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Poughkeepsie Journal - The primary focus of any health care legislation before Congress this year is to insure the nearly 46 million Americans with no coverage, to improve coverage for those who already have some form of insurance, and to reduce the skyrocketing cost of health care. It's also an important opportunity to strengthen Medicare, the health insurance program already used by 45 million seniors and disabled Americans. For more than four decades, Medicare has provided quality health care for those members of our population who need it most while serving as a remarkable example of the good that government can do for our people. It's also been cost-effective: approximately 5 percent of Medicare spending is devoted to administrative fees while private insurance companies spend up to 30 percent of their budget on administrative, advertising, and overheard expenses.
Medicare beneficiaries receive coverage to see doctors, undergo surgeries, receive prescription drugs, and get many of the benefits offered by traditional health care plans at a lower cost. However, as we're seeing with the entire health care system and as the result of more Baby Boomers turning 65, costs continue to rise and benefits are not as thorough as they should be. Far from hurting Medicare, as some have suggested, the pending health reform bill takes several steps to expand benefits and prevent the insolvency of the program in the future. The current health care reform legislation pending before the House provides us with the right vehicle through which to enact positive reform that will strengthen Medicare by enhancing benefits, improving care and access to doctors, and containing costs.
Seniors should take comfort in knowing that this bill would take important steps to ensure that they can continue to see the doctors they like and gain access to more choices of doctors. The House health care bill eliminates the 21 percent Medicare reimbursement cut for doctors that was scheduled to go into effect, ensuring that these doctors will remain Medicare providers. Without reform, 40 percent of doctors said they would reduce the number of Medicare patients they treat. Additionally, the bill seeks to reverse the shortage of well-trained doctors in the country by providing new scholarships, loans, and loan repayment assistance to help recruit qualified people into the medical field.
The bill also tackles the rising costs of prescription drugs. Each year, approximately 165,000 seniors in New York, including 7,200 seniors living in the congressional district I represent, enter what is known as the donut hole -- a gap in prescription drug coverage that forces Medicare Part D enrollees to pay 100 percent of the cost for drugs once they exceed $2,700 in annual drug costs. Beneficiaries must spend $3,454 in out-of-pocket expenses, on top of their monthly premiums, before the donut hole closes and they can begin receiving drug coverage again. The proposed health care bill in the House would provide seniors with immediate relief by shrinking the donut hole so that prescription drug coverage resumes earlier, saving many seniors $500 in 2011. The measure then continues to further shrink the donut hole, ultimately eliminating it altogether several years down the line. Further, seniors who fall into the donut hole during this transition period would receive brand name drugs at a 50 percent discount in order to help ease the burden. This provision has the potential to save seniors thousands of dollars in extra costs they are forced to pay each year for prescription drugs they need.
Also included in the House bill is a provision that would finally grant the government the authority to negotiate with pharmaceutical companies for discounts on drugs that are being bought in bulk for the Medicare Part D program. The legislation that established the drug benefit program several years ago explicitly prohibited any such negotiations. As a result, it's enabled drug companies to take advantage of seniors and run up prices without any restraint. This bill would put the government on the side of seniors, instead of the drug industry by enabling the government to negotiate for better prices.
Importantly, the health care bill also focuses on saving costs through preventative care. Currently, under
Medicare, seniors must make a copayment in order to get a physical exam or screening if they believe they have an illness or a serious medical condition such as cancer. Preventative care is the last thing we should be charging seniors for because it deters people from getting screened. The health care bill in the House eliminates this copayment. If we can detect cancer and other diseases early on through preventative screenings, then not only are we better positioned to save lives but we will also save everyone significant long-term treatment costs.
By taking these worthwhile steps, the health care reform bill before the House will improve the quality of care for seniors and disabled Americans, save lives, and save money for all taxpayers.
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