Seniors seek health-care clarity

Tribune NewspapersAugust 16, 2009 

  • Here's a look at the basics of current health-care proposals, as they affect seniors. The information is based on a bill offered by three committees in the House of Representatives:

    No cuts to basic Medicare benefits are being proposed.

    There is no plan to ration medical care for seniors. An independent organization of health-care experts and medical professionals would study medical therapies to determine which work well and which are ineffective. Doctors could use the information as they see fit.

    Plans call for $231.4 billion in Medicare expenditure savings over 10 years, according to AARP. Attempts to curb spending focus on reducing payments to hospitals. Physicians are to receive more money.

    Medicare Advantage plans are a big target for spending cuts. Just over 10 million seniors are enrolled in Medicare Advantage plans, which are private plans that subsidize fees and often offer extra benefits such as eyeglasses or gym memberships.

    Physicians would be compensated for counseling seniors every five years about care at the end of life. These discussions would be voluntary and private. The choice of what therapies to pursue would remain with patient and doctor.

  • Obama in Colorado

    President Barack Obama on Saturday criticized what he termed as the "scare tactics" of opponents to health-care reform. He told a town hall meeting in Grand Junction, Colo., that "what is truly scary is if we do nothing" to solve health-care problems.

    And he attempted to deflect some of the sharpest criticism of the health- care plans before Congress from those who say it would mean government control over the health-care system.

    "I don't want government bureaucrats meddling in our health care, but the point is I don't want insurance companies' bureaucrats meddling in our health care either," Obama declared, prompting a cheer.

— Far from the hue and cry over health reform erupting in town hall meetings across the U.S., many older citizens are quietly confused about what a health-care overhaul might mean to them.

The opinions they form in weeks ahead may well prove crucial, as seniors are a highly influential, politically active group of voters.

They bring a unique perspective to the topic: Older Americans are the only group in the country with guaranteed health care, from Medicare. Also, they're the heaviest users of medical services.

On a recent afternoon, a group of 80- to 90-year-olds at a 14-story retirement complex just north of downtown Denver voiced some of the same questions about health reform circulating in living rooms, retirement communities and senior centers throughout the country.

"Will it affect how quickly I can get in to see my doctors?" asked Anna Janeway, 80, a retired marriage and family counselor.

"You hear all these things about Medicare going broke if we do nothing. Where would that leave everybody?" asked Anthony Mehelich, 82, a former construction company administrator.

"Do we really have to make so many changes all at once?" inquired Joseph Duffy, 90, a former accountant. "Couldn't we just take parts of the problem and solve those?"

Rep. Eliot Engel, D-N.Y., said his offices had received "hundreds of calls" from older people eager to understand how they might be affected. Other members of Congress report a similar outpouring of concern.

A tough sell

Convincing these experienced voters of the need for change is proving to be an uphill battle. A recent CNN/Opinion Research Corp. poll found that a majority of voters over 50 years old oppose a health-care overhaul while most voters under 50 support it.

The lack of a definitive plan only adds to seniors' uncertainty. The picture could change after Congress returns. But the essential thrust of reform isn't likely to change.

Gail Wilensky, who once ran Medicare as head of the Health Care Financing Administration, a federal agency that has since been renamed, said, "The major focus of reform is clearly not on seniors. It is on expanding coverage to the under-65 population."

Every U.S. citizen who turns 65 qualifies for Medicare. The government pays the bills for care provided by private doctors and hospitals, and beneficiaries contribute.

If that sounds like a government-run health-care plan, it is, although many people don't understand that. Among them are elderly constituents who Rep. Jim Tanner, D-Tenn., said have contacted him, saying, "I'm happy with Medicare; don't let the government take it over."

Perhaps the most controversial charge raised by critics of health reform surrounds care for seniors at the end of life. The House bill for the first time would pay doctors for discussing end-of-life treatment options with patients every five years. The discussions would be voluntary. Currently, doctors aren't paid for having these discussions.

Although federal law has recognized advance directives as legitimate for years, critics have seized upon these provisions in reform legislation as leading to euthanasia or government control of older people's end-of-life decisions. Those charges are false, according to numerous organizations and a close reading of the legislative language.

"Nothing could be further from the truth," according to a statement issued last week by the Association of Bioethics Program Directors, representing leading medical ethicists across the U.S.

News & Observer is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service