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Medicare News
Lots of Talk but Little Action on Changes to
Medicare
Washington Times explores problems elderly have
with medication
June 14, 2006 – There are a number of ideas for
making changes to Medicare kicking around Washington, but KaiserNet.org
says Congressional leaders are sending "mixed signals" about the
possibility of action any time soon. The daily report by Kaiser also
looks at a report in the Washington Times on how elderly patients often
experience problems with dosages and improper combinations of
medications.
 Congress Sending 'Mixed
Signals' on Medicare Bills' Prospects for 2006
Congressional leaders are "sending mixed signals
about the timing of any move to work through" Medicare legislation in
2006,
The Hill reports.
According to The Hill, lawmakers have proposed a
number of bills related to the Medicare prescription drug benefit and
"several of [Medicare's other] perennial problems," but the Bush
administration and Republican leaders in both chambers are "said to be
wary of opening the door to a wider debate on Medicare this year."
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Any action on the bills likely will not occur until
after the August congressional recess, and "speculation is rampant" that
House and Senate leaders could postpone final action until after the
midterm elections this November, The Hill reports.
Senate Finance Committee
Chair Chuck Grassley (R-Iowa) and Rep. Nancy Johnson (R-Conn.), chair of
the
House Ways and Means Subcommittee on
Health, have sponsored bills (S
2810,
HR 5399) that would eliminate
the financial penalty for Medicare beneficiaries who missed the May 15
enrollment deadline for the prescription drug benefit. The Johnson bill
is expected to come under discussion on Wednesday at a Ways and Means
Committee hearing on the implementation of the drug benefit, The Hill
reports.
However, despite support from some Republican
lawmakers, the Bush administration and congressional leaders "have been
cool to the idea" of waiving the penalty, and "lawmakers have few
realistic options available to pay for a package containing these or
other costly provisions," The Hill reports.
Other Issues
According to The Hill, the "biggest driver behind Congress' tackling of
Medicare this year ... is a strong desire by many lawmakers to prevent a
cut in Medicare's payments to physicians."
With medical malpractice reform legislation
defeated last month, the
American Medical Association
has turned its primary lobbying efforts toward stopping the scheduled
cuts, which would begin next year without legislation. However,
proposals to repeal the cuts or change the payment formula could face
opposition because of the projected high costs of a repeal.
The
Congressional Budget Office
estimated that maintaining the current payment level for one year would
cost about $10 billion, The Hill reports.
Meanwhile, the nursing home and physical therapy
industries are pushing for Congress to postpone or eliminate planned
caps on the amount of therapy Medicare beneficiaries can receive. The
caps are scheduled to go into effect Jan. 1, 2007, but eliminating them
would cost more than $500 million, according to The Hill.
Sen. John Ensign (R-Nev.) and Rep. Phil English
(R-Pa.) have proposed legislation (S
438,
HR 916) that would repeal the
caps (Young, The Hill, 6/14).
Opinion Piece
The "real problem" with the Medicare prescription drug benefit "is that
this program eventually will replace existing public and private
spending for drugs with new taxpayer financing -- at a time when
entitlement costs already are growing much more rapidly than the tax
receipts that are supposed to pay for them," Robert Moffit, director of
the
Center for Health Policy Studies
at the Heritage Foundation, writes in a
Washington Times opinion
piece.
According to a Heritage Foundation analysis, the
cost of Medicare, Medicaid and Social Security will "boost federal
spending from 20% of gross domestic product to almost 38% ... by 2050"
without "serious entitlement reform," Moffit writes.
He says that Congress should enact legislation that
would require higher-income Medicare beneficiaries to pay more toward
Part B premiums.
"The next step should be to start transforming
Medicare from a defined-benefit program to a defined-contribution
program," Moffitt writes. He also says that Baby Boomers should be
encouraged to carry private health coverage into retirement and should
receive a capped government contribution toward premiums.
Moffit concludes, "Congress can delay taking
action, but every delay raises the tab for taxpayers" (Moffit,
Washington Times, 6/14).
Washington Times Examines Problems With
Medications for Elderly Patients
The
Washington Times on Tuesday
examined how elderly patients often experience problems with dosages and
improper combinations of medications. According to the Times, elderly
patients "must go beyond the doctor's office to find out the proper
doses and combinations to keep health issues at bay."
Patricia Harris, director of geriatric education at
the Washington Hospital Center, said, "In hospitals, there's a tendency
to overmedicate the elderly," adding, "Some (patients) overmedicate
themselves with over-the-counter medicine."
Neil Resnick, chief of the division of geriatric
medicine and professor of medicine at the
University of Pittsburgh School of
Medicine, added that pharmaceutical companies do not conduct
adequate research on the effect of new medications on elderly patients,
who often do not participate in clinical trials.
He said, "As a result, when the drug is approved,
there's very little knowledge as to how that drug will work when given
to a 75-year-old person taking eight to 10 other drugs." In addition,
physicians often cannot determine whether elderly patients will
experience adverse reactions from combinations of medications because of
a lack of research, Resnick said.
On average, elderly patients take between four and
five medications daily, and those in nursing homes take as many as 12
daily. Physicians recommend that elderly patients maintain lists of
their medications, ask more questions about treatments and research
medications on the Internet to help prevent potential problems.
Philip Bryant, a psychiatrist and medical director
at
Good Shepherd Rehabilitation Network,
said, "We should have a cultural expectation that patients and their
families be more aware. They need to be active (in the process)" (Toto,
Washington Times, 6/13).
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