Tuesday, August 25, 2009

Tell Grandma: Health care reform won't cut your benefits!

This past Friday I was watching the Jim Lehrer NewsHour with my girlfriend before we went to sleep (pretty thrilling Friday, eh?). As usual he had NY Times columnist David Brooks (pictured above), as well as Ruth Marcus from the Washington Post, on to discuss the news of the week. Not surprisingly they talked about all the furor around health care reform, and not surprisingly they spread some falsehoods about reform, in the process demonstrating some of the major flaws of the mainstream media.

Check out the transcript and streaming video here. Right as they begin discussing health care, both Brooks and Marcus cite proposed changes to Medicare under current legislation as motivation for the opposition to reform. Both of them explicitly say that the Democrats' bills will cut seniors' benefits under Medicare. Brooks mentions "Medicare cuts and taking benefits away from people." Marcus asserts, probably correctly, that seniors are the demographic most concerned with health care reform, but follows that up saying that "there are some serious changes in Medicare, needed changes in Medicare, but they will affect seniors, some of them, in terms of seniors' benefits.

Brooks and Marcus are incorrect. Although the House and Senate bills do reduce Medicare spending, these changes do not cut benefits for seniors. Rather, the Medicare savings in the bill are created mostly by achieving greater efficiency and cutting costs in the system.

The Medicare Rights Center, a non-profit consumer group that helps the elderly negotiate Medicare issues and advocates around Medicare policy issues, issued a fact sheet on the effects on Medicare of HR 3200, the bill that passed out of committee in the House. It's important to note that the Center is primarily concerned about the effects of legislation on the elderly and that reforming the entire health care system isn't part of their agenda, so they aren't inherently biased in favor of overall health care reform.

They write in bold letters: "There are no cuts to Medicare benefits in HR 3200." Well David Brooks, it seems that you're wrong.

The bill achieves a large amount of savings by cutting overpayments to private insurance plans that operate under Medicare Part C, the Medicare Advantage program (wikipedia explains). This Physicians for a National Health Plan blog post explains the nefarious history of Medicare Advantage. Under the MA program, Medicare pays insurance companies to provide coverage to people who enroll, and pays them significantly more than what it pays for traditional Medicare coverage.

Conservatives claimed that private company involvement would make Medicare more efficient, but the opposite turned out to be true. While traditional Medicare coverage has administrative costs of just 2%, MA plans have administrative costs of more than 11%, and one government study found those costs to be 16.7% when you include insurance company profits (see here). So basically our taxes are paying for these companies to be inefficient and reap big profits. As the PNHP blog post states, conservatives really wanted to drive up Medicare costs as an excuse to shrink or destroy Medicare, and enrich their insurance company cronies at the same time.

By cutting overpayments to MA plans, HR 3200 might cause insurance companies to stop their involvement in the program, meaning some people covered under their plans would switch to Original Medicare coverage. Some MA plans did formerly offer more benefits than Original Medicare, but HR 3200 expands benefits under Original Medicare to compensate. It eliminates copays and deductibles for preventive care under Original Medicare, which formerly was advantage of MA plans.

Between cutting overpayments to MA plans and cutting the growth in payments to hospitals and nursing homes, HR 3200 would make Medicare solvent until 2022 instead of just 2017 as it would be otherwise.

Overall the Center finds that HR 3200 not only improves the fiscal outlook for Medicare but improves affordability and quality of care for seniors. In addition to eliminating fees for preventive services, it expands assistance for low-income seniors to buy prescription drugs. It gives incentives to hospitals to give better care so that patients don't have to make return trips to the hospital. Finally, it makes sure that payments to doctors don't get cut as planned so that doctors don't stop treating seniors (aforementioned PNHP blog post has a lot on this and history of planned Medicare pay cut to doctors).

So tell your grandma and grandpa, the Democrats' reform plan is actually good for you! It will make preventative health care and prescription drugs more affordable, ensure that your doctor doesn't drop you, and make sure Medicare doesn't run out of money for at least 12 years.

It's ironic that Marcus mentions the "mischaracterizations" of legislation by opponents of health care reform just before she falsely claims that that legislation will cut benefits for seniors. Hey Ruth: seniors aren't magically concerned about health care reform--they're concerned because people like you are falsely telling them that their Medicare benefits will be cut.

These journalists have no self-awareness of their effect on the public discourse. To begin with, it's the fault of newspapers and television news channels that the worst mischaracterizations of reform are out there because they don't do their own research to contest those mischaracterizations. On top of that they assume that they report impartially without projecting their opinions, or that they project their opinions based on only the facts Brooks and Marcus are excellent testaments to the mainstream media's failure to report basic facts and figures of public policy, resulting in an uninformed American public.

No comments:

Post a Comment