Rescuing Medicare Step 1 in Saving U.S. Health Care Diane Archer Founder and Special Counsel Medicare Rights Center May 13, 2004

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Rescuing MedicareStep 1 in Saving U.S. Health
Care Diane ArcherFounder and Special
CounselMedicare Rights CenterMay 13, 2004
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What is the Medicare Rights Center (MRC)?

• MRC is the largest independent source of Medicare
  information and assistance in the U.S.
• Founded in 1989, MRC helps older adults and
  people with disabilities get high-quality,
  affordable health care.
• MRC has three main programs
• Education and training
• Client services
• Policy and advocacy

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Tonights talk

• What people really want to know about the new
  Medicare reforms
• What lies beneath the demons lurking among the
  MMAs 681 pages
• Why Original Medicare works
• How we can save Medicare, and set the country on
  the path to NHI

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1 concern paying for prescription drugs

• A wide range of people with Medicare struggle to
  afford their medicines
• Disabled individuals under 65
• Retirees with no retiree drug benefits
• People with incomes that are low but too high for
  Medicaid
• People with HMOs but inadequate benefits

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Lack of Rx coverage impedes access to medicine

• People with Medicare without prescription drug
  coverage are significantly more likely to
• Skip prescribed doses
• Spend less on basic needs to afford drugs
• Completely forgo prescribed drugs

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The big question on the minds of people with
Medicare

• How will the new law help me afford my
  prescription drugs?
• For the vast majority, it wont.

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The new law the Good, the Bad, and the Ugly

• The Good may help people with low incomes afford
  drugs
• The Bad these limited benefits will not help and
  will likely hurt millions of people with Medicare
• The Ugly the benefits sugarcoat changes designed
  to poison Original Medicare

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The Good

• All people with Medicare whose incomes fall below
  135 of poverty can get 600 annual subsidy for
  drugs in 2004 and 2005 and a free drug discount
  card
• People with low incomes can get additional help
  paying for drugs starting in 2006
• People with very high drug costs and enough means
  to spend 3,600 on drugs will have catastrophic
  coverage.

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The Bad

• To get 2004-2005 low-income assistance, people
  must actively enroll and pick a card out of a sea
  of conflicting options
• Experience with MSPs shows bureaucratic, opt-in
  systems depress enrollment
• Web card comparison tool is overwhelming
• The list of drugs discounted by a card and the
  price of drugs can change at any time

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The Bad (continued)

• The government is spending tens of millions of
  taxpayer dollars to promote cards that offer
  discounts often worse than those available via
  other options
• Even though drugs discounted can change, people
  are locked in for a year

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The Bad (still more)

• The 2006 Medicare drug benefit will
• have a premium that will likely be prohibitive
  for millions with Medicare
• require people to pay 3,600 out of pocket on
  covered drugs before catastrophic coverage kicks
  in
• Low-income assistance will not be automatic for
  most people, who will have to pass an asset test

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The Ugly

• Promoted as Same Medicare, More Benefits, law
  includes provisions to privatize Medicare
• Adds 130B in overpayments to private plans over
  10 years
• Forces people to get 2006 drug benefit from a
  private plan
• Imposes 2010 premium support demonstrations on
  six metropolitan areas
• Creates special trigger to allow Congress to
  slash payments and restructure Medicare

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Medicare is good government

• Original Medicare is one of the most successful
  government programs
• Automatic coverage
• Dramatic reduction in poverty
• People love it
• Protects wide choice of doctors
• Better at cost containment
• Able to negotiate reasonable prices

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New law undermines strength of Original Medicare
program

• Law prohibits Medicare from negotiating
  reasonable prices for drugs
• Permits drug prices to soar unchecked
• Makes 2004-2005 discount cards 10-20 discounts
  meaningless
• Leaves sour taste in peoples mouths for 539
  billion, cant government do better?

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Need confidence in government

• Since Medicares birth, faith in government has
  plummeted
• Right wing push to highlight failings of
  government and virtues of private marketplace
• Confidence grows from results
• Private marketplace has never been able to meet
  the needs of people with costly health
  conditions why Medicare was started
• Can the government effectively lower your drug
  prices?

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Private marketplace is poor model for health
insurance

• Leaves behind the most vulnerable people
• Pre-Medicare older adults
• People with disabilities or other conditions
• Worse at cost containment
• First principle is profit motive (not patient
  health)

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Key to national health insurance

• Original Medicares success is the best evidence
  that national health insurance can work
• But creating NHI in effect, Medicare for all
  will depend upon confidence in Medicare

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The road to NHI

• First, preserve Original Medicare
• Build off the peoples confidence in this form of
  national health insurance
• Then, expand Original Medicare
• Give other age groups access to what can continue
  to be a successful program

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How you can help NOW

• Demand that Congress repeal the provision
  forbidding government interference with drug
  pricing
• Local letter writing campaign
• Phone calls
• Jumping on cars

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Conclusion

• New Medicare law is anathema to national health
  insurance because it undermines confidence in
  government
• Long-term success in NHI movement may depend on
  preserving Medicare now

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Stay abreast of Medicare news and advocacy efforts

• Sign up for MRCs free advocacy and educational
  newsletters at www.medicarerights.org/periodicalsf
  rameset.html
• To learn more about the Medicare Rights Center,
  visit www.medicarerights.org.