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Health Care
What's New? - Archive
WomenMatter will continuously post updates on all this and other issues as we monitor the continuing philosophical and practical debates nationwide. Please check back often for updates.
Past updates are available for reference on the Healthcare Archives page.
Universal Medicare in a Worldly Budget Crisis
The year 2000 Presidential campaigns promised Medicare reform and prescription drugs for seniors. Three years later, seniors are still waiting to find out just what their future healthcare will look like. So, what’s the holdup?
Well, Congress has made clear where their philosophies collide. Both Houses have Republican majorities. In the House the bill reflects the Republican desire to privatize Medicare at best and at least to bring marketplace competition into the picture. The House bill requires wealthier seniors to spend more on prescription drugs before getting catastrophic coverage. It also creates competition between Medicare and Preferred Provider Organizations (PPOs) beginning in 2010. In addition, the House bill allows people to set up tax-free "health savings accounts."
The Senate bill has no provision for such accounts and does not require Medicare to directly compete with private PPOs. But the Senate has some Democrats that have joined Republicans, particularly over the cost of Medicare prescription drug plans. For more detailed information on the Medicare reform bills, [click here].
A joint committee of 11 Republican and 6 Democratic Congresspeople (there is one woman among them) is currently working out the differences between the two bills. How can two philosophies find common ground that President Bush might be willing to sign?
Committee progress
Since July 2003, Medicare reform has received little press coverage. There was almost no word of the committee’s progress until The New York Times reported a development on October 6, 2003. The committee reportedly has avoided the issue of privatizing. It has avoided a point of view that says that richer people can buy better quality health services as part of a competitive market. What it has proposed is to keep all health services the same for all of our older citizens (universal care) and just charge higher premiums to seniors who happen to have more money at the time of retirement.
Why did this provision gain bipartisan backing?
Working with tight funds
With an enormous deficit looming over their heads, and baby boomers’ retirement on the horizon, legislators are attempting to find ways to slow Medicare spending.
Representatives on both sides agree that increasing premium rates for the wealthy is one way to avoid benefit cuts (for all) in the future. Some Democrats who used to be opposed to the idea have changed their opinions because of new data and the huge deficit. Studies from the Center on Budget and Policy Priorities and the Urban Institute have concluded that raising premiums for richer seniors is one of the best ways to control Medicare spending.
Historically, Democrats have been opposed to premiums based on means. They have claimed that charging the wealthy more money for the same services undermines the "universal" nature of the program.
Yet, Democrats (and all other legislators) are faced with tough choices. Is it preferable to cut general benefits? To cut some prescription drug benefits? Or, is it best to raise premium prices for individuals with annual incomes of over $100,000 a year?
High-profile Democrats are in disagreement over the issue
Senator Dianne Feinstein (D-CA) is in favor of charging wealthy seniors more for Medicare. She believes that it is illogical to charge poor, struggling seniors the same rate ($58.70 per month) as wealthy seniors who can afford to pay more.
Fellow Democrat Edward M. Kennedy of Massachusetts does not agree. He believes charging wealthy seniors more will cause them to leave Medicare in search of private options. This would result in higher costs for middle and low-income seniors who stay with Medicare.
However, a study conducted by the Urban Institute concluded that the wealthy would be likely to stick with Medicare. Even with raised premiums, Medicare is still a great bargain.
Senator Kennedy also feels that uneven premium rates will dampen higher-income seniors’ support of the Medicare program.
Republicans, who are largely in favor of the provision, point out that higher Medicare premiums for the wealthy are not altogether different than higher income taxes for the wealthy, an idea which Democrats favor.
No longer universal?
Some Democrats worry that increased premiums for some change the program for all. They say the "universal" nature of the program would be altered, and it would become more of a need-based, welfare-like program. However, the program would still be available to all seniors, and all seniors would receive the same benefits and care.
Does "universal" mean everyone receiving the same care and contributing the same amount? Right now, this is the case. But currently, poorer seniors pay a larger percentage of their incomes for the program, and some may actually be receiving inadequate care. Since prescription drugs are not covered at present, many low-income seniors go without needed medicines that their doctors consider to be necessary.
Perhaps the Medicare program would become more "universal" if the wealthy used their resources to strengthen the program for all. What do you think? Discuss this topic with other WomenMatter readers in one of our online forums. Read more about healthcare and our other nine life issues. You can also contact your representatives and let them know what you think.
Posted on: 10/8/2003
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