Are Republicans Wrecking SeniorCare?

Blue America has endorsed 4 progressive doctors this cycle, Lee Rogers (CA-25), Syed Taj (MI-11), David Gill (IL-13) and Matt Heiz (D-AZ). The first 3 won their primaries and will face anti-health care Republicans in November. Matt still has a primary, August 28, against ConservaDem Ron Barber. All 4 doctors were motivated to run for Congress in no small part because of issues around health care. Lee Rogers explains:

Medicare was started in 1965 because seniors were not able to obtain affordable coverage in the private market. Seniors, and the disabled who qualify for Medicare, are generally sicker and higher risk than the younger population who are able to obtain insurance coverage through employers. Insurance companies, which typically use risk to calculate premiums, had priced seniors out of the market.

The Ryan budget proposal, which passed the House in April 2011, is not the answer to our budget problems. It would force our 50 million Medicare beneficiaries into the private insurance market again, at the mercy of big insurance companies. The nonpartisan Congressional Budget Office estimated that seniors will have to spend an additional $6,000 per year under this plan. This is simply not affordable because half of our seniors live on less than $18,000 per year.

In my practice, 75% of my patients are on Medicare. I see their struggles every day. Irresponsible spending in Washington now threatens the viability of Medicare. We can’t let Medicare funding lose out to war spending, corporate tax breaks or subsidies for the wealthiest corporations.

As a doctor, I help my patients navigate through our complex health system to get the best care possible. But in most cases, patients encounter difficulty from lack of understanding or find certain health products and services unavailable or uncovered.

Our health care crisis cannot be separated from our fiscal crisis. We continue to spend more on healthcare and receive less. We need reforms that matter. Reforms that actually improve the quality of care and lead to lower costs.

Chronic diseases, like diabetes, obesity, and cardiovascular disease are costing us billions of dollars every year. Not only are these diseases expensive, but their complications are as well. For the most part, these are preventable diseases. If we change our health care practices to focus on education and prevention, rather than treating diseases once they develop, we can simultaneously improve our health and save money.

Even before right-wing extremists forced Romney into naming Paul Ryan as his running-mate, and thereby embracing Ryan's plan to kill off Medicare and privatize Social Security, we asked public health care expert Maricel Anderson to help us understand how conservative policies toward healthcare management have exacerbated the problems of today’s geriatric care. While this may lead to more jobs in healthcare management, it doesn’t bode well for America’s seniors. Maricel breaks down Democrats’ and Republicans’ approaches to healthcare and geriatric care.

Conservative Healthcare Management Created a Gap in Geriatric Care

-by Marciel Anderson

How to best care for elders is a question that was as relevant to the ancient Egyptians and Romans as it is today. Rather than burial rites or succession lines, however, much of the modern debate centers on health care-- or more specifically, who will pay for the healthcare needs of society’s most aged.  

The United State’s answer in recent decades has been the Medicare and Social Security programs. These programs were designed in a very different era, however. Advances in medical science and general preventive health mean that Americans are commonly living until their 80s or 90s, drawing on resources for years longer than previously expected.

Recent Republican health care changes and proposals have worsened what is already a geriatric healthcare crisis. Unless something changes soon, the future could be bleak-- if not outright bankrupting-- for our elders and their families.

The Republican health care “solution” did not seem so problematic at the start. In 2010, when the party took control of the House, one of its main rallying cries was the protection of geriatric care. They lambasted the Obama administration for proposing a health care reform law, known colloquially as “Obamacare,” that would have, they claimed, cut $500 million from the Medicare program before 2020. On closer inspection, their solution was seen by many as an even further slide into dangerous waters, however.

“Nearly every House Republican, led by Budget Chairman Paul Ryan of Wisconsin, voted for a plan last year that built on the health care law’s $500 billion in spending reductions and went much further,” the advocacy organization Seniors Network reported in 2011. “The plan would have eventually abolished traditional fee-for-service Medicare for those currently 55 and younger, and replaced it with a premium support system that would limit federal spending.”

The plan was not taken up by the Senate, and did not ultimately upset the Obama administration’s proposal. Still, the movement caused enough of a backlash to significantly stall things, and has only served to widen the gap between seniors and affordable, effective health care. Talk of premiums and privatization is still rampant within the Republican Congress, too.

Part of the problem, of course, is that there are far more seniors today than the current system is designed to serve. Modern living expenses-- the average U.S. nursing home, for instance, costs $72,000 per year by some estimates-- and increasingly costly medical needs, like heart disease treatment and diabetes care, have meant that the health requirements of many elders far exceed the allotments they receive from Medicare.

While it is not quite fair to assign complete blame for the crisis at the feet of Republican lawmakers, party leaders have made significant missteps that have made the problem far worse than it has to be.

Cuts in prescription plan coverage for Medicare recipients, pension plan reductions, and health insurance reforms focused on the middle-aged, many of which were covertly passed during the Bush years, have slowly corroded the system from the inside out. A number of policy mismanagement issues have also come to light, particularly as relates to the processing of Medicare claims for those in the “Baby Boomer” generations. To make matters worse, some Republican members of Congress seem to think that cutting down on care for the elderly is not only justifiable economically, but is also morally defensible-- and are not shy about saying so.

“You want the government to take care of you, because your employer decided not to take care of you. My question is, ‘When do I decide I'm going to take care of me?,’” Georgia Representative Rob Woodhall famously quipped at a town hall he sponsored in a rural town in his constituency. “Folks, if you give people things for free, don't blame them for taking them.”

Democrats hold firmly to the alternative view. “‘Obamacare was called ‘socialist’ by the Republicans because uninsured individuals and small business would be allowed to purchase private insurance through an exchange regulated by the government,” Oregon representative Peter DeFazio explains on his website.  “Ironically, the Republican leaders’ privatization plan forces future seniors and disabled out of Medicare and requires them to purchase insurance plans approved by the government,” DeFazio said. The premiums on most of these plans are likely to be astronomical, DeFazio said, and for most, completely unaffordable. “Medicare is not the problem and privatizing it solves nothing. Our nation would be a lot healthier if ideologies were set aside and we focused on the real flaws in our health care system,” DeFazio said.

The swelling debate over how to patch the holes in the Medicare system, remedy the problems introduced and continually proposed by Republicans in Congress, and provide robust healthcare for all is not likely to be settled anytime soon. Geriatric health coverage is likely to be a major point of contention in the coming 2012 presidential election, in fact. More seniors than ever before are on the voting rolls, and their families-- many of whom are already providing significant care and financial support-- are likely to take a renewed interest, as well. There are no easy solutions, but focusing, as DeFazio emphasized, on the main issues rather than shortsightedly taking the ax to ancillary costs is likely the best way forward.