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Senior Citizen Politics
Senior Citizen Issues Seldom Mentioned in Campaigns
or in Washington
Bush required to send a Medicare savings plan to
Congress; will address Medicare paycut for physicians in State of Union
 Jan. 22, 2008 With a challenging presidential
race in both parties and power in Washington divided between the two
parties, it might be assumed there would be a lot of discussion of
issues that are important to senior citizens, the most prolific voters.
There has not been much a brief squabble over funding Social Security
between Democrats, a proposal by Sen. John McCain to allow prescription
drug reimportation and the annual battle in the Washington over cutting
the pay doctors get from Medicare is about it. But things could be
getting more interesting.
President Bush Expected To Announce Medicare
Physician Fee Formula Proposal In State of Union
President Bush likely will reveal his proposal for
changing the Medicare physician fee formula during his State of the
Union address on Monday, CongressDaily reports (CongressDaily, 1/22).
Bush for the first time is required by law to send
a Medicare savings plan to Congress after he releases his fiscal year
2009 budget proposal because Medicare trustees last year triggered a
"Medicare funding warning."
The warning is issued when trustees for two
consecutive years predict that federal general fund revenue must be used
to pay for 45% or more of total Medicare costs within seven years. Bush
last month signed into law a bill that delays the fee cut through July 1
and extends SCHIP through March 2009.
The bill increased Medicare physician fees by 0.5%
during that period and extended several programs that provide higher
Medicare reimbursement rates to rural health care providers and hospital
laboratories (Kaiser
Daily Health Policy Report, 1/17).
Lawmakers working on a Medicare package that would
delay the physician fee cut are awaiting details of the proposal.
According to CongressDaily, congressional aides and lobbyists say the
plan "could significantly alter Capitol Hill discussions surrounding
Medicare and other health-related issues" (CongressDaily, 1/22).
Opinion Piece on Importing Prescription Drugs
Sen. McCain, during a recent presidential debate in
New Hampshire, said that he supports prescription drug reimportation
from Canada, a proposal that "amounts to importing Canada's price
controls, a large step toward a system in which some medicines would be
inexpensive but many others -- new pain-relieving, life-extending
pharmaceuticals -- would be unavailable," columnist George Will writes
in a
Washington Post opinion piece.
Will writes, "Setting drug prices by government
fiat rather than market forces results in huge reductions of funding for
research and development of new drugs."
According to Will, "McCain's evident aim is to
reduce pharmaceutical companies' profits," but "if all those profits
were subtracted from the nation's health care bill, the pharmaceutical
component of that bill would be reduced only from 10% to 8% -- and
innovation would stop, taking a terrible toll in unnecessary suffering
and premature death."
He adds, "Republicans are supposed to eschew
demagogic aspersions concerning complicated economic matters," but
"applause greets faux 'straight talk' that brands as 'bad' the industry
responsible for the facts that polio is no longer a scourge, that
childhood leukemia is no longer a death sentence, that depression and
other mental illnesses are treatable diseases, that the rate of heart
attacks and heart failures has been cut by more than half in 50 years"
(Will, Washington Post, 1/20).
Bush Administration 2008 Health Care Agenda Will
Work To Limit Government Role in Health Care System
The Bush administration health care agenda for this
year likely "will consist largely of fending off Democratic lawmakers
until a new president and Congress take charge," the
AP/Miami Herald reports.
HHS Secretary Mike Leavitt said that the administration seeks to
reduce the role of the federal government in health care delivery.
According to the AP/Herald, that "goal is at odds with several
Democratic proposals." Leavitt said that the debate over health care
proposals in Congress this year "will be replete with the kind of
conflict this town is famous for."
Most policy analysts do not expect compromises on
any major health care proposals this year.
Democrats seek to expand SCHIP to cover an
additional four million children nationwide, according to Rep. Frank
Pallone (D-N.J.), chair of the House Energy and Commerce
Health Subcommittee. Congress on Wednesday will attempt to override
a presidential veto of legislation that would expand SCHIP. A similar
veto override vote failed by 13 votes in the House last year.
In addition, Democrats seek to reduce Medicare
reimbursements to private Medicare Advantage plans. Medicare
reimbursements for MA plans, which cover about nine million
beneficiaries, cost 12% more than reimbursements for the fee-for-service
program for equivalent benefits. Leavitt said that the administration
will not support a reduction in Medicare reimbursements to MA plans.
Democrats also seek to pass legislation to allow
FDA to regulate tobacco products. Leavitt said the administration
opposes such legislation because FDA regulation of tobacco products
might prompt individuals to believe such products are safe.
Some Agreement
Despite disagreement on most health care issues,
Democrats and Republicans both support legislation to reverse a 10%
reduction in Medicare reimbursements to physicians. Congress last year
delayed the reduction, previously scheduled to take effect on Jan. 1, by
six months.
Democrats and Republicans also have some agreement
on the issue of food safety (Freking, AP/Miami Herald, 1/20).
Coalition Proposes Catastrophic Long-Term Care
Program
A coalition of long-term care groups last week
unveiled a proposal to create a catastrophic long-term care program for
U.S. residents ages 65 and older that would encourage individuals to
save for their health care needs and reduce the financial burden on
state and federal budgets to provide such benefits,
CQ HealthBeat reports. The proposal was introduced by the
Alliance for Quality Nursing Home Care, the
National Center for Assisted Living and the
American Health Care Association.
The plan, which would be phased in over 10 years,
would be intended for Medicare-eligible individuals who have purchased
at least $100,000 in long-term health care coverage in 2007 dollars,
either through insurance policies or health savings accounts. According
to CQ HealthBeat, that amount could be adjusted based on a sliding
scale, and low-income individuals would be exempt from the requirement.
Under the proposal, individuals eligible for the
catastrophic federal assistance would receive money to pay for
community-based health care programs, or skilled nursing facility or
assisted living facility services. Individuals also could enroll in a
Medicare Advantage plan that provides long-term care coverage.
States' share of Medicaid funding for long-term
care would shift to the federal government, according to the proposal.
In addition, the proposal calls for a post-acute care patient assessment
tool developed by
HHS that would do a better job of matching medical services to a
patient's individual needs, with equal rates of federal reimbursement,
CQ HealthBeat reports (Carey, CQ HealthBeat, 1/18).
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