It is hard to picture life without Medicare. Imagine not having affordable private health insurance or being denied coverage because of your age or a pre-existing condition, such as cancer. Before President Lyndon Johnson signed Medicare into law in 1965, this often was a reality for many older Americans.
Today, workers pay Medicare taxes throughout their working lives so Americans 65 and older, as well as people living with disabilities, can subscribe to good health insurance coverage. Currently, 288,000 Mainers are covered by Medicare, and there are 315,000 of us between the ages of 50 and 64 who will become eligible for the program over the next 15 years.
For many beneficiaries, the physician relationship is extremely important and one they are concerned will be affected by changes to Medicare. Most Medicare beneficiaries are in traditional Medicare, which allows them to receive care from virtually any licensed health care provider and to receive any covered service that they and their provider consider appropriate. Some beneficiaries do choose a private insurance option.
Americans count on Medicare to help protect their financial and health security as they age. Yet, Medicare faces a number of challenges because of rising health care costs and changing demographics. We believe there is a right way — and a wrong way — to strengthen Medicare for current and future generations.
Under consideration in Washington is a proposal to shift more costs to seniors, especially those who can least afford to absorb additional expenses. A voucher system — or “premium support” as some in Washington call it — would hurt hardworking Americans who have paid for Medicare their entire working lives. Such a system would hit those near retirement and those with lower incomes the hardest.
A voucher system would replace Medicare’s current guaranteed benefits with a risky alternative: The federal government would substitute Medicare’s guaranteed benefits package with a fixed dollar amount or “defined contribution” that beneficiaries would apply toward their health coverage. Each Medicare beneficiary’s premium would be the difference between this defined contribution (voucher value) and the cost of the insurance plan he or she chose. If the fixed dollar amount turned out to be insufficient to cover necessary health care costs, the beneficiary would have to spend their savings or ignore their medical concerns.
We believe there is a better way. We can stabilize Medicare for future generations and keep the promise we’ve made to seniors with common-sense ideas that will improve care, reduce costs and find real savings.
One way to reduce costs is to allow Medicare to negotiate lower drug prices. Unlike other programs and private insurance plans, Medicare is prohibited from negotiating with pharmaceutical companies for lower drug costs. Allowing Medicare to use the bargaining power of its 55 million beneficiaries nationwide to negotiate lower prescription drug prices, particularly for high-priced brand name drugs, will save money for seniors and reduce the cost of health care.
Medicare also needs to improve its coordination of care. By creating systems that better connect doctors and health care facilities and make better use of information technology, we can ensure patients receive safer, better care. There is agreement among Maine physicians that the improvement of health care quality and cost transparency will result in a better patient experience for Mainers of all ages. More care coordination also will reduce medical errors, help prevent hospital readmissions and ensure patients are getting recommended care.
Finally, we must crack down on waste and fraud in Medicare such as improper institutional billing and fraudulent claims from patients. Fraud costs Medicare approximately $60 billion each year. We can improve payment systems and technology to enable Medicare to stop fraudulent claims before they are paid.
For more than 50 years, Medicare has provided health and financial security to millions of Americans. Unfortunately, the proposed voucher system would severely compromise that security, while failing to take advantage of a number of opportunities for very significant savings.
Maine’s congressional representatives are back in the state during the congressional recess. Those concerned about protecting Medicare should contact their offices and make their voices heard. Our elected leaders owe it to all of us to keep Medicare strong for today’s seniors and for generations to come.
Charles Pattavina is the president of the Maine Medical Association. Lori K. Parham is the director of AARP Maine.