Seniors are wary of health care reform

Senior citizens are emerging as a formidable obstacle to President Barack Obama's health care reform plans.

Discontent has risen to such a level the administration is scrambling to devise a strategy to woo the elderly.

Obama's task will not be easy. Proposals to take more than $500 billion out of Medicare's growth in the next decade have fueled fears his effort to expand coverage to millions of younger, uninsured people will damage elder care.

"People have gotten more and more worried," said Nancy LeaMond, a vice president at AARP, which will unveil a pro-reform TV and print ad campaign today. "They are very concerned about the myths they keep hearing that care will be rationed and they won't have access to doctors."

A mailing by 60 Plus Association, which calls itself a "conservative alternative to AARP," warns the proposed Medicare changes will mean "longer wait times at hospitals and doctors offices, less money for new treatments, restrictions on care, prescriptions and what's best for you - the patient!"

Conservative talk-radio shows have raised the prospect of euthanasia based on a provision to reimburse doctors through Medicare for counseling sessions about end-of-life directives.

The legislation approved by three House committees trims $563 billion out of Medicare's growth rate during the next 10 years while pumping in about $320 billion.

Three retiree groups and several independent policy analysts say most of the proposed savings affect providers, rather than beneficiaries, and have the potential to improve quality over the long term. Discounts for prescription drugs, higher reimbursements for many doctors and elimination of co-payments for preventive services are some of the ideas advocates applauded.

"I don't see anything that will affect beneficiaries' access to care, though some of it will depend on implementation," said Joseph Baker, president of the Medicare Rights Center, a nonprofit group focused on older Americans.

Diane Rowland, executive vice president of the nonprofit Kaiser Family Foundation, said the House legislation does not "address all of the issues in Medicare that seniors would like to see addressed," including money for long-term care. But discounts on prescription drugs and provisions that would extend the Medicare Trust Fund for at least five years are "an attempt to reassure" them.

Under the bills, insurance companies selling managed-care plans known as Medicare Advantage would take the largest hit. The independent Medicare Payment Advisory Commission has recommended reducing payments under Medicare Advantage, noting insurance plans touted as more efficient should not cost 14 percent more than traditional fee-for-service Medicare policy.

MEDICARE CHANGES

Comprehensive health care legislation approved by three House committees include changes to the Medicare program for 45 million elderly and disabled people. The bills:

•Extend the life of the Medicare Trust Fund by five years.

•Waive all co-payments on preventive services.

•Provide 50 percent discounts on brand-name prescriptions in the coverage gap known as the "doughnut hole." Eliminate the gap entirely within 12 years.

•Eliminate 14 percent in "overpayments" to Medicare Advantage plans over 10-year period; pay $10 billion in bonuses to high-quality plans.

•Increase reimbursements to primary-care doctors, general practitioners and psychiatrists by 5 percent.

•Reduce payments to skilled-nursing homes and rehabilitation centers by $15 billion over the next decade.

•Pay medical professionals for counseling patients about end-of-life options.

•Reduce payments to providers that have patients with high hospital readmission rates.

•Grant biologic therapies 12 to 14 years of market protection before a generic version can seek Food and Drug Administration approval.

•Cancel a proposed 21 percent cut in physician reimbursements, estimated to cost $228 billion over 10 years.

Sources: Congressional Budget Office, House Ways and Means Committee, Kaiser Family Foundation