Tag Archives: Medicare

Not just older, but better!

 

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If you are an American who is getting older – and who isn’t? – you will benefit from several current trends when you reach retirement age.

We have come a long way since the 30s when half the senior population lived in poverty. After Social Security took effect 80 years ago, the rate began to drop. It was 40 percent in 1959, and Pres Johnson’s expansions accelerated its fall in the 60s. By 1970, a quarter of seniors were poor, and today 15 percent are still living in poverty.

In healthcare, medical technology and disease management should continue to advance. The reforms of health policy in the Affordable Care Act benefit all ages.

Read more . . .

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Filed under American Society, Income and Wealth Inequality, Retirement

Medicare compromise

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Congressional leaders Pelosi, McConnell, Reid, Boehner hold hands after passing bipartisan bill (AP Photo/Susan Walsh)

Sad to say, the optimism in a post I wrote a month ago was misplaced. “Don’t look now, but we’re actually governing!” was quite misleading. While it’s true that the bipartisan legislation passed with overwhelming support from both parties and it solved the “doc fix” dilemma that had been frustrating doctors and legislators for years, it does so at a significant cost (surprise, surprise!).

The physicians were being paid successively less each year, and many were threatening to leave Medicare while others had already left. The new legislation will give them a guaranteed 0.5 percent pay hike for the next five years. While the doctors win, wealthier seniors (earning $133,500 to $214,000 yearly) will pay more for their medical insurance and prescription drug coverage.

Somebody has to pay, not just seniors. Medicare’s budget will be cut by billions of dollars. Spending for long-term care (hospice, home health services, nursing homes) will also be reduced. A reason to cheer, though, is the two-year extension of CHIP, the Children’s Health Care Program.

Pres. Obama is extremely happy to sign the second most significant health care bill after the Affordable Care Act, popularly known as Obamacare. The Tea Party of course isn’t happy. Senators Ted Cruz (R-TX) and Marco Rubio (R-FL) denounced the bill because it will add to the deficit. (These presidential contenders seem to be going out of their way to antagonize significant sectors of the electorate with their stances on immigration, gay marriage, and now seniors.)

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“Don’t look now, but we’re actually governing!”

PelosiBoehnerSo said Rep. Renee Elmers, Republican of North Carolina. She was celebrating the achievement of House Republicans and Democrats, who accomplished the seemingly impossible. Speaker John Boehner (R-OH) and Democratic Leader Nancy Pelosi (D-CA) found a way to reduce Medicare costs while improving medical care and then sold the deal to their caucuses. The parties actually negotiated and came to a bipartisan agreement on how to fix Medicare’s financial woes and other health-related problems. In today’s polarized government, this was nothing short of a miracle.

The sweeping change to Medicare is to reward doctors based on successful outcomes rather than fee-for-service. Until now, doctors were paid for every test and procedure they ordered or performed, regardless of the outcome. “Now,” said Marilyn Moon, a health economist and former trustee of the Medicare program, “doctors get paid more if they do more. In the future, they will be paid more if they do it better — and may be paid more for doing less.”

Some of the cost will be offset by higher premiums for the wealthiest Medicare beneficiaries. Without this bill, physicians with Medicare patients would face a 21-percent reduction in their fees on April 1. Many doctors would consequently feel compelled to drop out of Medicare, leaving seniors scrambling for access to many fewer doctors. Republicans also agreed to extend CHIP, the government-funded health insurance for needy children. Democrats wanted a four-year extension, but settled for two years in the hope of a longer extension in the future.

What remains is for the Senate to vote its approval. Passage of the bill in Senate is all but certain, given the overwhelming majority in the House, which passed the bill by a vote of 392 to 37. Pelosi corralled all but four Democrats to vote in favor, while Boehner lost only 33 of the most conservative Republicans.

Was this an amazing fluke, or are the people we elected to govern actually learning to play well together? Stay tuned.

Photo by KAZ Vorpal

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Filed under Health, Politics

Huh? Chained CPI? What’s that?

You are reading this post, so you must be curious about the chained CPI.

What is it and why should you care?

If you are one of the 15 percent of Americans who live below the poverty line or a retiree whose income is largely dependent on Social Security, you should care very much. Even if you are years away from retirement, the decision politicians make today about how to calculate the Consumer Price Index will hugely affect your income for the last third of your life. Continue reading

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Sen. Graham, Social Security’s not the problem

Today on Fox Sen. Lindsey Graham (R-SC) flat-out blackmailed Pres. Obama and congressional Democrats:

I cannot in good conscience raise the debt ceiling without addessing the long-term problems of this country. And I will not.

Graham wants “meaningful entitlement reform,” that is, raising the age of retirement for Social Security, means testing and (downward) changes in the way benefits are calculated. In other words, in exchange for keeping the country solvent, he would use various measures to decrease benefits for the elderly and the sick.  Continue reading

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Tossing seniors over the fiscal cliff

Raising the age of eligibility for Medicare is a key proposal in the fiscal cliff negotiations. Unhappily, it’s a smoke screen, because it won’t save the federal government much money and will seriously impact at least 90 percent of Americans (people earning less than $135,000). Let’s think about it. A little reflection without going too much into the weeds reveals why this is a very bad idea.

Distribution_of_Annual_Household_Income_in_the_United_StatesThe retirement age for Social Security is scheduled to complete a graduated rise from the original age of 65 to 67 in 2022. It’s assumed that the Medicare eligibility age will rise with it. Currently, raising the age to 70 has also been suggested. A study by the Kaiser Family Foundation found that raising the age to 67 would save the federal government $5.7 billion in 2014. But there are costs to consider as well.

Raising the Medicare eligibility age is a terrible idea because:  Continue reading

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Get off the fiscal cliff, already! (or, It’s not austerity, stupid)

taxVgdp4-24-12All this hand-wringing about the fiscal cliff is really annoying, not because it’s not a serious problem, but because it’s not so difficult to resolve. Democrats propose raising taxes for the top two percent. The Republicans like to say that the real problem isn’t taxes, it’s spending. They want to double down on spending cuts because a prime goal of theirs is to starve the beast— to eviscerate the government except, of course, for defense spending, which they would not limit, not even to current levels, but increase.

The real problem, folks, is jobs. When people go back to work, they pay taxes and spend the money they’ve earned. The latter boosts the economy, and both increase revenue. A return to the pre-crisis employment rate would go a long way towards eliminating the deficit.  Continue reading

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