Why are seniors opposed to health care reform?

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Forums > All Posts > Why are seniors opposed to health care reform?

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2010-03-28 10:31 AM

Magpie
Denver, CO
Posts: 5

In the Gallup Poll of March 24th, most groups are supportive or only slightly unsupportive of the new health care legislation. However, the one group that sticks out by their opposition is seniors. By a margin of 36 to 54 they are solidly against it.

In looking at the breakdown of the numbers as presented by Gallup, this opposition doesn't make much sense. The two parts of Medicare that might possibly affect seniors negatively are Medicare Part C or Medicare Advantage, the private insurance part subsidized heavily by the government, and Medicare Part B for those earning more than $85,000 a year. However, both of these provisions would largely affect only the wealthiest of Medicare recipients. Everyone on Part B, and Part D would benefit from the closure of the Prescription Drug donut hole, and everyone on Part B would benefit from free preventive services. No one on Parts A or B would have any of their benefits cut, and these two groups represent the vast majority of Medicare recipients.

The poll shows that people making over $90,000 a year are also supportive of the new law by a 49-46 margin. So if there are lots of seniors in the upper income levels that worry about higher premiums for Part B or Part C, it is not reflected in the polls...and certainly would not account for the wide margin of seniors against the new legislation.

So why indeed are seniors opposed so strongly? Is it the false "throw gandma under the bus" and "death panels" rhetoric that still persists today? Or is it the Republican talking point repeated over and over again in the right wing media that the bill cuts billions out of Medicare to pay for other parts. Those "billions" are the unjustified payments in Medicare Part C to health insurance companies...almost an "earmark" if you like that term.

Obama and the Democrats and AARP need to do a better job of educating seniors. Once seniors understand, there is no reason for them to oppose the new law. It is very difficult to change people's minds once they have formulated a negative opinion. Republicans were first out the door with their false message to seniors and as false as that message is and was, it has stuck.

2010-03-28 09:22 PM

Listening
Lenexa, KS
Posts: 49

Magpie Wrote: In the Gallup Poll of March 24th, most groups are supportive or only slightly unsupportive of the new health care legislation. However, the one group that sticks out by their opposition is seniors. By a margin of 36 to 54 they are solidly against it.

In looking at the breakdown of the numbers as presented by Gallup, this opposition doesn't make much sense. The two parts of Medicare that might possibly affect seniors negatively are Medicare Part C or Medicare Advantage, the private insurance part subsidized heavily by the government, and Medicare Part B for those earning more than $85,000 a year. However, both of these provisions would largely affect only the wealthiest of Medicare recipients. Everyone on Part B, and Part D would benefit from the closure of the Prescription Drug donut hole, and everyone on Part B would benefit from free preventive services. No one on Parts A or B would have any of their benefits cut, and these two groups represent the vast majority of Medicare recipients.

The poll shows that people making over $90,000 a year are also supportive of the new law by a 49-46 margin. So if there are lots of seniors in the upper income levels that worry about higher premiums for Part B or Part C, it is not reflected in the polls...and certainly would not account for the wide margin of seniors against the new legislation.

So why indeed are seniors opposed so strongly? Is it the false "throw gandma under the bus" and "death panels" rhetoric that still persists today? Or is it the Republican talking point repeated over and over again in the right wing media that the bill cuts billions out of Medicare to pay for other parts. Those "billions" are the unjustified payments in Medicare Part C to health insurance companies...almost an "earmark" if you like that term.

Obama and the Democrats and AARP need to do a better job of educating seniors. Once seniors understand, there is no reason for them to oppose the new law. It is very difficult to change people's minds once they have formulated a negative opinion. Republicans were first out the door with their false message to seniors and as false as that message is and was, it has stuck.

I would suggest that before calling something a false message you prove that it is false.

The "billions" you refer to are 500 billion over 10 years. That is a lot of cuts that supposedly will be found by cutting out waste and inefficiency.

However, if this all going to the insurance companies, I have a couple of questions (and I certainly don't claim to know the entire context of the debate, so rebuttals are welcome if they improve my knowledge).

First, this comes from June 2009....

As Congress debates how to rein in cost and at the same time improve quality in the nation's health care system, top executives from nine health provider organizations Friday endorsed a set of ideas tied to coordinated care for patients that they predicted could save the Medicare system some $500 to $600 billion in 10 years.

"We will not control health care costs until we create clear incentives for providers — the people who deliver care — to focus on quality and efficiency," the CEOs, many of them from the West Coast, said in a report produced by the non-profit New America Foundation.

At a forum organized by the foundation, the CEOs said that the traditional fee-for-service Medicare system is unsustainable and that providers should be held accountable by Medicare for reasonable cost and quality standards by a specified date. Because Medicare drives so much of what goes on in the rest of the health system, change should start there and in Medicaid to the degree possible in that program, they said.

They also declared that Medicare should begin the transition toward bundled payment models, encourage accountable organizations that accept full responsibility for high-quality patient care and efficient performance, make payments contingent on compliance with strict quality standards and eliminate the Sustainable Growth Rate (SGR) for determining physician payments. The SGR is a mechanism devised by Congress in 1997 to keep a lid on the growth of such payments in comparison with the growth of the economy overall.

Next, I watched a hit piece on CNN where the top insurance company made a whopping 3.2 billion (said somewhat in sarcasm, I obviously would not mind it someone gave that amount....but that is the top company....and in this discussion 3.2 billion is inside the margin of error of a lot of calculations. So, If I assume that this company has 5 to 10% of the market share, that means that total profits are less than 50 billon a year. Are you saying that Obama is essentially going to save that money by taking away all their profits (which they only get because of this money you are saying they don't deserve) ?

Then there is the question of how we suddenly expect to find 50 billion a year in savings ? I mean, if Barrack Obama knows it exist, WHY HAS IT NOT BEEN FIXED YET ? Or has it. How long has it beeng going on and doesn't 50 billion seem like there is a chance of fraud somewhere ? Are we going after people. That number is simply beyond my comprehension.

Finally, you have the issue as highlited by this recent occurance:

http://hotair.com/archives/2010/01/04/mayo-clinic-dropping-medicare-patients/

Barack Obama hailed the Mayo Clinic system as a model for health-care reform last summer — until Mayo opposed ObamaCare as a reform solution. They warned at the time that the bill passing through Congress would make Medicare and Medicaid reimbursements too low to pay for the costs of service and that providers would stop treating patients in those systems. Last week, that became a self-fulfilling prophecy of sorts:
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman. The decision, which Yardley called a two-year pilot project, won’t affect other Mayo facilities in Arizona, Florida and Minnesota.

Obama in June cited the nonprofit Rochester, Minnesota-based Mayo Clinic and the Cleveland Clinic in Ohio for offering “the highest quality care at costs well below the national norm.” Mayo’s move to drop Medicare patients may be copied by family doctors, some of whom have stopped accepting new patients from the program, said Lori Heim, president of the American Academy of Family Physicians, in a telephone interview yesterday.
“Many physicians have said, ‘I simply cannot afford to keep taking care of Medicare patients,’” said Heim, a family doctor who practices in Laurinburg, North Carolina. “If you truly know your business costs and you are losing money, it doesn’t make sense to do more of it.”

How bad has it gotten for Mayo? The clinics in question lost $120 million on treating Medicare patients. The Mayo system overall lost close to a billion dollars the year before, dropping $840 million on patients from government-funded treatment plans.

Overall, Bloomberg reports that providers receive 20% less from Medicare than from private insurers. Part of that disparity comes from charging higher rates to patients whose insurance will cover services in order to cover their losses — and to patients who pay cash. The dirty little secret in the health-care industry is that these insurance companies subsidize Medicare through these cost transfers, which allow providers to remain in business but which amount to a hidden tax on everyone who buys private insurance.

One cannot expand Medicare while cutting payments to providers and expect that services will not be degraded and benefits curtailed. Providers will start opting out of the system altogether, as Mayo will do in Arizona and as they are contemplating doing altogether. A decreasing availability of providers for Medicare and Medicaid will mean fewer resources, longer waiting times, and poorer health care for people covered by those plans.

**************************************

I have not heard much since this article came out. I have read lot's of repeats, and no real rebuttals to this so if it incorrect I would like to know about it.

If it is correct, it says that medicare isn't paying enough as it is. At best, this 500 billion in saving gives you no less care....so if you can't get it now and that is the best you can hope for, I am not sure how you can expect this not have a negative impace.

Seniors are generally in a situation where they have set themselves up on a glidepath. They can't do much if someone starts shooting at them. I suspect that is why they are most afraid of changes.

2010-03-29 01:09 AM

Zach F
Denton, TX
Posts: 941

None of the Mayo Clinic's primary care facilities have stopped accepting medicare patients. According to a press release from the Mayo Clinic, they are searching for options to stimy the massive losses they are encoutering each year and one family practice associated with the Mayo Clinic will stop accepting Medicare patients during a trial period.

Source: http://healthpolicyblog.mayoclinic.org/2010/01/05/medicare-and-mayo-clinic-in-arizona

The Mayo Clinic still favors reform and this trial period is not a response to the recent bill in any way.

I'm not familar enough with Medicare to comment on it, but the Mayo Clinic does a lot of non-profit work and I do not see them cutting off Medicare patients at primary care facilities anytime soon.

2010-03-29 05:47 AM

Listening
Lenexa, KS
Posts: 49

Zach F Wrote: None of the Mayo Clinic's primary care facilities have stopped accepting medicare patients. According to a press release from the Mayo Clinic, they are searching for options to stimy the massive losses they are encoutering each year and one family practice associated with the Mayo Clinic will stop accepting Medicare patients during a trial period.

Source: http://healthpolicyblog.mayoclinic.org/2010/01/05/medicare-and-mayo-clinic-in-arizona

The Mayo Clinic still favors reform and this trial period is not a response to the recent bill in any way.

I'm not familar enough with Medicare to comment on it, but the Mayo Clinic does a lot of non-profit work and I do not see them cutting off Medicare patients at primary care facilities anytime soon.

Frank,

Thanks for the link.

As a point of reference:

The assertion is being made that seniors are being scared into fighting against the health care bill.

I have already stated that I don't agree with the things the the GOP or the dems are doing to win the battle. Both sides are lying.

But what I put forth is an argument that seniors have a real reason to be concerned. In other words, there is reason for them to be concerned. Your link does nothing to to assauge that fact.

From the link:

Some recent media reports have inaccurately stated that Mayo Clinic in Arizona is no longer seeing any Medicare patients. This is not true.

Rather, a five-physician Mayo Clinic Arizona family practice clinic in Glendale, Ariz., has opted out of Medicare as part of a Mayo Clinic time-limited trial that will be reviewed at its conclusion. This means that Medicare will no longer reimburse Mayo Clinic for primary care services at this specific primary care facility, not at Mayo Clinic in Arizona overall. This affects only primary care office visits for the five Mayo family practice physicians at this site. Specialty care, laboratory services, imaging studies and ancillary services at Mayo Clinic are still covered by Medicare. Current Medicare patients may continue receiving primary care at the Glendale clinic but will be required to pay out-of-pocket for office visits.

***********************************

While I took this off of hotair...it is all over the place on the net and seems that this information should have been included. I don't know if this office is the basis for saying 3,000 (and Phoenix, my native hometown certainly has more than 3,000 seniors) people are being dropped from medicare coverage.

But the link does say what the original article says...they have to pay out of pocket for office visits.

But, the link also reenforces the point:

Mayo Clinic loses a substantial amount of money every year due to the reimbursement schedule under Medicare. The discrepancy between what Medicare pays and our cost of providing services is particularly acute for our clinics that provide primary care. Due to these ongoing financial challenges, the five physicians at Arizona’s Mayo Clinic Family Medicine – Arrowhead in Glendale will no longer accept Medicare payments for primary care office visits. This is one of several options we are exploring to address the Medicare shortfall situation.

.......

Nevertheless, decades of underfunding and paying for volume rather than value in Medicare have led us to this decision. Providers who do fewer unnecessary tests and services are paid the least, and they are the doctors and hospitals which will go out of business first if we don’t change the payment system.

*****************************************

This clearly says again that Mayo is losing money.

This is isn't about GOP or dem. I need someone to answer the question...how is this happening (with Mayo being a good cost model) all the while there is an effort to gut the system of 500 Billion. I think there are some good answers, but I am interested to see if they come out here or if people are just interested in defending the current health care bill which is going to do nothing to address the issues that Mayo is experiencing.

Unless, of course, it is. If so, I am interested to see some information on that. I certainly have a lot to learn about this.

But, I will tell you that other clinics in the area are looking at this effort by Mayo and are considering the same thing. Essentially, it sounds as if they are trying to do what they think health care reform should do....not make it to easy to go see the doctor every time you have a cough.

Tell me where I am wrong or missing information.

But, for now, I contend that seniors, absent additonal information have every reason to be concerned.

2010-03-29 07:04 PM

Zach F
Denton, TX
Posts: 941

Well the Mayo Clinic is a non-profit organization, I do not think they are the best example to use for businesses losing money. But lets try and toss around some ideas for reducing costs on the Mayo Clinic.

Having patients pay for regular doctor visits may not be a bad way to start. The basic premise insurance is a group of people consolidating risk in case of an emergency. Isurance is not suppose to pay for routine maintence. Car insurance doesn't pay for oil changes, home owner's insurance doesn't pay for new coats of paint or spackle. Health insurance should not pay for general check-ups. Coughs, sniffles, physicals and such should be paid out of pocket. This is just basic maintence that should be done from time to time to stay healthy. Health insurance should step in when something more serious occurs. Broken arms, serious illnesses, and injuries.

I understand this is a very simplyfied explanation of a very complex question. What qualifies as serious and what doesn't, for starters, but I thought this would be a good place to start if we are looking for options to reduce the costs.

2010-03-30 02:16 PM

Listening
Lenexa, KS
Posts: 49

Zach F Wrote: Well the Mayo Clinic is a non-profit organization, I do not think they are the best example to use for businesses losing money. But lets try and toss around some ideas for reducing costs on the Mayo Clinic.

In the spirit of the thread, this seems to be getting ahead of things.

To respond to this point, what I would say is that Mayo has been held up as one of the near "ideal" cost models that GRHC advocates hold up as an example of how things should be done.

That is what makes this so damning. If Mayo runs such a tight, low cost ship and still can't get by, what does that tell you about others ?

2010-04-01 07:42 PM

Zach F
Denton, TX
Posts: 941

Listening Wrote:
Zach F Wrote: Well the Mayo Clinic is a non-profit organization, I do not think they are the best example to use for businesses losing money. But lets try and toss around some ideas for reducing costs on the Mayo Clinic.

In the spirit of the thread, this seems to be getting ahead of things.

To respond to this point, what I would say is that Mayo has been held up as one of the near "ideal" cost models that GRHC advocates hold up as an example of how things should be done.

That is what makes this so damning. If Mayo runs such a tight, low cost ship and still can't get by, what does that tell you about others ?

It says the cost of healthcare is absolutely ridiculous. A reduction in the underlying costs of basic health would qucikly reduce that huge loss.

2010-04-02 09:55 AM

Listening
Lenexa, KS
Posts: 49

Zach F Wrote:
Listening Wrote:
Zach F Wrote: Well the Mayo Clinic is a non-profit organization, I do not think they are the best example to use for businesses losing money. But lets try and toss around some ideas for reducing costs on the Mayo Clinic.

In the spirit of the thread, this seems to be getting ahead of things.

To respond to this point, what I would say is that Mayo has been held up as one of the near "ideal" cost models that GRHC advocates hold up as an example of how things should be done.

That is what makes this so damning. If Mayo runs such a tight, low cost ship and still can't get by, what does that tell you about others ?

It says the cost of healthcare is absolutely ridiculous. A reduction in the underlying costs of basic health would qucikly reduce that huge loss.

I am sorry Zach, but that is an arbitrary statement that you will have to back up. Otherwise, it qualifies as nothing more than a rant.

What it says is that the low cost model still can't make it on current reimbursements and thus can't provide services. Unless you can show Mayo (which everyone lauds as the "best") how to reduce these rediculously high costs....you are faced with the reality that Medicare does not provide the level of payment needed to get the services people want.

And that is the point....if they are not paying enough now....how do they get 500 Billion out of it in the future ?

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