insurance companies.

US Cracks Down on Some Medicare Plan Marketing (June 18, 2007)
The Centers for Medicare and Medicaid Services (CMS) recently received 2,700 complaints of insurance agents using deceptive techniques to sell the increasingly popular private fee-for-service Medicare plans. According to the CMS, the agents “may have encouraged confusion and misperceptions” about the plans. A total of seven insurance companies have agreed to stop marketing and sales events for their fee-for-service Medicare plans until they can ensure that agents accurately describe and sell the plans.

Retirees Face Costly Dental Bills (June 18, 2007)
Because Medicare does not cover dental care, when older persons lose their employer-provided health plan after retirement, they are often left without dental coverage just as they begin to need it most. Only one in five seniors can afford private dental insurance, so most must pay for their care out-of-pocket. This article suggests making use of discount plans, dental colleges, and community clinics as options to reduce the cost of dental care.

Edwards Lays Out Health Care Plan (June 14, 2007)
Presidential candidate John Edwards, a Democrat, recently disclosed some details of his proposal for universal health care coverage. Among his ideas is a proposal to offer cash payments in place of patents to pharmaceutical companies that develop new drugs. He believes that this will lower prescription drug prices because the companies will no longer have a monopoly on manufacturing the drugs they develop. Edwards’ plan also calls for insurance companies to spend at least 85% of their premiums on patient care and a requirement that every person purchase health insurance.

Older People With Diabetes More Apt to Suffer Depression, UF Study Shows (June 14, 2007)
Researchers at the University of Florida believe that older persons with type-2 diabetes might be at an increased risk of developing depression. They speculate that a chemical imbalance caused by diabetes could trigger the depression. The study also illuminates the dangerous possibility of an older diabetic developing depression and therefore adhering less to the treatment, thus making the diabetes, and the depression, more severe.

The Coming Crisis for Medicare (June 9, 2007)

The rise in medical costs has outpaced economic growth for decades, leading to the gradual depletion of the funds available to finance Medicare. As evidence of the system’s diminishing resources, Medicare trust funds’ trustees released a “Medicare funding warning.” The warning will force President Bush to propose legislation to address the alert by early next February. Retired Goldman-Sachs banker Thomas Healey argues that the government must find incentives to consume less healthcare, lower the costs of treatment, or reduce the value of the Medicare entitlement. Die earlier?

As Boomers Age, Alzheimer’s Toll Will Rise (June 5, 2007)
As the baby boomers age in the next few years, Alzheimer’s, a degenerative disease common among people 60 or older, is expected to rise. Currently, 5.1 million Americans are diagnosed with the disease, and it is estimated to increase to 7.7 million in 2030, based on a study from the Alzheimer’s Association. Combined with present Medicare problems, this growth will pose further complications because costs will inevitably rise. According to the association, “Medicare spends nearly three times as much on average for people with Alzheimer’s and other dementias as it does for people without dementia.” Therefore, the elderly will be hit with more out-of-pocket costs. 

State Officials Worry About Proposed Federal Cuts For Seniors (June 5, 2007)

States are concerned that the potential depletion of the Older Americans Act funds will compromise elderly programs and services, such as low-cost meals. New Hampshire, for example, currently receives roughly $5.5 million per year, but the Bush administration plans to make a 6 percent cut of all state funds. This budget cut would minimize the availability of injury prevention programs, long-term care, and other support programs for older persons. 

Doctors Say Medicare Cuts will Hurt Patients (June 4, 2007)
Congress has proposed to cut Medicare funds by 10 percent in 2008. In a survey given to around 9,000 doctors, 14 percent said they would discontinue caring for Medicare patients if the cut is made. The majority of the doctors say they would limit care or shift care to hospitals. Most agree that such a cut would put the US healthcare system for older persons into further havoc. The American Medical Association, recognizing that Medicare patients will have a difficult time accessing doctors, is currently preparing to urge opposition to such cuts. 

Obama Offers Universal Health Care Plan (May 29, 2007)
Democratic Presidential Candidate Barack Obama submitted his universal healthcare plan, saying that it could potentially save the average American $2,500 dollars. Obama proposes that government and business would be required to support a sliding scale subsidy to insure the currently 45 million uninsured persons in the United States. Former Senator John Edwards has also said a tax increase for the richest would be needed for his health plan. While John Edwards would make health insurance mandatory, Obama would not. Senator Clinton has said her plan would include preventative health measures that’s part of Obama’s plan as well. 

US: Clinton Reenters the Health-Care Fray (May 25, 2007)
The issue of healthcare in the United States has emerged as a mounting political issue. Citizens are pressing Democrat candidates, such as Hillary Clinton, to present specific plans on how to fix the US healthcare system, in which over 4 million Americans have no insurance. Thus far, Senator John Edwards has presented his ideas on the issue, admitting that he plans to raise taxes in order to pay for a more efficient system. Clinton has slowly begun to release details of her strategy, citing a seven-step plan highlighting prevention and cutting back costs of chronic care. Senator Obama, on the other hand, is expected to announce his plan for healthcare in Iowa next week. 

Vices and Virtues of the American Health System (May 19, 2007)
(Article in French)
As part of the Cannes Festival and American director Michael Moore’s new movie, Sicko, Le Monde interviewed US and French Health Systems American expert Vicor G Rodwin. He described the limitations of the US health system and pointed out some of the positive aspects of the French system. He explained that the privatization of the US system leaves many people behind.

Defrauding Seniors (May 8, 2007)
In addition to providing Medicare "Part D" prescription drug coverage, private insurers offer a "Medicare Advantage" plan for seniors—private plans that supposedly save money. But the private insurance companies “cherry pick” the youngest and healthiest beneficiaries resulting in extreme overpayments to the private managed care plans. The additional payments to Medicare Advantage plan are causing higher premiums for all beneficiaries and speeding the depletion of the Hospital Insurance Trust Fund for Medicare.

Fewer Employers Offer Health Benefits (May 1, 2007)
An increasing number of new small employers choose not to offer health benefits to their workers. The US Government Accountability Office reports that there is an 8 percentage point drop in the share of small employers offering benefits from 2001 to 2006 and said many employers that offer health benefits now make workers pay a higher share of out-of-pocket costs.

Medicare Part D Drug Prices Are Climbing Quickly (April 2007)
Increases in Medicare Part D prices are outpacing consumer inflation and seniors’ incomes, creating a growing burden for both beneficiaries and taxpayers. The Medicare Modernization Act, which created Part D, prohibited Medicare from using its clout to bargain on behalf of its 43 million beneficiaries to obtain lower prices. In contrast, no Part D plan—even those with the largest numbers of enrollees—has been able to gain enough market share to bring down prices; instead prices for 15 of the drugs most frequently prescribed to seniors have increased. The time has come to make Medicare Part D more cost effective by eliminating the prohibition that prevents Medicare from bargaining for better prices.

Medicare’s Phony Problem: The 45 Percent Threshold (April 2007)
The 2007 Medicare Trustees’ report projects that by the year 2013 more than 45 percent of Medicare’s total funding will come from general revenues. Under the 2003 Medicare Modernization Act (MMA), if the 45% threshold is crossed, then a series of specific steps to deal with the “problem” is triggered. A closer look, however, shows that this 45 percent threshold has no real significance. Moreover, correcting this nonexistent problem could do serious harm to Medicare beneficiaries and distract policymakers from honest discussions about how best to strengthen Medicare.

As Health Plan Falters, Maine Explores Changes (April 30, 2007)
Maine became the first state in years to enact a law intended to provide universal health care. By 2009, the State planned to provide coverage to approximately 130,000 uninsured residents. So far, it has not come close to that goal. As Maine tries to implement reforms, some challenges include how to better address the concerns of their largely rural, poor and elderly populations with significant health needs.

Medicare’s Troubling Prospects (April 26, 2007)
Recent reports announce that the date of insolvency of the Medicare program has been pushed back by a year — to 2019. Now politicians are trying to find financial solutions. A clause in the 2003 law that established the new Medicare drug program states that no more than 45 percent of total Medicare expenditures can come out of general revenues. Any revenue gained from repealing Bush’s tax cuts for the wealthiest 1% could not be used to help finance Medicare. This New York Times editorial suggests that instead of cutting healthcare benefits or payments to health care providers, politicians should look to cut the lavish subsidies provided to private health plans that participate in Medicare.

Report: Medicare 101: What You Really Need to Know: Alliance for Health Reform (April 20, 2007)
A panel sponsored by the Alliance for Health Reform and the Kaiser Family Foundation features experts explaining how Medicare is funded, who it serves, and what Parts A, B, C and D cover. This discussion is available both as a transcript and as a video webcast.

 Report: Forthcoming Medicare Trustees’ Report May Contain Dubious “Medicare Funding Warning” (April 20, 2007)
Anticipating the release of the annual report of the Social Security and Medicare trustees, the Center on Budget and Policy Priorities declares that it may contain a dubious “Medicare Funding Warning” that is based on a deeply misleading measure of the program’s health. The 45-percent threshold represents an ideologically driven approach to Medicare’s financing woes that protects the nation’s most affluent residents at the expense of Medicare beneficiaries and working families of more modest means. Also, focusing on this dubious “warning” is not only devoid of analytic merit but will impede efforts to address Medicare’s problems.

Senate Bars Medicare Talks for Lower Drug Prices (April 19, 2007)
The US Senate blocked a proposal to let Medicare negotiate lower drug prices for millions of older Americans, a practice now forbidden by law. Democrats could not muster the 60 votes needed to take up the measure in the face of staunch opposition from Republicans. The opponents said private insurers and their agents, known as pharmacy benefit managers, were already negotiating large discounts for Medicare beneficiaries. Senator Amy Klobuchar, a freshman Democrat from Minnesota, said the vote showed that “the power of big pharma,” the pharmaceutical industry, “is still a presence in the halls of Congress.”

AARP Says It Will Become Major Medicare Insurer While Remaining a Consumer Lobby (April 17, 2007)
AARP, the former American Association for Retired Persons, announced that it would become a major participant in the nation’s health insurance market, offering an HMO plan to Medicare recipients and several other products to people 50 to 64 years old. People ages 50 to 64 often find that health insurance is unavailable or unaffordable when they try to buy it on their own. AARP said its underwriting practices would be less stringent than those of many commercial insurers, but it reserved the right to deny coverage to some sick people ages 50 to 64.

Report: Rhetoric versus Reality: Comparing Medicare Part D Prices to VA Prices (April 2007)
This report compares the lowest prices for drugs offered by Medicare Part D. Since the inception of the Part D benefit, evidence shows that private plans have not reduced drug prices for seniors. Rather, prices have climbed. Over the past year, Part D drug prices have increased several times faster than the inflation rate. Families USA analyzed the prices for certain drugs most frequently prescribed to seniors and found that Part D insurers charged prices that were substantially higher than those obtained by the Department of Veterans Affairs (VA).

Report: Waste and Inefficiency in the Bush Medicare Prescription Drug Plan: Allowing Medicare to Negotiate Lower Prices Could Save $30 Billion a Year (April 2007)
If the Senate follows the House in passing legislation that will allow Medicare to negotiate for cheaper prescription drugs, the result will be around $30 billion in savings for seniors, for the Medicare Part D program, and for the health care system as a whole. These kinds of policy changes offer significant savings for the government that, in this era of pay-as-you-go budgeting, could be used to fund other vital programs or to help fill in the Part D coverage gap known as the doughnut hole. The proposed changes in the Medicare Part D law would undo the legislative provisions that were only inserted into law only because of special interest lobbying.

Report: The Effect of Different Public Health Interventions on Longevity, Morbidity, and Years of Healthy Life (April 2007)
What is the goal of public health for older persons? Public health doctors and their staff must consider what results their actions will produce. In a highly statistical study that has ethical implications, the researchers looked at interventions that would help different sets of persons. For example, interventions aimed at keeping persons healthy increased longevity and years of healthy life, while decreasing morbidity and medical expenditures. Interventions that focused on preventing mortality had a greater effect on longevity, but had higher future morbidity and medical expenditures. Finally, the researchers found that if public health doctors did more comprehensive screening and treatment of new Medicare enrollees, they likely would improve enrollees’ health and longevity without increasing future medical expenditures.

Report: Medicaid and Long-Term Care: How will Rising Costs Affect Services for an Aging Population? (April 2007)
This brief from the Center for Retirement Research at Boston College explores trends in Medicaid spending on long-term care and the implications of its rapid growth for taxpayers and for the needs of an ag¬ing population. The first section defines long-term care. The second section describes Medicaid’s role in financing it. The third section describes the impact of Medicaid on state budgets. The final section assesses efforts to rein in Medicaid spending.

Report: Medicaid Long-Term Care: Few Transferred Assets before Applying for Nursing Home Coverage; Impact of Deficit Reduction Act on Eligibility Is Uncertain (March 2007)
The Medicaid program paid for nearly one-half of the nation’s total long-term care expenditures in 2004. The GAO (Government Accountability Office) recently released a report that examines the demographic and financial characteristics of a sample of Medicaid nursing home applicants. Researchers examined the extent to which these applicants transferred assets for less than Fair Market Value and the potential effects of the Deficit Reduction Act provisions on Medicaid eligibility for long-term care.

Govs and Hospitals Try to Block Medicaid Cuts (March 22, 2007)
A coalition of governors and hospital groups says it has the support of nearly two-thirds of the members of Congress to block a Bush administration plan to cut $5 billion in Medicaid funding. Governors, state Medicaid directors and public hospitals are urging Congress to pre-empt a new rule proposed to take effect in September that would limit federal reimbursements to government-run hospitals. Budget considerations could potentially hamper efforts to block the administration’s rules. It’s unclear whether the Democratic leadership in Congress would require cuts elsewhere to offset the $5 billion in savings the administration was counting on when it drafted its budget. 

Insuring Children May Squeeze Seniors (March 26, 2007)
The Democratic Party leadership of Congress is moving to provide healthcare coverage to millions of uninsured children this year, but there's a catch: senior citizens enrolled in a popular Medicare program may have to help pay the bill. Lawmakers want to provide coverage to as many as 6 million of an estimated 9 million uninsured children, by increasing federal spending as much as $60 billion over the next five years. But budget rules designed to curb the deficit require new expenditures to be offset by tax increases or cuts in programs. To help meet the cost, Congress is considering trimming payments to Medicare managed-care plans. The privately run alternatives to traditional programs serve about 8 million senior citizens, including those in health maintenance organizations. If funding is reduced, the plans may cut dental, vision and other benefits. 

Report: Long-Term Care Preferences: A Survey of Alabama Residents Age 35+ (March 2007)
A recent AARP study shows that Alabama residents prefer receiving long-term care services in the home. Two-thirds of respondents support spending more state funding on home and community-based care. The Alabama State Legislature is currently evaluating a Center for Medicare and Medicaid Services (CMS) supported program called Money Follows the Person Program. Through this program, persons eligible for Medicaid long term care services would be able to decide the setting in which they receive services and funds would be allocated to support their choices. 

Report: Medicare: A Primer (March 2007)
This Kaiser Family Foundation guide examines Medicare, a program established in 1967 which provides health coverage to nearly 44 million people—including about 37 million people age 65 and older and another 7 million younger adults with permanent disabilities. The primer looks at the characteristics of the Medicare population, what benefits are covered, how much people with Medicare pay for their benefits and the program’s overall costs and future financing challenges. Particularly interesting is the table showing the number of Medicare beneficiaries in each state, broken out by age and income level.

Medicare Providers Face Tighter Scrutiny (March 20, 2007)
A congressional probe into tax fraud by physicians, suppliers and other Medicare providers may lead to changes in how the program pays contractors and could expand into a wider inquiry into whether other individuals and institutions doing business with Medicare also abused the tax system.

To do Health Care Right, Rich Must be Taxed (March 14, 2007)
New York Governor Spitzer’s commitment to clear away the bureaucratic obstacles that keep hundreds of thousands of eligible New Yorkers off Medicaid is a major step forward. Unfortunately, while Spitzer is extending health coverage with one hand, he is yanking away a lifeline from the state's hospitals and nursing homes with the other. One solution to help with the Medicare budget is to place a tax on earnings consisting of one day’s pay for every $500,000 earned annually.

Report: Health Care Spending and the Aging of the Population (March 13, 2007)
This report, prepared for Congress by the Congressional Research Service, focuses on health care spending which has been growing as a percentage of national income, federal spending, and many consumers’ income. Growth in spending for health care is of particular concern to policymakers because Medicare and Medicaid already account for about 21% of federal spending. Over the next several decades, both national and federal spending on health care are expected to grow rapidly due to changing demographics (growing percentage of older people) and rising health care costs for all age groups. This has implications regarding public spending priorities and economic growth.

Reject Bush's Health Care Plan (March 12, 2007)
Bush’s health plan throws the responsibility of healthcare on the individual rather than making care a shared risk that the state helps shoulder. This plan inevitably forces people to be more frugal with their healthcare spending, resulting in fewer people taking preventive measures with their health. When treatable illnesses go undetected for years, they grow into expensive serious illnesses. Many new plans with a shared risk approach have surfaced since the Democrats gained control of the Senate. One such plan, written by Jacob Hacker from Yale University and published as part of the Economic Policy Institute’s Agenda for Shared Prosperity, draws on the strengths of the employer-provided health insurance system and the advantages of public insurance. Hacker’s plan would permit people without Medicare or employer-based health care to buy into the Health Care for America insurance pool, modeled largely on Medicare, but tailored for the non-elderly population.

Most Support U.S. Guarantee of Health Care (March 2, 2007)
According to the latest New York Times/CBS News poll, a majority of US citizens willing to pay higher taxes to have universal health insurance. More than three-quarters are not happy with Bush’s handling of the healthcare issue. The majority believe that the Democrats are more likely to improve the healthcare system. More than 46 million uninsured Americans would greatly benefit from a universal healthcare system.

Medicaid Cuts Would Cost Public Hospitals, Other Facilities (March 1, 2007)The Bush Administration plans to cut nearly $4 billion in aid for public hospitals and other healthcare facilities for uninsured patients.  Medicaid, the federal-state program, serves more than 55 million low income people, including the working poor, elderly nursing home residents with few financial resources and many children of low income parents.  The administration is attempting to move forward with these proposed changes without any input from Congress or governors.  However, 43 senators and 226 House members are trying to pass legislation to block the cuts from going into effect.

Profit for Some or Care for All (February 27, 2007)
Current health coverage in the US is costly and inefficient. A publicly administered policy with an affordable premium that allows a choice of doctors and hospitals with reliable benefits would force private insurance companies to be more efficient in order to compete. 

Universal Care: Watch Your Language (February 27, 2007)
A study group was put together by Lake Research Partners to decode arguments claiming that the current US health system is the most effective one. The study found that the main point needing emphasis is quality affordable health care--a system that covers everyone but does not drive up costs for everyone else or decrease quality of care.

Report: Is Medicaid Sustainable? Spending Projections for the Program’s Second Forty Years (February 23, 2007)
A recent Kaiser Family Foundation lays out the national concern about baby boomers’ LTC (long term care) costs and the pressures placed on Medicaid by the expected decline in employer-sponsored insurance. The report claims that the growth in government revenues will be large enough to sustain Medicaid spending increases. Researchers make clear that there is no need to rush headlong into changes in Medicaid for fear that Medicaid is unsustainable or will bankrupt state and federal taxpayers. A measured, careful approach makes much more sense.

Saving Private Insurance (February 22, 2007)
Proposals for healthcare reform all revolve around private insurance companies, while the problem with the healthcare system in the US is the conflict of interest of private insurance companies. Public coverage has been proven in other industrialized countries to reduce costs and increase efficiency and coverage to all citizens. By examining the history of insurance in the US and understanding the shortcomings of the current system, this article shows how public coverage is the most logical solution to the healthcare crisis in the US.

Bush Goes on Road to Push Health Plan (February 21, 2007)
President Bush’s plan to expand health coverage by revamping the tax code to cut taxes for the poor so they can afford private health insurance has been pronounced dead by leading Democrats on Capitol Hill. The plan, however, has invited mixed reactions from Democrats. While all feel that the plan needs to be largely altered, some appreciate that universal healthcare has been brought to the headlines.

Caring for an Aging America (February 15, 2007)
In an invited testimony before the US House of Representatives Committee on Appropriations as part of the Hearing on Health Care Access and the Aging of America, Mary Jane Koren, assistant vice president of the Commonwealth Fund, explained the changing health concerns of an aging America. Since the elderly will constitute a significantly larger part of the population by 2020 and one fifth of the population by 2050, the healthcare system requires reform to meet the needs of an aging society. Koren suggests that our long-term health system should not try to extend the lives of older persons using very painful and costly methods. Rather, she believes funding should support care that helps them maintain their independence and quality of life. 

US: Report: Medicaid In Depth: A Special Research Series (February 2007)
Governor Spitzer’s 2007-08 Executive Budget calls for a series of Medicaid cost-containment measures, including a freeze on hospital and nursing-home reimbursement rates. New York’s high Medicaid spending— more than double the per-capita norm for all states—stems from deeply rooted patterns of health-care spending, regulation and use that have failed to produce better care. In keeping with Governor Spitzer’s “patients first” perspective, this special research series uses the latest federal data to highlight Medicaid spending on major demographic groups: the elderly, children, non-elderly adults, and the disabled.

US: Report: The Rising Burden of Health Spending on Seniors (February 2007)
Increasing life expectancies, rising spending per retiree and a growing retired population are fueling higher health care expenditures on the older US population. Experts say that retirees’ health care cost are projected to rise substantially, even under current-law projections. If the cost sharing shifts and seniors are asked to pay more of their own health care costs, health care will crowd out other spending options for future retirees. Current workers must anticipate these changes. They will have to consider staying in the workforce longer, saving more or consuming less health care as the relative price of health care increases. The report does not address changing the fundamental structure of US health care as a way to reduce retirees’ costs. 

Report: State by State Formulary Variability in Medicare Prescription Drug Plans for Auto-Assigned Long Term Care Residents (February 2007)
The Long Term Care Pharmacy Alliance published a recent study that documents how most low income nursing home residents have a poor chance of being enrolled in the Medicare Part D plan that best covers their medications.

$3 Trillion Bush Budget to Trim Domestic Programs (February 2, 2007)
US President Bush recently submitted a budget proposal to Congress to increase spending on more military operations in Iraq and Afghanistan . The Defense Department also seeks $481.4 billion to run the department for 2008. All the while, Bush plans to continue to decrease domestic program spending on Medicare, Medicaid for the poor and disabled, farm programs and college grants for low income students.

Georgetown University Long-Term Care Financing Project Fact Sheets: Medicare and Long-term Care (February 2007) 
Medicare has contributed to the wellbeing of the nation’s elderly and people with disabilities. Over the past four decades, Medicare has helped to improve the health of its beneficiaries. But Medicare also has significant gaps. This report examines how Medicare could be modified to play a larger role in financing long-term care. Options include federalizing long-term care costs for dual eligibles and adding a personal care benefit to Medicare.

Bringing Health Care to Katrina’s Uninsured (January 29, 2007)
More than a year after Hurricane Katrina, eastern New Orleans remains without a stable medical or health-care infrastructure. Hundreds of people, young and old, are still without health insurance in areas hit hard by the storm.  A week-long health fair event recently began to serve those citizens who no longer have insurance, are unemployed or otherwise cannot afford regular health care. By the end of the week, 10,000 patients are expected to be seen.  People began arriving as early as 2 a.m. in need of health services. 

Qualifying for Medicaid after Making Cash Gifts (January 27, 2007)
Since the implementation of the Deficit Reduction Act in February 2006, stricter rules have made qualifying for Medicaid much more difficult.  Oftentimes, seniors turn to Medicaid for help in paying long-term care bills.   Individuals typically become eligible for Medicaid after using up all but about $2,000 of their cash and investments with certain exceptions. One way of reaching that threshold without spending the money is to give it to someone else, often their children.  But the parents, if they enter a nursing home, could be left in a bind.

Bush’s Focus on Health Care Draws Criticism, New Hope (January 23, 2007)
The Administration’s proposals for shrinking the number of health-uninsured citizens in the country face much criticism. Critics state that President Bush's tax break for health insurance proposal would do little to reduce the ranks of the uninsured. "Since most uninsured citizens pay low or no taxes, they would receive little help from this plan," said the Center for American Progress Action Fund. Additionally, this approach could undermine the employer-based insurance system by shifting many citizens from stable employer-based insurance, where the risk is spread over an entire work force, into the unstable individual insurance market.

Group Offer Health Plan for Coverage of Uninsured (January 19, 2007)
Business and consumer groups, doctors, hospitals and drug companies recently laid out a major proposal to provide health coverage to more than half of the nation’s 47 million uninsured. The plan proposes to address the nation’s health care crisis by expanding federal benefit programs and offering new tax credits to individuals and families.  Critics feel tax credits may not guarantee access to comprehensive coverage and could leave consumers with high out-of-pocket costs. Nevertheless, more action has taken place to address this crisis. Dr. Reed V. Tuckson, senior vice president of UnitedHealth Group states, “Day after day, people die. We are sick and tired of the debate. We are focusing on what is achievable."

Fed Chief Sends Warning on Budget (January 18, 2007)
Once again the US Administration is floating privatization of Social Security.  Leaders fail to take responsibility for the enormous tax cuts given to the richest in the US and now cry “poverty” for social progra