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PostPosted: 31 Mar 2010, 18:42 
WASHINGTON – Seniors aren't breaking out the champagne for President Barack Obama's health care law, and for good reason. While Democrats hail the overhaul as their greatest health care achievement since Medicare, seniors fear it's a raid on that same giant health care program — a bedrock of retirement security — in order to pay for covering younger, uninsured workers and their families.

There's no doubt that broad cuts in projected Medicare payments to insurance plans, hospitals, nursing homes and other service providers will sting. What hasn't sunk in yet is that the new law also improves the lot of many Medicare beneficiaries. Obama is hoping that most will eventually conclude the plusses outweigh the minuses.

Keenly aware that this is a congressional election year, Democrats structured the law so virtually all the cuts start next year and take effect only gradually. For this year, the law provides a sweetener. More than 3 million seniors who have been falling into a Medicare prescription coverage gap will get a $250 rebate, a down payment on closing the "doughnut hole."

Nonetheless, seniors are anxious.

"I'm afraid from the little I've heard that it's not good for seniors," said Muriel Couzon, 86, a retired supervisory social worker from New York City. A Democrat, Couzon says the legislation could affect her vote this fall: "I have to see what it will do to me and other seniors like me."

It's going to take a while before the verdict is in. Change will come slowly to Medicare, which covers 46 million seniors and disabled people. There will be winners and losers:

_Gross cuts in projected payments to insurers, hospitals and other providers total $533 billion over 10 years, according to a preliminary analysis by the Kaiser Family Foundation. About $100 billion will be plowed back into Medicare, leaving a net cut of $428 billion. Medicare spending will continue to grow under the law, just not as fast. The reductions are smaller (about 6 percent) than Democratic President Bill Clinton and a Republican Congress came up with in 1997 (12 percent). Still, they're deep enough that some experts believe a future Congress will reconsider them.

_The law strengthens traditional Medicare, which covers about three-fourths of seniors, by improving preventive care and increasing payments to frontline primary care doctors and nurses serving as medical coordinators. But it gradually reduces generous government subsidies to private insurance plans, Medicare alternatives that have lately gained popularity. That could lead to an exodus from the private plans.

_The most significant new benefit — closing Medicare's prescription coverage gap — won't be fully phased in until 2020. That's a long time if you're old and frail. The coverage gap starts after the first $2,830 spent on medications in a year. Seniors then pay entirely out of their pocket until they have spent $4,550, when the government starts picking up 95 percent of the tab. After the rebate this year, seniors in the gap will get a 50 percent discount on brand name drugs in 2011, and a smaller break on generics. The discounts gradually ramp up until the "doughnut hole" is closed.

_One change has received little attention but could have major consequences. The law authorizes a variety of experiments to provide better care for seniors struggling with multiple chronic illnesses — about half the program's beneficiaries. Prominent voices in the medical community have been clamoring for the government to use Medicare as a laboratory for change. If the approach succeeds, fewer people may end up in the hospital for bad drug reactions and other common problems.

"It's going to be very important for Medicare beneficiaries to understand that on the whole, this is not the disaster some people have painted it to be," said health economist Marilyn Moon, who as a former Medicare trustee helped oversee program finances from 1995 through 2000. "It is a bit of a mixed bag, but I think on balance it is going to put the program in a better position, over a long period of time."

Her one major caveat: Many seniors in private insurance plans under Medicare Advantage will face higher premiums and reduced benefits as subsidies are scaled back over three to six years to bring the private plans' costs in line with those of traditional Medicare.

"Beneficiaries will notice that, and they're going to be unhappy because it's a takeaway," said Moon, who directs the health care program at the American Institutes for Research.

Government payments to the private plans — about 10 percent richer than per-person spending for traditional Medicare — have enabled them to offer comprehensive coverage for less. Seniors flocked to sign up, boosting enrollment to about one quarter of all Medicare beneficiaries.

The same cuts will benefit seniors in traditional Medicare, who have been paying higher monthly premiums to support the government's generosity. There's also a potential silver lining for private plans. The law allows them to earn bonus payments for high quality.

Such nuances got lost in an emotional debate that veered off into "death panels" and "pulling the plug on grandma." Nothing that drastic was ever in the bill. Still, Republicans accuse Obama of slashing Medicare, and polls show the message has stuck.

An Associated Press-GfK survey in March found that 54 percent of seniors opposed the legislation then taking final shape in Congress, compared with 36 percent of people age 18-50.

"We've got an education job to do with seniors," said Sen. Chris Dodd, D-Conn. "I think they are probably the least open to seeing the benefits."

AARP and other major organizations representing seniors supported the law, despite the polls. Now they're planning a sustained outreach campaign to call attention to the legislation's benefits. It might not be an easy sale.
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Wasser Sat Mar 20, 2010 12:50 pm PDT Report Abuse

America's health care industry and interest groups have spent over $800 million in recent months influencing health care legislation through lobbying, advertising and in direct political contributions to members of Congress. They hire people to post on Yahoo 24/7 around the clock. They have thrown their money behind the populist right wing backlash against Obama's health care reform and have created fears in the public, exactly like the way as they have done before for previous administrations.

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Doctors are extremely overcharging the medicare assistance programs, making it near impossible for patients to pay the share of cost, I should know, I am one of those patients.

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Jimmie Sat Mar 20, 2010 12:55 pm PDT Report Abuse

North Korea has the only answer for this guy.

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Happy Quilter
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Happy Quilter Sat Mar 20, 2010 12:55 pm PDT Report Abuse

We've already seen some changes coming down the pike. Our Medicare Complete co-pays for 2010 have jumped to $30 to see your PCP (primary care physician), $40 copay to see a specialist (neurology, pulmonary, cardiologist). No they are not paying the physicians more, we are. I'd like to hear from those of you on SSD (social security disablity) (not SSI) and how your visits are handled. I went in for a pacemaker check, the fee was $75, Medicare paid $35, leaving me a balance of $40. I thought this was an HMO..... it's more like a screw you! What is happening here?

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MichaelS Sat Mar 20, 2010 12:58 pm PDT Report Abuse

I copied this, I wish I had wrote it.

1. Americans spend $36,000,000 at Wal-Mart Every hour of every day.
2.. This works out to $20,928 profit every minute!
3. Wal-Mart will sell more from January 1 to St. Patrick's Day (March 17th) than Target sells all year.
4. Wal-Mart is bigger than Home Depot + Kroger + Target + Sears + Costco + K-Mart combined.
5. Wal-Mart employs 1.6 million people and is the largest private Employer, and most speak English.
6. Wal-Mart is the largest company in the history of the World.
7. Wal-Mart now sells more food than Kroger & Safeway combined, and keep in mind they did this in only 15 years.
8. During this same period, 31 supermarket chains sought bankruptcy.
9. Wal-Mart now sells more food than any other store in the world.
10. Wal-Mart has approx 3,900 stores in the USA of which 1,906 are Super Centers; this is 1,000 more than it had 5 Years ago.
11. This year 7.2 billion different purchasing experiences will occur At a Wal-Mart store. (Earth's population is approximately 6.5 Billion.)
12. 90% of all Americans live within 15 miles of a Wal-Mart.

MAYBE we should hire the guys who run Wal-Mart to Fix the economy.
This should be read and understood by all Americans Democrats, Republicans, EVERYONE!!

To President Obama and all 535 voting members of the Legislature,
It is now official you are ALL corrupt morons:

1. The U.S. Post Service was established in 1775. You have had 234 years to get it right and it is becoming more unsustainable by the day.

2. Social Security was established in 1935. You have had 74 years to get it right and it is bankrupt.

3. Fannie Mae was established in 1938. You have had 71 years to get it right. It is bankrupt and now has an unlimited line of credit from the Fed.

4. The War on Poverty started in 1964. You have had 45 years to get it right; $1 trillion of our money is confiscated each year and transferred to "the poor" and they only want more.

5. Medicare and Medicaid were established in 1965. You have had 44 years to get it right and they are bankrupt.

6. Freddie Mac was established in 1970. You have had 39 years to get it right. It is bankrupt and now has an unlimited credit line from the Fed.

7. The Department of Energy was created in 1977 to lessen our dependence on foreign oil. It has ballooned to 16,000 employees with a budget of $24 billion a year and we import more oil than ever before. You had 32 years to get it right and it is an abysmal failure.

You have FAILED in every "government service" you have shoved down our throats while overspending our tax dollars AND YOU WANT AMERICANS TO BELIEVE YOU CAN BE TRUSTED WITH A GOVERNMENT-RUN HEALTH CARE SYSTEM??

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Annoyed Sat Mar 20, 2010 01:01 pm PDT Report Abuse

Dear Mr. President:
During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ringtone.
While glancing over her patient chart, I happened to notice that her payer status was listed as "Medicaid"! During my examination of her, the patient informed me that she smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and beer.
And, you and our Congress expect me to pay for this woman's health care? I contend that our nation's "health care crisis" is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a "crisis of culture", a culture in which it is perfectly acceptable to spend money on luxuries and vices while refusing to take care of one's self or, heaven forbid, purchase health insurance. It is a culture based in the irresponsible credo that "I can do whatever I want to because someone else will always take care of me".
Once you fix this "culture crisis" that rewards irresponsibility and dependency, you'll be amazed at how quickly our nation's health care difficulties will disappear.

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Patricia Sat Mar 20, 2010 01:02 pm PDT Report Abuse

I'm on disiability i go everythree weeks to have injection in my back that doctor told me as of april 1st she will no londer take medicare and if i want to keep coming it would be three hundred out of my pocket.Hello government im on disability like i have that king of money laying around.

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Desktop Insurance
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Desktop Insurance Sat Mar 20, 2010 01:02 pm PDT Report Abuse

I think doctors could be compensated in other ways such as tax credits instead of giving them more money. Really doctors work for the people they should be part of government instead of being considered part of the general population their immediate family should be receiving government subsidies. That's all the doctors who can prescribe medication. With that we probably would'nt need health insurance as we know it.

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Carl Sat Mar 20, 2010 01:03 pm PDT Report Abuse

Democrat= self centered, self rigthous idiot. Time for the revolution, we the people need to take back this country while it can still be caved. We have put our faith in professionl politicians and what have we gotten for it screwed. Big business, Special interests, Big BAnks, Big Oil all have screwed us over in the name of there god GREED. Nancy Pelosi and her welfare liberal elitists need to just up and die and rid trhe world of this plague.

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