Republicans Using Seniors for Partisan Purposes

Sen. Grassley is making up excuses as he goes along. He's the top Republican on the Senate Finance Committee and his group recently decided to exclude end-of-life counseling from the House bill because, in Grassley's words, "We should not have a government program that determines if you're going to pull the plug on grandma."

However, yesterday, on Face the Nation, Grassley admitted that the House bill would not "pull the plug on grandma." He lied and got called on it, so now Grassley is using the cost to justify dumping the counseling provision.

SCHIEFFER: Well, that’s what I was trying to get from you this morning. You’re not saying that this legislation would pull the plug on grandma, you’re just saying there are a lot of people out there who think that it would. Or do you want to say this morning that that is not true, that it won’t do that?

GRASSLEY: It won’t do that, but I wanted to explain why my constituents are concerned about it, and I also want to say that there is an $8 billion cost with that issue, and if you’re trying to save money and you put an $8 billion of doctors giving you some advice at the end of life, doctors are going to take advantage of earning that $8 billion and constituents see that as an opportunity to save some money. [emphasis added]

Grassley is being penny wise and pound foolish. Counseling may cost $8 billion, but according to the Urban Institute, the government could save $90.8 billion over 10 years by better managing end-of-life care.

Also, according to Harvard Science, "in the Archives of Internal Medicine, investigators... found that patients who reported having an EOL conversation had an estimated average of $1,876 in health care expenses during their final week of life, compared with $2,917 for those who didn't, a difference of $1,041, or 36 percent."

Savings aside, a new study offering end-of-life counseling to dying cancer patients found that it improved their mood and quality of life, and the patients who got counseling also lived an average of 5 months longer. Death is scary for most of us, but if counseling improves our mood and helps us enjoy what time we have remaining on earth, that's a good thing.

Besides, Republicans like Grassley (and McCotter) are simply grasping at straws in their opposition because end-of-life counseling is already included in Medicare, and has been since 2005 when Republicans championed the plan.

People aged 65 are entitled to a "Welcome to Medicare" exam that includes a physical and mental assessment, counseling on how Medicare works and what it covers, tips on how to prevent falls at home and the now-controversial counseling. The government would pay for this up to one year after Medicare enrollment. [emphasis added]

The proposed health care legislation that Grassley's Senate Finance Committee dumped would have paid for end-of-life discussions every five years instead of the one time, and it was "milder than legislation sponsored by Sen. Johnny Isakson, R-Ga., that would have required Medicare patients to have a living will."

Republicans are shameful. They've thrown our senior citizens under the bus for partisan purposes, along with our democracy. Or, as Joe Klein said, "How can you sustain a democracy if one of the two major political parties has been overrun by nihilists?


(Cross-posted at Blogging for Michigan.)

Who Do Americans Trust On Health Care Reform?

Gallup asked Americans who they trust to make the right recommendations on health care reform. Guess who came in last. Republicans. Behind insurance companies!


Why don't Americans trust Republicans? Possibly because they continue to peddle lies and scare stories (socialism, socialism!).

Or because the Medicare Advantage program they rammed through during Bush's first term will give insurance companies "an estimated $177 billion in excess payments over 10 years to compete with Medicare - subsidies that Obama would sensibly cut to help pay for health care reform."

Or because Republicans blocked Medicare from negotiating for lower drug prices, blocked importing drugs from Canada or Mexico, and argued that competition would lower prices. How did that work out?

Today, seniors pay 60% more for the same drugs than the price charged veterans because the Veteran's Administration does negotiate lower prices.

Republicans just aren't credible. They had an opportunity to do something good for seniors and they blew it, choosing instead to side with powerful pharmaceutical lobbyists.

Happy Birthday Medicare

What government program is known as one of the most successful social programs in the United States? Medicare. Not only does the program provide essential health care to our seniors and disabled, it does so without putting profits first or excluding people based on their health history. How many private insurance companies can make that claim?

No wonder people across the country are celebrating Medicare's birthday today.

President Lyndon Johnson signed Medicare into law on July 30, 1965, to provide access to quality, affordable health care for older Americans. Since then, Medicare has been a cornerstone of the health and security of America’s seniors. Today, more than 44 million Americans depend on the program for health care benefits.

According to AARP, "before Medicare’s enactment, only half of all older Americans had health insurance. Since that time, poverty among that group has dropped by two-thirds. Medicare has proven critical to the health and economic security of the people it serves."

Unless you live under a rock, you know that Medicare still finds itself under attack from Republicans who seek to privatize the program or reduce benefits. A couple weeks ago, Congress overrode President Bush's veto and passed a bill that stopped pending cuts in payments to doctors who treat Medicare patients. They were supported by the American Medical Association which came down hard on the President and Republicans who supported these cuts. Had they gone into effect, the AMA predicted as many as 60 percent of physicians would have been forced to stop treating new or current Medicare patients.

We can celebrate Medicare's birthday and successes, but we can't let our guard down. It's important that we vote for the candidate who promises to safeguard and strengthen Medicare, and that candidate is not John McCain.

McCain's record speaks for itself. McCain voted to raise the Medicare eligibility age from 65 to 67; he voted against protecting seniors from higher Medicare premiums; and he missed a critical vote to reduce prescription drug costs for seniors.

Obama? He fought against cuts to Medicare and worked to lower prescription drug prices for seniors. He also voted to protect seniors from steep increases in their Medicare Part B premiums, an increase they faced because Congress increased Medicare payments to physicians but failed to enact savings from Medicare payments to private health plans. (S. 1932, Vote 287, 11/3/05)

The choice is simple. Obama doesn't want to place added burdens on our seniors. McCain? It takes a lot of chutzpah for a man who's enjoyed a lifetime of government-run health care to treat our seniors this way.

(Cross-posted at BFM.)

Government can be a force for good

As we consider the fruits of our labor this weekend, most of us will be discussing the growing number of working people without health care. By and large, Americans feel insurance companies are the problem, and a majority of us think the government should provide health insurance for all of us - even if it means raising our taxes.

Canada's health system is often used as an example of the kind of plan we should emulate. Is this a good idea? One Canadian businessman thinks so.

Canadian care costs less, insures all citizens and could help cut U.S. poverty, crime rates

By David Karwacki
The Salt Lake Tribune
08/10/2007

(Editor, Salt Lake Tribune: The writer is addressing the question, “Should the U.S. use Canada as its model for health-care reform?”)

SASKATOON, Saskatchewan - Americans set their sights admirably high by seeking a Jeffersonian guarantee of life, liberty and the pursuit of happiness.

Advances in medical science and technology, especially diagnostics and pharmaceuticals, can certainly help them achieve those goals - if they can afford them. Many millions, unfortunately, find their life, liberty and happiness threatened because of illness and a lack of access to even basic, let alone advanced, medical care.

Access to universal medical coverage was introduced in my province of Saskatchewan in 1962 and was adopted by the federal government to apply to all Canadians in 1964.

Instead of life liberty and the pursuit of happiness, Canada’s constitution stresses “peace, order and good government.” We believe that government can be a force for good and in some areas - public health care being one - and can actually do a better job than private corporate interests.

For more than 40 years Canada’s Medicare has improved the quality of life for tens of millions of people, liberated them from the threat of unaffordable medical bills and made it easier for them to pursue their own definition of happiness.

Our Medicare system isn’t perfect, but then neither is democracy. We don’t think that’s reason enough to get rid of them. Besides, there’s more than just a political “feel-good” reason for embracing universal health care. It’s good for business.

I’m the owner of a company in Canada and another in the United States that distribute fresh produce around the globe. My Canadian company has three corporate advantages over my U.S. company and our U.S. competitors: healthy workers, lower operating costs and better worker safety through social cohesion.

In my experience, healthy workers are more productive because they take less sick time than those who don’t, or can’t afford, to take care of their health. Lack of health-care access is a barrier to preventive care. Those who ignore early symptoms of an illness because their credit cards are maxed-out end up being less productive and may have to leave the work force. Then the employer faces the expense of training replacement workers.

The Organization for Economic Co-operation and Development estimates that total health expenditures in Canada amounted to 9.9 percent of GDP in 2004. In the United States it was 15.3 percent. And even though Americans spend more on health care, their life expectancy is, on average, two years less than Canadians.

Many U.S. companies enjoy a competitive edge in technology because of the R&D of the military industrial complex. In Canada it’s our single-insurer health-care system that provides us with a competitive advantage.

My U.S. company pays, on average, a premium of $9,300 per year for each employee to provide just basic medical insurance. My Canadian firm pays no premium. The costs are paid out of taxes and from resource royalties.

High health-care costs in the United States have been cited as one very big reason for what some people are calling “the outsourcing of America.” Witness the steady decline of the domestic auto-manufacturing sector.

Finally, I would argue that universal health care provides a social cohesion and increases our general security by helping to lift people out of poverty. A healthy population with access to health care is more likely to be productive and beneficial to the community. The rates of violent crime in Canada have yet to reach even a shadow of what is happening in America.

The economic reasons for universal medical coverage are clear. Just as important, however, is what Medicare says about our country and its people. We believe in the principle that everyone should have access to reasonable health care. That way life, liberty and the pursuit of happiness is for all of us - not just those who can afford it [all emphasis added].

Most Americans believe that everyone should have access to health care too, but it won't happen unless we vote for the candidates that see eye-to-eye with us instead of the insurance companies and lobbyists.

Labor unions are on our side. So are Physicians for a National Health Plan, Rep. John Conyers and presidential candidate Dennis Kucinich. They all sponsor HR 676, which would expand Medicare to everyone. Medicare is a government success. It's provides accessible health care to millions of senior and disabled Americans, and about 98% of the money that goes into the Medicare program comes back out as medical services. I call that a good government program, and we all deserve to have that same level of care.

Uninsured Americans Raise Medicare Costs

Here's another reason universal health insurance makes sense:

Uninsured Americans Raise Medicare Expenditures

Americans who weren't insured before they reached age 65 and gained access to Medicare cost the program a lot more than those who did have health insurance, a new study finds.

Data on more than 5,000 older people from a national study found that the previously uninsured needed 13 percent more doctors visits, experienced 20 percent more hospitalizations and had 51 percent higher total medical expenditures after their care began to be covered by the government program.

"Providing health insurance coverage for these adults [before age 65] could not only improve their health but also partially offset the costs of expanding coverage," said Dr. J. Michael McWilliams, a research associate in the Harvard Medical School department of health care policy and lead author of a report in the July 12 New England Journal of Medicine.

The study didn't estimate possible savings, but the chronic conditions that resulted in higher expenditures for the uninsured included high blood pressure, diabetes, heart disease and stroke; conditions that require monitoring and prophylactic treatment to prevent them from worsening, which in turn translates into healthier people with improved quality of life.

IMHO, the money saved is secondary to good health care for all Americans. You can't put a price tag on something like that.

If you want my vote, fix the health care problem

Pollster John Zogby thinks the Iraq war will be the top issue in the 2008 presidential campaign and he's probably right, but my vote will go to the candidate with the best plan to fix health care. Next to the war, it is also the one issue I find my baby boomer friends and I discussing when we get together. We're caught in the middle between our adult children and parents. We worry about our children who don't have employee provided health insurance and the ones who have it and struggle to pay increasingly expensive deductibles and co-pays, not to mention our children who simply don't have insurance at all.

On the other side, we have our elderly parents who find it difficult to pay for prescriptions, home health care or - God forbid - long-term care. One serious medical emergency can wipe out a lifetime of savings and leave our parents destitute. The fortunate ones will have children they can turn to for help. The others will be at the mercy of the overburdened and underfunded Medicaid system they'll be forced to turn to when they become penniless.

I'm speaking from experience here. Several months ago, I told you about my mother who was then in a skilled-care nursing home covered by Medicare and her supplemental insurance plan. She regained her health and was discharged to go back home to live with my sister and brother-in-law. Mom is almost 90-years-old and has had Alzheimer's for nearly a decade, but she moved in with my sister years ago simply because she outlived her money and couldn't afford to live on her own. Her only source of income is social security, and mom was too proud to live in a rent subsidized senior apartment.

Moving in with my sister turned out to be a godsend. We noticed the early symptoms of Alzheimer's sooner than we might have and got mom the help she needed, which included the extremely expensive medication Aricept (one month's supply was more than $350). Over time, however, the disease progressed and it became clear that mom needed someone with her 24 hours a day, so my brother-in-law retired a few years earlier than planned and stayed home to care for my mom.

Out of respect for my mother's modesty, we hired an aide to come in to help her bathe, wash her hair, etc., and that worked out well until my mother became totally incontinent and we needed the aide 5 days a week. My sister and I were splitting the cost of the aide and mom's medications and the expenses were becoming a burden. We eventually turned to Medicaid for help and mom was instantly approved. She is now considered dual-enrolled since she has Medicare and Medicaid, in addition to the prescription program.

How does all of this relate to what I said at the top about voting for the candidate with the best plan to fix health care? Simple, I think Medicare and Medicaid have provided my mother with a level of care that all people should have access to - regardless of age.

That being said, Medicare and Medicaid don't do enough to help families caring for loved ones in their homes. Medicare only covers a home health aide for a short period of time after hospitalization or transition from a rehab facility. Medicaid provides home care assistance, but there's a long waiting list in our area (my mom's been on the list for 18 months). Respite care isn't available either, unless the person is terminal and a doctor certifies the patient has less than 6 months to live.

The government is penny wise and pound foolish when it comes to helping loved ones care for family at home, as we found out firsthand. Overwhelmed by the level of care my mother has needed for years, and the out-of-pocket expense of having to hire aides to deal with her daily hygiene, my sister and I decided last week it was time to put mom in a long-term care facility. It was the hardest thing we ever had to do. We cried and we prayed. We wanted to honor mom's wishes to die at home someday, but we just don't have the strength or the financial means to do so anymore. Instead, mom will soon be going to live in a nursing home that accepts Medicaid.

This is where the government is being foolish. They limit the funds available to provide home health care support, but they'll spend thousands of dollars a year to keep someone in a nursing home. In my mother's case, my sister saved the government thousands of dollars over the years by caring for my mother at home, and we waited for years after my mom exhausted all her resources to apply for help...help that just wasn't enough and didn't come in time. How many other people can't manage to hold on as long as we did?

So, my vote, my sister's vote, my husband's vote, and I'm sure the votes of millions of others will go to the candidate that has a plan to insure all Americans and expand the level of home care available to families taking care of loved ones.

Iraq may be the top issue, but among my friends there's a lot of anger about health care in this country. Our thinking goes something like this: If there are tax dollars available to keep an American presence in Iraq for up to 50 years, then there darn well better be tax dollars to take care of people here at home.

(I've started researching where the candidates stand on this issue and I'll be posting something on it real soon. In the meantime, here's a link that gives more information on Michigan's Medicaid Program.)