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December 19, 2008
By ROBERT PEAR
WASHINGTON — The Congressional Budget Office said Thursday that many of the health care proposals championed by President-elect Barack Obama and other Democrats would carry a high price tag and would generate only modest savings.
The budget office, an influential voice in the work of Congress, analyzed 115 options, including proposals to expand coverage and slow the growth of health spending.
Some of the options, including proposals to increase taxes on cigarettes and nondiet soft drinks, are sure to meet stiff political opposition.
One bright spot in a generally bleak picture was the estimate of potential savings from a requirement for doctors and hospitals to use health information technology, including electronic medical records, as a condition of participating in Medicare.
Such a requirement could save the federal government $7 billion in the first five years and a total of $34 billion over 10 years, by reducing medical errors and avoiding unnecessary tests and procedures, the budget office said. It “would also lower health insurance premiums in the private sector,” the report said.
Without action by Congress, the report said, health costs will continue to soar, the number of people without insurance will rise by nearly one million a year, to a total of 54 million in 2019, and spending on health care will increase to 25 percent of the gross domestic product in 2025, up from 16 percent in 2007.
In keeping with its duty to provide objective, impartial analysis, the budget office did not endorse any options, but it fleshed out many ideas circulating on Capitol Hill.
Democrats and many Republicans say they will make a serious effort to overhaul the health care system in 2009. Those changes are essential for economic recovery, they say.
But Mr. Obama and other Democrats have not been precise about the cost of their proposals, nor have they said in detail how they would pay for them. One of the Democrats’ favorite proposals, rolling back tax cuts for high-income people, is already scheduled to occur in 2011, so, under the bookkeeping rules used by Congress, it would not produce a windfall of new revenue.
Lawmakers from both parties said they would pay close attention to the cost of new federal subsidies for health coverage because these subsidies — unlike the one-time bailouts for banks and other financial institutions — would be recurring federal obligations for years to come.
Requiring employers to provide health insurance to their employees or pay a fee to the federal government would bring in $47 billion of new federal revenue in the next 10 years, the report said.
A proposal to establish a national insurance pool for people who cannot obtain coverage on their own in the individual market would cost $16 billion in the next decade, it said.
Mr. Obama and many other Democrats want the government to negotiate with drug manufacturers to get lower prices for Medicare beneficiaries.
The Congressional Budget Office said such negotiations “would produce small if any savings” because the government would not have enough leverage to secure significant discounts beyond those already obtained by private insurance companies that manage the Medicare drug benefit.
But the budget office said Medicare could save $110 billion in the next 10 years if Congress simply imposed a form of price controls, requiring drug makers to provide the government with a 15 percent rebate, or discount, on brand-name drugs covered by the new Part D of Medicare.
Eliminating a notorious gap in Medicare coverage of prescription drugs, known as a doughnut hole, would cost more than $130 billion over 10 years, the report said.
Research to compare the effectiveness of different drugs and treatments might help doctors and patients make better decisions.
But it would not save the government much — $1.3 billion in the next decade — and it would reduce total spending on health care in those years by less than one-tenth of 1 percent, the budget office said.
The federal government could save $12 billion in the next decade if it established a procedure for approval of generic versions of expensive biotechnology drugs, the report said. It did not estimate the additional savings for consumers and employers, which could be substantial.
The report sets forth an elaborate proposal that would allow doctors and hospitals to share in the savings if they improve the quality and reduce the cost of care for people on Medicare.
Under the proposal, Medicare would pay bonuses to groups of doctors who met certain performance measures.
In response to such financial incentives, the report said, doctors would become more efficient and would reduce “the volume and intensity of services provided to their patients,” saving $5 billion for Medicare in the next decade.
In one particularly sobering chapter, the report notes that, under existing law, Medicare will cut fees paid to doctors by 21 percent in 2010 and by about 5 percent in each of the next few years.
To avoid such cuts and freeze payment rates at their 2009 levels would cost the government $318 billion over the next decade, the report said.
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Friday, December 19, 2008
Sunday, November 30, 2008
KENNEDY ESTABLISHES COMMITTEE WORKING GROUPS ON HEALTH REFORM
November 18, 2008
FOR IMMEDIATE RELEASE
Washington, DC— Senator Edward M. Kennedy, Chairman of the Senate Committee on Health, Education, Labor and Pensions, today established three working groups of the committee to deal with critical issues of health reform. Under Senator Kennedy's direction, the working groups will concentrate on three areas essential to comprehensive reform: (1) prevention and public health, (2) improvements in the quality of care, and (3) insurance coverage. Senator Tom Harkin will lead the working group on prevention and public health, Senator Barbara Mikulski will lead the working group on improvements in quality, and Senator Hillary Clinton will lead the working group on insurance coverage. Senator Kennedy released the following statement:
"Our committee is fortunate to have the services of major leaders who are committed to improving health care for the American people. Senator Harkin, Senator Mikulski, and Senator Clinton have generously offered to step forward and assume an expanded role on critical aspects of health reform. I commend them for their leadership, and I look forward very much to working with them, with all our colleagues on the committee and throughout Congress, and with the Obama Administration to achieve the goal at long last of quality, affordable health care for all Americans."
###
Press Contact
Anthony Coley/ Melissa Wagoner (202) 224-2633
--
Howard McGowan
MaldenSenior
FOR IMMEDIATE RELEASE
Washington, DC— Senator Edward M. Kennedy, Chairman of the Senate Committee on Health, Education, Labor and Pensions, today established three working groups of the committee to deal with critical issues of health reform. Under Senator Kennedy's direction, the working groups will concentrate on three areas essential to comprehensive reform: (1) prevention and public health, (2) improvements in the quality of care, and (3) insurance coverage. Senator Tom Harkin will lead the working group on prevention and public health, Senator Barbara Mikulski will lead the working group on improvements in quality, and Senator Hillary Clinton will lead the working group on insurance coverage. Senator Kennedy released the following statement:
"Our committee is fortunate to have the services of major leaders who are committed to improving health care for the American people. Senator Harkin, Senator Mikulski, and Senator Clinton have generously offered to step forward and assume an expanded role on critical aspects of health reform. I commend them for their leadership, and I look forward very much to working with them, with all our colleagues on the committee and throughout Congress, and with the Obama Administration to achieve the goal at long last of quality, affordable health care for all Americans."
###
Press Contact
Anthony Coley/ Melissa Wagoner (202) 224-2633
--
Howard McGowan
MaldenSenior
Wednesday, November 12, 2008
US Sen Baucus to Unveil Health-Policy Vision Wednesday November 12
By Patrick Yoest, Of DOW JONES NEWSWIRES
WASHINGTON -(Dow Jones)- A top Senate Democrat will make his pitch on broad- scale health-care overhaul to cover more people without insurance, with a growing consensus emerging that Congress will have to tackle health issues with a single bill.
Senate Finance Chairman Max Baucus, D-Mont., will unveil a package Wednesday that has been billed as his vision for comprehensive health-care change. Baucus, along with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy, D-Mass., controls the bulk of Senate jurisdiction over health-care issues.
Kennedy aides have said that he plans to move aggressively on health care in 2009, with the arrival of President-elect Barack Obama providing a boost to Democratic efforts to bring about fundamental change. But Kennedy will need the cooperation of Baucus, who could have a more cautious approach.
"I'm looking for Baucus to establish a strong centrist position that will give Obama real insight into what's happening in the Senate," said Alexander Vachon, a health-policy consultant and a former Finance Committee staffer.
It won't be the first time Baucus has discussed major health-care changes. Last year, he drew up a series o of principles on providing universal coverage, including the idea of "pooling" individuals and small businesses to allow them to get more competitive rates for health insurance.
It appears that the pooling concept will be part of the proposal Baucus offers Wednesday as well.
"Sen. Baucus has long said that he believes that pooling arrangements should be a necessary part of comprehensive heatlh-care reform, and he intends to discuss that in detail that at tomorrow's press conference," said Baucus spokeswoman Carol Guthrie.
The legislative process for incorporating competing policy ideas on health care is an initial hurdle for congressional Democrats, who are keen to avoid President Bill Clinton's failure to enact a health-care overhaul in 1993. Kennedy staffer Michael Myers said Nov. 6 at a Families USA event that a "one- bill strategy" is in the works in the Senate, which would preclude tackling health care changes piecemeal.
"Certainly as politicians, people will want to say 'here was my idea, I was a leader on health care," Myers said, but added that "I think there's a growing recognition that the best way, maybe the only way that this gets done is for Democrats to unite behind a single bill."
It is unclear exactly what a single-bill strategy means. Guthrie said that Baucus is seeking a "consensus product" and has reached out to Sen. Kennedy, but the single-bill concept would have even larger significance if Baucus announces he wants an overarching health package to also include items such as a Medicare reimbursement fix for physicians.
Such an approach could put Baucus into conflict with Rep. Pete Stark, D- Calif., who on Monday said he wants to pass a series of policy initiatives -- including expanding the state children's health-insurance program, chnages in Medicare reimbursements for physicians and health technology legislation -- in advance of a broad health-care measure. Starks chairs the House Ways and Means health subcommittee.
The idea of a comprehensive approach that ties measures to cover more uninsured people to other health-care initiatives has gained the support of some who assert that it will be easier to accomplish a fundamental restructuring of the health-care system.
"You could do all that in a comprehensive package," said Karen Ignagni, president and chief executive of America's Health Insurance Plans, a health insurers' trade group. "To approach this comprehensively actually gives you an opportunity to lay out the issues.
Much depends on Obama, whose transition team is meeting with congressional staff to lay out the groundwork for health overhaul. Stark said that, upon receiving Obama's health policy priorities, he expected the House and Senate to each produce bills that would see a conference to reconcile them -- a process that would require long, difficult negotiations.
"I think we are awaiting the president-elect's program, and when it arrives, we will proceed in regular order," Stark said on Monday.
-By Patrick Yoest, Dow Jones Newswires; 202
WASHINGTON -(Dow Jones)- A top Senate Democrat will make his pitch on broad- scale health-care overhaul to cover more people without insurance, with a growing consensus emerging that Congress will have to tackle health issues with a single bill.
Senate Finance Chairman Max Baucus, D-Mont., will unveil a package Wednesday that has been billed as his vision for comprehensive health-care change. Baucus, along with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy, D-Mass., controls the bulk of Senate jurisdiction over health-care issues.
Kennedy aides have said that he plans to move aggressively on health care in 2009, with the arrival of President-elect Barack Obama providing a boost to Democratic efforts to bring about fundamental change. But Kennedy will need the cooperation of Baucus, who could have a more cautious approach.
"I'm looking for Baucus to establish a strong centrist position that will give Obama real insight into what's happening in the Senate," said Alexander Vachon, a health-policy consultant and a former Finance Committee staffer.
It won't be the first time Baucus has discussed major health-care changes. Last year, he drew up a series o of principles on providing universal coverage, including the idea of "pooling" individuals and small businesses to allow them to get more competitive rates for health insurance.
It appears that the pooling concept will be part of the proposal Baucus offers Wednesday as well.
"Sen. Baucus has long said that he believes that pooling arrangements should be a necessary part of comprehensive heatlh-care reform, and he intends to discuss that in detail that at tomorrow's press conference," said Baucus spokeswoman Carol Guthrie.
The legislative process for incorporating competing policy ideas on health care is an initial hurdle for congressional Democrats, who are keen to avoid President Bill Clinton's failure to enact a health-care overhaul in 1993. Kennedy staffer Michael Myers said Nov. 6 at a Families USA event that a "one- bill strategy" is in the works in the Senate, which would preclude tackling health care changes piecemeal.
"Certainly as politicians, people will want to say 'here was my idea, I was a leader on health care," Myers said, but added that "I think there's a growing recognition that the best way, maybe the only way that this gets done is for Democrats to unite behind a single bill."
It is unclear exactly what a single-bill strategy means. Guthrie said that Baucus is seeking a "consensus product" and has reached out to Sen. Kennedy, but the single-bill concept would have even larger significance if Baucus announces he wants an overarching health package to also include items such as a Medicare reimbursement fix for physicians.
Such an approach could put Baucus into conflict with Rep. Pete Stark, D- Calif., who on Monday said he wants to pass a series of policy initiatives -- including expanding the state children's health-insurance program, chnages in Medicare reimbursements for physicians and health technology legislation -- in advance of a broad health-care measure. Starks chairs the House Ways and Means health subcommittee.
The idea of a comprehensive approach that ties measures to cover more uninsured people to other health-care initiatives has gained the support of some who assert that it will be easier to accomplish a fundamental restructuring of the health-care system.
"You could do all that in a comprehensive package," said Karen Ignagni, president and chief executive of America's Health Insurance Plans, a health insurers' trade group. "To approach this comprehensively actually gives you an opportunity to lay out the issues.
Much depends on Obama, whose transition team is meeting with congressional staff to lay out the groundwork for health overhaul. Stark said that, upon receiving Obama's health policy priorities, he expected the House and Senate to each produce bills that would see a conference to reconcile them -- a process that would require long, difficult negotiations.
"I think we are awaiting the president-elect's program, and when it arrives, we will proceed in regular order," Stark said on Monday.
-By Patrick Yoest, Dow Jones Newswires; 202
Thursday, November 6, 2008
Health Care Agenda
Democrats Pick Up House, Senate Seats; Newspapers Examine Implications For Health Care, Other Issues
06 Nov 2008
KaiserDemocrats on Tuesday increased their majorities in the Senate and the House and next year likely will seek to pass legislation to expand health insurance to more U.S. residents, among other bills, the Wall Street Journal reports (Hitt/Mullins, Wall Street Journal, 11/5). In the Senate, Democrats and two independents who caucus with them will increase their majority from 51 seats to at least 56 seats, with four races still undecided as of Wednesday morning. Republicans will hold at least 40 seats. In the House, Democrats will increase their majority from 236 seats to at least 252 seats, with 10 races undecided. Republicans will hold at least 173 seats (CNN.com, 11/5).
According to the Boston Globe's "Political Intelligence" blog, Democrats next year first will "address the low growth, high unemployment and economic strain on American workers," and in the "longer term," they are "hopeful they can complete a health care plan." The larger majorities might allow Democrats to pass a "slew of legislation that was blocked by the Bush administration" or that "failed to pass by small margins in the House or Senate," such as bills to expand SCHIP and allow expanded federal funding for embryonic stem cell research, the Globe's "Political Intelligence" blog reports (Milligan, "Political Intelligence," Boston Globe, 11/4).
However, as a result of the record federal budget deficit, the recently enacted $700 billion bailout for Wall Street firms and the "threat of a deep recession, Democrats will have to limit or postpone any big new spending programs, such as ones to expand health care," Reuters reports (Ferraro/Cowan, Reuters, 11/5).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
--------------------------------------------------------------------------------
Article URL: http://www.medicalnewstoday.com/articles/128375.php
Main News Category: Health Insurance / Medical Insurance
Also Appears In: Public Health,
--------------------------------------------------------------------------------
Save time! Get the latest medical news headlines for your specialist area, in a weekly newsletter e-mail. See http://www.medicalnewstoday.com/newsletters.php for details.
Send your press releases to pressrelease@medicalnewstoday.com
06 Nov 2008
KaiserDemocrats on Tuesday increased their majorities in the Senate and the House and next year likely will seek to pass legislation to expand health insurance to more U.S. residents, among other bills, the Wall Street Journal reports (Hitt/Mullins, Wall Street Journal, 11/5). In the Senate, Democrats and two independents who caucus with them will increase their majority from 51 seats to at least 56 seats, with four races still undecided as of Wednesday morning. Republicans will hold at least 40 seats. In the House, Democrats will increase their majority from 236 seats to at least 252 seats, with 10 races undecided. Republicans will hold at least 173 seats (CNN.com, 11/5).
According to the Boston Globe's "Political Intelligence" blog, Democrats next year first will "address the low growth, high unemployment and economic strain on American workers," and in the "longer term," they are "hopeful they can complete a health care plan." The larger majorities might allow Democrats to pass a "slew of legislation that was blocked by the Bush administration" or that "failed to pass by small margins in the House or Senate," such as bills to expand SCHIP and allow expanded federal funding for embryonic stem cell research, the Globe's "Political Intelligence" blog reports (Milligan, "Political Intelligence," Boston Globe, 11/4).
However, as a result of the record federal budget deficit, the recently enacted $700 billion bailout for Wall Street firms and the "threat of a deep recession, Democrats will have to limit or postpone any big new spending programs, such as ones to expand health care," Reuters reports (Ferraro/Cowan, Reuters, 11/5).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.
© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
--------------------------------------------------------------------------------
Article URL: http://www.medicalnewstoday.com/articles/128375.php
Main News Category: Health Insurance / Medical Insurance
Also Appears In: Public Health,
--------------------------------------------------------------------------------
Save time! Get the latest medical news headlines for your specialist area, in a weekly newsletter e-mail. See http://www.medicalnewstoday.com/newsletters.php for details.
Send your press releases to pressrelease@medicalnewstoday.com
Kerry-Grassley Bill At home Care
----------------------------------------------------------------------
07/24/2008
Kerry-Grassley Bill Increases At-Home Care For Those In Need
WASHINGTON, D.C. – As millions of Americans face significant challenges when it comes to caring for loved ones who needs significant support, Sens. John Kerry (D-Mass.) and Chuck Grassley (R-Iowa) today introduced the “Empowered at Home Act.” The bill seeks to increase access to home and community based services by giving states new tools and incentives to make these services more available to those in need.
“Far too many elderly or disabled Americans can’t get the help they need in their home and community,” said Sen. Kerry. “Home- and community-based services are high-quality, cost-effective, and help many people live independent lives, but Medicaid continues to favor nursing homes. It’s a problem when the nation’s largest purchaser of long-term care services is tilted towards nursing homes rather than home and community based services. This bill will level the playing field and give families real choices to care for their loved ones, and give cash-strapped states new tools to provide cost-effective long-term care options to the most vulnerable.”
“Being able to live at home greatly improves quality of life because people can be with loved ones and have the dignity that goes with greater independence,” said Sen. Grassley. “This bill encourages states to help make that possible, which is also fiscally smart because institutional care is the most expensive form of long-term care that Medicaid pays for. This bill also empowers individuals to manage the financial burdens that come with caregiving needs.”
The “Empowered at Home Act” has four basic parts:
First, it will improve the Medicaid HCBS State Plan Amendment Option by giving states more flexibility in determining eligibility for which services they can offer under the program, which will create greater options for individuals in need of long-term supports. In return we ask that states no longer cap enrollment and that services be offered throughout the entire state.
Second, the bill ensures that the same spousal impoverishment protections offered for new nursing home beneficiaries will be in place for those opting for home and community based services. In addition, low-income recipients of home and community based services will be able to keep more of their assets when they become eligible for Medicaid, allowing them to stay in their community as long as possible.
Third, the Empowered at Home Act addresses the financial needs of spouses and family members caring for a loved one by offering tax-related provisions to support family caregivers and promote the purchase of meaningful private long-term care insurance.
Finally, the bill seeks to improve the overall quality of home and community based services available by providing grants for states to invest in organizations and systems that can help to ensure a sufficient supply of high quality workers, promote health, and transform home and community based care to be more consumer-centered.
The “Empowered at Home Act” has gained support of numerous health organizations including National Council on Aging, Alzheimer’s Association, American Geriatrics Society, Trust for America’s Health, and SEIU.
###
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Third Floor
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07/24/2008
Kerry-Grassley Bill Increases At-Home Care For Those In Need
WASHINGTON, D.C. – As millions of Americans face significant challenges when it comes to caring for loved ones who needs significant support, Sens. John Kerry (D-Mass.) and Chuck Grassley (R-Iowa) today introduced the “Empowered at Home Act.” The bill seeks to increase access to home and community based services by giving states new tools and incentives to make these services more available to those in need.
“Far too many elderly or disabled Americans can’t get the help they need in their home and community,” said Sen. Kerry. “Home- and community-based services are high-quality, cost-effective, and help many people live independent lives, but Medicaid continues to favor nursing homes. It’s a problem when the nation’s largest purchaser of long-term care services is tilted towards nursing homes rather than home and community based services. This bill will level the playing field and give families real choices to care for their loved ones, and give cash-strapped states new tools to provide cost-effective long-term care options to the most vulnerable.”
“Being able to live at home greatly improves quality of life because people can be with loved ones and have the dignity that goes with greater independence,” said Sen. Grassley. “This bill encourages states to help make that possible, which is also fiscally smart because institutional care is the most expensive form of long-term care that Medicaid pays for. This bill also empowers individuals to manage the financial burdens that come with caregiving needs.”
The “Empowered at Home Act” has four basic parts:
First, it will improve the Medicaid HCBS State Plan Amendment Option by giving states more flexibility in determining eligibility for which services they can offer under the program, which will create greater options for individuals in need of long-term supports. In return we ask that states no longer cap enrollment and that services be offered throughout the entire state.
Second, the bill ensures that the same spousal impoverishment protections offered for new nursing home beneficiaries will be in place for those opting for home and community based services. In addition, low-income recipients of home and community based services will be able to keep more of their assets when they become eligible for Medicaid, allowing them to stay in their community as long as possible.
Third, the Empowered at Home Act addresses the financial needs of spouses and family members caring for a loved one by offering tax-related provisions to support family caregivers and promote the purchase of meaningful private long-term care insurance.
Finally, the bill seeks to improve the overall quality of home and community based services available by providing grants for states to invest in organizations and systems that can help to ensure a sufficient supply of high quality workers, promote health, and transform home and community based care to be more consumer-centered.
The “Empowered at Home Act” has gained support of numerous health organizations including National Council on Aging, Alzheimer’s Association, American Geriatrics Society, Trust for America’s Health, and SEIU.
###
Offices Locations
Washington D.C.
304 Russell Bldg.
Third Floor
Washington D.C. 20510
(202) 224-2742 Boston
One Bowdoin Square
Tenth Floor
Boston, MA 02114
(617) 565-8519 Springfield
Springfield Federal Building
1550 Main Street
Suite 304
Springfield, MA 01101
(413) 785-4610 Fall River
222 Milliken Place
Suite 312
Fall River, Ma 02721
(508) 677-0522
At Work In Congress | Working For MA | How Can I Help You? | About John | MA Resources | Newsroom | Contact
Sitemap | Privacy Policy | TBA
Sunday, October 12, 2008
Health care takes a back seat in the election
By: Lelia Chaisson
Posted: 10/9/08
Two years ago, Americans couldn't get enough of the health care debate. With Massachusetts leading the way to universal coverage, health care dominated the headlines. Forty-seven million uninsured, staggering U.S. expenditures on medical technology and lagging U.S. health statistics were disturbingly familiar, and it seemed certain that America was on its way to health care reform.
So what happened?
Right in the middle of our attempt to fix the "broken system," health care lost its momentum, much as it did in the 1990s with Hillary Clinton's failed attempt to revolutionize it. In both cases, huge movements swiftly lost their authority and eventually faded into the background, leaving Americans to deal with the ever increasing costs of health care. It seems that, despite the perpetual health care calamity in America, every time we get close to making some progress, health care disappears from the headlines.
Health care has once again taken a back seat in the 2008 election, despite the fact that recently published reports show that access to health care remains a considerable problem for more American families than ever before. Indeed, the Center for Studying Health System Change recently disclosed that almost one in five families struggled to pay medical bills last year; Twenty percent of those having problems even considered declaring personal bankruptcy. Nor is the issue limited to those without medical insurance. Reports indicate that of the 57 million Americans under pressure, 43 million have some form of insurance. The health care crisis is far from over, yet real reform is not even on the horizon.
Why is it so hard to get the ball rolling on health care? It's not because Americans don't want health care reform. While the issue has slipped behind the financial crisis and the Iraq war in the current election, it remains firmly in the top three issues among all demographics. Nor is it for lack of ideas. Over the years myriad diverse plans have been proposed by Republicans and Democrats alike.
I can only conclude that the standstill is due to the public's wishy-washiness. Americans simply don't know what they want. Or, rather, they know what they want, but they aren't willing to take any of the necessary steps to get it. What is perhaps the most interesting thing about this debate is the combination of America's conviction that every person should have access to affordable, high-quality care, and its simultaneous skepticism concerning every proposed plan for change.
Just look at the public's reaction to some of the ideas for reform. To the suggestion that we require coverage for every American to promote preventive care comes the loud retort that forcing everyone to have insurance is un-American. To the notion that we should cut spending on costly, infrequently used procedures comes the cry that Americans should have access to any medical procedure they could ever possibly want, nevermind the price tag.
Now, I'm not saying that all of these ideas are perfect. I'm just pointing out the irony that Americans demand affordable coverage and access for all, yet reject any policy that has the potential to address these problems.
America's fickleness has reared its head once again in the current election. On the one hand, Barack Obama has suggested creating a national health plan available to all Americans, with guaranteed eligibility, benefits similar to those offered in the plan available to members of Congress and subsidies for those who do not qualify for Medicaid or SCHIP but still need financial aid.
Seemingly, his plan has addressed every criticism. No mandate for universal coverage. Affordable care for every American. Guaranteed access. Choice between private and employer-based coverage.
The public's reaction? Obama's plan is too costly and will create too much regulation.
Senator McCain, on the other hand, wants nothing close to a national health care plan, and instead advocates stimulating the private market and doing away with tax breaks for employer-based health insurance.
Now, come on. Voters say they want to ensure affordable coverage for every American. They say they want to take some of the power away from greedy insurance companies that deny care to the sick and disadvantaged. Is there really any question as to which plan will better address these issues? Granted, Obama's plan is going to be expensive. But let's be serious. Doing away with tax breaks will encourage employers to do away with their health care plans. And a $5,000 tax credit will be a drop of water in a sea of health care costs, which now average $12,680 a year for U.S. families. In addition to this, it is widely speculated that McCain's plan will leave millions of people uninsured and give more power to the insurance companies everyone despises.
But, in the end, no matter who gets elected, I doubt we'll ever get far enough to see either of these plans enacted. America loves to talk the talk, but won't walk the walk. When given the choice of actually addressing their constantly reiterated concerns about health care or doing nothing, Americans consistently choose the latter.
--------------------------------------------------------------------------------
© Copyright 2008 News-Letter
Posted: 10/9/08
Two years ago, Americans couldn't get enough of the health care debate. With Massachusetts leading the way to universal coverage, health care dominated the headlines. Forty-seven million uninsured, staggering U.S. expenditures on medical technology and lagging U.S. health statistics were disturbingly familiar, and it seemed certain that America was on its way to health care reform.
So what happened?
Right in the middle of our attempt to fix the "broken system," health care lost its momentum, much as it did in the 1990s with Hillary Clinton's failed attempt to revolutionize it. In both cases, huge movements swiftly lost their authority and eventually faded into the background, leaving Americans to deal with the ever increasing costs of health care. It seems that, despite the perpetual health care calamity in America, every time we get close to making some progress, health care disappears from the headlines.
Health care has once again taken a back seat in the 2008 election, despite the fact that recently published reports show that access to health care remains a considerable problem for more American families than ever before. Indeed, the Center for Studying Health System Change recently disclosed that almost one in five families struggled to pay medical bills last year; Twenty percent of those having problems even considered declaring personal bankruptcy. Nor is the issue limited to those without medical insurance. Reports indicate that of the 57 million Americans under pressure, 43 million have some form of insurance. The health care crisis is far from over, yet real reform is not even on the horizon.
Why is it so hard to get the ball rolling on health care? It's not because Americans don't want health care reform. While the issue has slipped behind the financial crisis and the Iraq war in the current election, it remains firmly in the top three issues among all demographics. Nor is it for lack of ideas. Over the years myriad diverse plans have been proposed by Republicans and Democrats alike.
I can only conclude that the standstill is due to the public's wishy-washiness. Americans simply don't know what they want. Or, rather, they know what they want, but they aren't willing to take any of the necessary steps to get it. What is perhaps the most interesting thing about this debate is the combination of America's conviction that every person should have access to affordable, high-quality care, and its simultaneous skepticism concerning every proposed plan for change.
Just look at the public's reaction to some of the ideas for reform. To the suggestion that we require coverage for every American to promote preventive care comes the loud retort that forcing everyone to have insurance is un-American. To the notion that we should cut spending on costly, infrequently used procedures comes the cry that Americans should have access to any medical procedure they could ever possibly want, nevermind the price tag.
Now, I'm not saying that all of these ideas are perfect. I'm just pointing out the irony that Americans demand affordable coverage and access for all, yet reject any policy that has the potential to address these problems.
America's fickleness has reared its head once again in the current election. On the one hand, Barack Obama has suggested creating a national health plan available to all Americans, with guaranteed eligibility, benefits similar to those offered in the plan available to members of Congress and subsidies for those who do not qualify for Medicaid or SCHIP but still need financial aid.
Seemingly, his plan has addressed every criticism. No mandate for universal coverage. Affordable care for every American. Guaranteed access. Choice between private and employer-based coverage.
The public's reaction? Obama's plan is too costly and will create too much regulation.
Senator McCain, on the other hand, wants nothing close to a national health care plan, and instead advocates stimulating the private market and doing away with tax breaks for employer-based health insurance.
Now, come on. Voters say they want to ensure affordable coverage for every American. They say they want to take some of the power away from greedy insurance companies that deny care to the sick and disadvantaged. Is there really any question as to which plan will better address these issues? Granted, Obama's plan is going to be expensive. But let's be serious. Doing away with tax breaks will encourage employers to do away with their health care plans. And a $5,000 tax credit will be a drop of water in a sea of health care costs, which now average $12,680 a year for U.S. families. In addition to this, it is widely speculated that McCain's plan will leave millions of people uninsured and give more power to the insurance companies everyone despises.
But, in the end, no matter who gets elected, I doubt we'll ever get far enough to see either of these plans enacted. America loves to talk the talk, but won't walk the walk. When given the choice of actually addressing their constantly reiterated concerns about health care or doing nothing, Americans consistently choose the latter.
--------------------------------------------------------------------------------
© Copyright 2008 News-Letter
Saturday, October 4, 2008
Debit Card For unbanked Americans
Comerica Bank Named as Card Issuer
Washington, D.C. - (Jan. 4, 2008) - The U.S. Department of the Treasury's Financial Management Service (FMS) has designated Comerica Bank as its financial agent in a new initiative to give millions of unbanked Americans the option of using a prepaid debit card for receiving Social Security and other federal benefit payments. The "Direct Express®" card provides a safer and more convenient alternative to paper checks. Comerica Bank was selected, in part, because of its experience as a prepaid card issuer for millions of benefit recipients, particularly for state government programs.
"Direct Express represents a significant step forward in the evolution of federal benefit payments," said FMS Commissioner Judy Tillman. "The explosive growth in the prepaid card industry offers an important opportunity for Treasury to give unbanked payment recipients secure, easy access to their funds, at low or no cost to the cardholder. We ultimately would like to see an all-electronic Treasury - with all the security, efficiency and cost savings that would entail. This card takes us closer to that goal by combining the best in payment innovation with sound public policy. If every unbanked federal check recipient signed up to use the card, it would save taxpayers about $44 million per year."
The Treasury estimates that four million Social Security and Supplemental Security Income (SSI) check recipients do not have bank accounts, placing them at greater risk of check delivery delays due to poor weather, national or local emergencies, and other check related problems, such as lost or stolen checks. In fact, nine times out of 10, problems with Social Security payments are linked to paper checks, not direct deposit.
Financial Flexibility and Security
The Direct Express card will be introduced in spring 2008 and will be phased into national distribution by the end of the summer. Direct Express card holders will benefit from improved financial flexibility and security as compared to paper check recipients.
Each month, payments will be automatically deposited on the Direct Express card account on the federal beneficiary's designated payment day - which means people will have faster access to their money than they would if they had to cash a paper check. Card holders will be able to access their money at ATMs and financial institutions nationwide. They will be able to use their card to get cash back and make purchases at retail locations, as well as pay bills and make purchases online. In addition, these accounts are PIN-protected, FDIC-insured, and subject to federal consumer protection regulations (Regulation E).
"Millions of federal beneficiaries remain outside the banking system, which means they don't have access to payment methods that most Americans take for granted, such as getting cash at an ATM or paying with a card at a store," said Nora Arpin, Director of Government Electronic Solutions for Comerica Bank. "The Direct Express card provides an opportunity for people outside of the banking system, either because of personal choice or perhaps their inability to obtain a bank account, to gain a foothold in the financial mainstream."
The Treasury has already experienced significant success in increasing electronic payments with its Go Direct campaign, which is aimed at motivating banked federal benefit recipients to switch from paper checks to direct deposit. To date, Go Direct has achieved more than 1.6 million direct deposit conversions.
"Direct Express" is a registered trademark of the U.S. Department of the Treasury, Financial Management Service.
Last Updated: Thursday January 03, 2008
Washington, D.C. - (Jan. 4, 2008) - The U.S. Department of the Treasury's Financial Management Service (FMS) has designated Comerica Bank as its financial agent in a new initiative to give millions of unbanked Americans the option of using a prepaid debit card for receiving Social Security and other federal benefit payments. The "Direct Express®" card provides a safer and more convenient alternative to paper checks. Comerica Bank was selected, in part, because of its experience as a prepaid card issuer for millions of benefit recipients, particularly for state government programs.
"Direct Express represents a significant step forward in the evolution of federal benefit payments," said FMS Commissioner Judy Tillman. "The explosive growth in the prepaid card industry offers an important opportunity for Treasury to give unbanked payment recipients secure, easy access to their funds, at low or no cost to the cardholder. We ultimately would like to see an all-electronic Treasury - with all the security, efficiency and cost savings that would entail. This card takes us closer to that goal by combining the best in payment innovation with sound public policy. If every unbanked federal check recipient signed up to use the card, it would save taxpayers about $44 million per year."
The Treasury estimates that four million Social Security and Supplemental Security Income (SSI) check recipients do not have bank accounts, placing them at greater risk of check delivery delays due to poor weather, national or local emergencies, and other check related problems, such as lost or stolen checks. In fact, nine times out of 10, problems with Social Security payments are linked to paper checks, not direct deposit.
Financial Flexibility and Security
The Direct Express card will be introduced in spring 2008 and will be phased into national distribution by the end of the summer. Direct Express card holders will benefit from improved financial flexibility and security as compared to paper check recipients.
Each month, payments will be automatically deposited on the Direct Express card account on the federal beneficiary's designated payment day - which means people will have faster access to their money than they would if they had to cash a paper check. Card holders will be able to access their money at ATMs and financial institutions nationwide. They will be able to use their card to get cash back and make purchases at retail locations, as well as pay bills and make purchases online. In addition, these accounts are PIN-protected, FDIC-insured, and subject to federal consumer protection regulations (Regulation E).
"Millions of federal beneficiaries remain outside the banking system, which means they don't have access to payment methods that most Americans take for granted, such as getting cash at an ATM or paying with a card at a store," said Nora Arpin, Director of Government Electronic Solutions for Comerica Bank. "The Direct Express card provides an opportunity for people outside of the banking system, either because of personal choice or perhaps their inability to obtain a bank account, to gain a foothold in the financial mainstream."
The Treasury has already experienced significant success in increasing electronic payments with its Go Direct campaign, which is aimed at motivating banked federal benefit recipients to switch from paper checks to direct deposit. To date, Go Direct has achieved more than 1.6 million direct deposit conversions.
"Direct Express" is a registered trademark of the U.S. Department of the Treasury, Financial Management Service.
Last Updated: Thursday January 03, 2008
Wednesday, October 1, 2008
Nursing Home Tansparency and Quality of Care Improvement ACT
September 30, 2008
A report by the HHS Inspector General’s Office has gotten a great deal of press attention, and we wanted to provide you access to the report in case you get questions from the media or others. The report uses OSCAR data to show trends in deficiencies from 2005 – 2007 and is contained in a memorandum from Inspector General Daniel Levinson to Kerry Weems, the Acting Administrator at CMS. You can access it on the OIG website, Trends in Nursing Home Deficiencies and Complaints (OEI-02-08-00140) http://intranet/oiginternet/oei/reports/oei-02-08-00140.pdf.
Among the highlights of the findings:
The percentage of nursing homes with deficiencies increased from 91.1% in 2005 to 91.9% in 2007.
The average number of deficiencies per nursing home increased from 6.4% to 7.0%. 74% of deficiencies in 2007 were for quality of care violations.
94% of for-profit facilities were cited in 2007, compared with 88% of nonprofits and 91 percent of government-owned nursing homes. For-profit nursing homes also had a higher average number of deficiencies.
7.3% of chain-operated facilities were cited in 2007, compared with 6.7% of single-owned facilities.
There was a slight increase in the scope and severity of deficiencies cited, with a higher percentage of for-profit nursing homes cited for immediate jeopardy or actual harm (17% versus 15% for nonprofit and government facilities).
Facilities with substandard quality of care deficiencies increased from 3.0% of nursing homes in 2005 to 3.6% in 2007. Again, for-profit nursing homes had higher citations—4.2% compared to 2.3% for nonprofits and 3.0 for government facilities.
The number of substantiated complaints fell from 14,781 in 2005 to 14,394 in 2007. Only about 39% of complaints were substantiated. About 20% of substantiated complaints involved abuse or neglect.
The report does not address an issue raised in a previous OIG report and in repeated Government Accountability Office (GAO) studies: undetected care problems and the under-citing of deficiencies. A GAO report published last spring found that when federal surveyors did comparative (look-behind) surveys, about 15% of the federal surveys “identified state surveys that failed to cite at least one deficiency at the most serious levels of noncompliance—actual harm and immediate jeopardy.” (See Nursing Homes: Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weaknesses GAO-08-517, May 9, 2008.) The GAO attributes understatement of deficiencies to surveyors’ weak investigative and analytical skills.
In spite of shortcomings in the study, it provides an opportunity for advocates to make a case to the press and policymakers for the Nursing Home Transparency and Improvement Act (S. 2641), sponsored by Senators Chuck Grassley (R-IA) and Herb Kohl (D-WI), and its House companion bill, the Nursing Home Transparency and Quality of Care Improvement Act (HR 7128), introduced last week by Representatives Pete Stark (D-CA) and Jan Schakowsky (D-IL). The bills will provide the public better information about nursing homes’ owners and operators, expenditures, staffing levels, and sanctions, and will provide better tools for the government to monitor and sanction chains. It also lends support to passage of the Fairness in Nursing Home Arbitration Act, S. 2838 and HR 6126, which would invalidate providers’ efforts to force residents and their families into arbitration when a resident was neglected or abused.
A report by the HHS Inspector General’s Office has gotten a great deal of press attention, and we wanted to provide you access to the report in case you get questions from the media or others. The report uses OSCAR data to show trends in deficiencies from 2005 – 2007 and is contained in a memorandum from Inspector General Daniel Levinson to Kerry Weems, the Acting Administrator at CMS. You can access it on the OIG website, Trends in Nursing Home Deficiencies and Complaints (OEI-02-08-00140) http://intranet/oiginternet/oei/reports/oei-02-08-00140.pdf.
Among the highlights of the findings:
The percentage of nursing homes with deficiencies increased from 91.1% in 2005 to 91.9% in 2007.
The average number of deficiencies per nursing home increased from 6.4% to 7.0%. 74% of deficiencies in 2007 were for quality of care violations.
94% of for-profit facilities were cited in 2007, compared with 88% of nonprofits and 91 percent of government-owned nursing homes. For-profit nursing homes also had a higher average number of deficiencies.
7.3% of chain-operated facilities were cited in 2007, compared with 6.7% of single-owned facilities.
There was a slight increase in the scope and severity of deficiencies cited, with a higher percentage of for-profit nursing homes cited for immediate jeopardy or actual harm (17% versus 15% for nonprofit and government facilities).
Facilities with substandard quality of care deficiencies increased from 3.0% of nursing homes in 2005 to 3.6% in 2007. Again, for-profit nursing homes had higher citations—4.2% compared to 2.3% for nonprofits and 3.0 for government facilities.
The number of substantiated complaints fell from 14,781 in 2005 to 14,394 in 2007. Only about 39% of complaints were substantiated. About 20% of substantiated complaints involved abuse or neglect.
The report does not address an issue raised in a previous OIG report and in repeated Government Accountability Office (GAO) studies: undetected care problems and the under-citing of deficiencies. A GAO report published last spring found that when federal surveyors did comparative (look-behind) surveys, about 15% of the federal surveys “identified state surveys that failed to cite at least one deficiency at the most serious levels of noncompliance—actual harm and immediate jeopardy.” (See Nursing Homes: Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weaknesses GAO-08-517, May 9, 2008.) The GAO attributes understatement of deficiencies to surveyors’ weak investigative and analytical skills.
In spite of shortcomings in the study, it provides an opportunity for advocates to make a case to the press and policymakers for the Nursing Home Transparency and Improvement Act (S. 2641), sponsored by Senators Chuck Grassley (R-IA) and Herb Kohl (D-WI), and its House companion bill, the Nursing Home Transparency and Quality of Care Improvement Act (HR 7128), introduced last week by Representatives Pete Stark (D-CA) and Jan Schakowsky (D-IL). The bills will provide the public better information about nursing homes’ owners and operators, expenditures, staffing levels, and sanctions, and will provide better tools for the government to monitor and sanction chains. It also lends support to passage of the Fairness in Nursing Home Arbitration Act, S. 2838 and HR 6126, which would invalidate providers’ efforts to force residents and their families into arbitration when a resident was neglected or abused.
Friday, September 12, 2008
Home Act S 3327
Empowered at Home Act Introduced
Cosponsors Needed
August 4, 2008: The Empowered at Home Act, S. 3327, would increase the number of older adults and people with disabilities who are eligible for Medicaid coverage for adult day services and home care. Just introduced by Sens. Charles Grassley (R-IA) and John Kerry (D-MA), it now needs more cosponsors to move it forward in the Senate.
The legislation strengthens the Medicaid home and community-based state plan option under Section 1915(i) waivers by making income eligibility standards the same for Medicaid coverage of home- and community-based services and institutional care (300% of SSI). Limitations on the scope of services allowable under 1915(i) waivers would disappear, and states would no longer be able to limit the number of individuals eligible for home and community-based services. A new 1915(k) waiver would concentrate services and funding for individuals who are high risk of institutionalization. State grants also would be available for consumer-directed care. We are especially pleased that the bill promotes and protects community living with spousal impoverishment protections for home- and community-based services recipients.
Please urge your senators to sign onto this legislation to make home- and community-based services more available under the Medicaid program.
Take Action Now!
Cosponsors Needed
August 4, 2008: The Empowered at Home Act, S. 3327, would increase the number of older adults and people with disabilities who are eligible for Medicaid coverage for adult day services and home care. Just introduced by Sens. Charles Grassley (R-IA) and John Kerry (D-MA), it now needs more cosponsors to move it forward in the Senate.
The legislation strengthens the Medicaid home and community-based state plan option under Section 1915(i) waivers by making income eligibility standards the same for Medicaid coverage of home- and community-based services and institutional care (300% of SSI). Limitations on the scope of services allowable under 1915(i) waivers would disappear, and states would no longer be able to limit the number of individuals eligible for home and community-based services. A new 1915(k) waiver would concentrate services and funding for individuals who are high risk of institutionalization. State grants also would be available for consumer-directed care. We are especially pleased that the bill promotes and protects community living with spousal impoverishment protections for home- and community-based services recipients.
Please urge your senators to sign onto this legislation to make home- and community-based services more available under the Medicaid program.
Take Action Now!
Monday, September 8, 2008
Fannie Mae and Freddie Mac
Fannie was created during the depths of the Great Depression, and Freddie in 1970, to help make mortgages more affordable for homeowners. The companies buy billions of dollars in mortgages each month from commercial lenders. Some are sold to investors as mortgage-backed securities; others are held by the companies in their own investment portfolios.
The plan represents a cease-fire in a decades-long ideological battle over the proper role of the companies. Free-market conservatives see the companies as extensions of “big government,” while Democrats have protected them as the main vehicle to promote affordable housing for middle- and lower-income people.
The plan represents a cease-fire in a decades-long ideological battle over the proper role of the companies. Free-market conservatives see the companies as extensions of “big government,” while Democrats have protected them as the main vehicle to promote affordable housing for middle- and lower-income people.
Tuesday, September 2, 2008
MEDICARE PROBLEM DONUT HOLE
September 2, 2008
Editorial
Medicare’s Troubling Drug Gap
Probably no aspect of the new Medicare drug program has caused more confusion and irritation than the notorious “doughnut hole,” a gap in coverage that forces people who had been getting their drugs cheaply to suddenly pay the full price out of pocket. Now, for the first time, an analysis has quantified what happened last year when millions of beneficiaries fell into the gap. For patients with serious chronic conditions, the medical implications were very troubling.
Congress crafted the “doughnut hole” to limit federal spending on the drug benefit. Beneficiaries pay only deductibles and co-payments, with the rest covered by their insurance plan, until their drug purchases reach a specified limit. Last year, the gap began when beneficiaries purchased $2,400 worth of drugs. Then they fell into the doughnut hole and had to pay the full cost until their out-of-pocket spending reached $3,850, at which point they qualified for catastrophic coverage.
Last year, an estimated 3.4 million beneficiaries reached the coverage gap, according to a study by researchers at the Kaiser Family Foundation, Georgetown University and the National Opinion Research Center, or NORC, at the University of Chicago. Beneficiaries taking drugs to treat such chronic conditions as Alzheimer’s disease, diabetes, depression, osteoporosis and high blood pressure were especially likely to reach the gap.
What’s disturbing is that 15 percent of the beneficiaries taking drugs in eight categories said they stopped taking their medications when they reached the gap. Another 1 percent reduced their use by skipping doses, and 5 percent switched to another drug that was cheaper but might or might not be as effective.
For the 10 percent of diabetics who stopped taking their medication after reaching the gap, the health consequences could be immediate and serious. For those with high cholesterol or osteoporosis, the harm could take longer to show up but could still be serious.
There is no easy solution short of increasing federal spending or finding a way to drive down the cost of drugs. The program has helped millions of older Americans. The next administration and Congress will have to revisit the wisdom and need for the gap.
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Editorial
Medicare’s Troubling Drug Gap
Probably no aspect of the new Medicare drug program has caused more confusion and irritation than the notorious “doughnut hole,” a gap in coverage that forces people who had been getting their drugs cheaply to suddenly pay the full price out of pocket. Now, for the first time, an analysis has quantified what happened last year when millions of beneficiaries fell into the gap. For patients with serious chronic conditions, the medical implications were very troubling.
Congress crafted the “doughnut hole” to limit federal spending on the drug benefit. Beneficiaries pay only deductibles and co-payments, with the rest covered by their insurance plan, until their drug purchases reach a specified limit. Last year, the gap began when beneficiaries purchased $2,400 worth of drugs. Then they fell into the doughnut hole and had to pay the full cost until their out-of-pocket spending reached $3,850, at which point they qualified for catastrophic coverage.
Last year, an estimated 3.4 million beneficiaries reached the coverage gap, according to a study by researchers at the Kaiser Family Foundation, Georgetown University and the National Opinion Research Center, or NORC, at the University of Chicago. Beneficiaries taking drugs to treat such chronic conditions as Alzheimer’s disease, diabetes, depression, osteoporosis and high blood pressure were especially likely to reach the gap.
What’s disturbing is that 15 percent of the beneficiaries taking drugs in eight categories said they stopped taking their medications when they reached the gap. Another 1 percent reduced their use by skipping doses, and 5 percent switched to another drug that was cheaper but might or might not be as effective.
For the 10 percent of diabetics who stopped taking their medication after reaching the gap, the health consequences could be immediate and serious. For those with high cholesterol or osteoporosis, the harm could take longer to show up but could still be serious.
There is no easy solution short of increasing federal spending or finding a way to drive down the cost of drugs. The program has helped millions of older Americans. The next administration and Congress will have to revisit the wisdom and need for the gap.
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Copyright 2008 The New York Times Company
Thursday, August 28, 2008
The $300 billion housing bill signed into law on July 30 by President Bush helps stretched homeowners renegotiate their mortgages and provides tax credits to first-time buyers.
But it also addresses three major criticisms of reverse mortgage loans, which are increasingly popular among homeowners 62 and older who use the money for living expenses, health care, prescription drugs or to pay off an existing mortgage.
With a reverse mortgage, you can tap your home equity without having to make monthly payments. Instead the bank pays you. The loan comes due only when you die, sell or move away permanently. The amount you get depends on the home’s value, location, interest rates and the age of the youngest borrower if there are co-owners.
The new bill raises the amount you can get from the mortgage and lowers the cost of getting it.
Most reverse mortgages today are Home Equity Conversion Mortgages (HECMs), which are insured by the Federal Housing Administration. Up to now, HECM has capped a home’s appraisal, which affects the loan amount. The loan limit depends on the county where the home is located and ranges from $200,160 to $362,790.
While the new limit has not been finalized, the bill will increase the amount significantly. “The higher limit will give homeowners access to more cash from their home equity,” says Peter H. Bell, President of the National Reverse Mortgage Lenders Association.
A second criticism has been that the transaction fees for reverse mortgages are too high. An AARP Public Policy Institute study in December 2007 found that high costs were one of the main reasons why eligible homeowners decided against a home mortgage.
The new bill will make HECMs less expensive for many borrowers. Origination fees had been a flat 2 percent of the home’s value, but the new bill reduces that to 2 percent of the first $200,000 of the home’s value, and then 1 percent after that. Also, the fee is capped at $6,000.
And finally, the new bill puts an end to one of the main problems related to reverse mortgages: lenders cross-selling other financial products. The new law forbids requiring the purchase of an annuity, insurance product or investment product as a condition of the loan.
“These prohibitions will protect borrowers from aggressive marketers who try to get them to invest proceeds they receive from their reverse mortgages unwisely,” said David Certner, AARP legislative policy director. “For example, pushy marketing tactics used by some originators encourage borrowers to purchase deferred annuities or long-term care insurance products that are costly and generally not in the borrower’s best interest.”
But despite these changes, says Bell, “the most important safeguards remain talking candidly with your reverse mortgage counselor and dealing only with individuals and companies you know and trust, or have thoroughly checked out.”
AARP
--------------------------------------------------------------------------------
Cathie Gandel lives in New York and writes about business and finance
Thursday, August 21, 2008
Medicare
HOW IS MEDICARE FINANCED AND WHAT ARE
MEDICARE’S FUTURE FINANCING CHALLENGES?
Funding for Medicare comes primarily from payroll tax
revenues, general revenues, and premiums paid by
beneficiaries.
Medicare is funded as follows:
Part A, the Hospital Insurance (HI) Trust Fund, is financed
largely through a dedicated tax of 2.9 percent of earnings paid
by employers and their employees (1.45 percent each). In
2007, these taxes are estimated to account for 86 percent of the
$216 billion in revenue to the Part A Trust Fund.
Part B, the
Supplementary Medical
Insurance (SMI) Trust
Fund, is financed
through a combination
of general revenues
and premiums paid by
beneficiaries.
Premiums are
automatically set to
cover 25 percent of
revenues in the
aggregate. In 2007,
Part B revenue is estimated to be $194 billion.
Part C is not separately financed.
Part D is financed through general revenues, beneficiary
premiums, and state payments for dual eligibles eligible for drug
coverage under state Medicaid programs prior to 2006. In 2007,
Part D revenue is projected to be $64 billion, 78 percent of
which will be from general revenues.
MEDICARE’S FUTURE FINANCING CHALLENGES?
Funding for Medicare comes primarily from payroll tax
revenues, general revenues, and premiums paid by
beneficiaries.
Medicare is funded as follows:
Part A, the Hospital Insurance (HI) Trust Fund, is financed
largely through a dedicated tax of 2.9 percent of earnings paid
by employers and their employees (1.45 percent each). In
2007, these taxes are estimated to account for 86 percent of the
$216 billion in revenue to the Part A Trust Fund.
Part B, the
Supplementary Medical
Insurance (SMI) Trust
Fund, is financed
through a combination
of general revenues
and premiums paid by
beneficiaries.
Premiums are
automatically set to
cover 25 percent of
revenues in the
aggregate. In 2007,
Part B revenue is estimated to be $194 billion.
Part C is not separately financed.
Part D is financed through general revenues, beneficiary
premiums, and state payments for dual eligibles eligible for drug
coverage under state Medicaid programs prior to 2006. In 2007,
Part D revenue is projected to be $64 billion, 78 percent of
which will be from general revenues.
Wednesday, July 23, 2008
The bill, H.R. 562, the Medicare Long-Term Care Hospital Improvement Act of 2007
, would make changes to the Social Security Act that could help make quality long-term health care more available to seniors. The bill would establish criteria for long-term care hospitals (LTCH) and patient criteria for payment to an LTCH.
Though this bill is just one of many health care bills before Congress right now, seeing the effect an inability to afford long-term health care has on our aging population and their families impassioned me to co-sponsor this legislation. As Congress continues to explore the broad reforms needed in the Medicare and Social Security programs, the specific need of long-term health care must not be overlooked. Our nation’s seniors who spent their lives embodying the American work ethic have truly earned it
Though this bill is just one of many health care bills before Congress right now, seeing the effect an inability to afford long-term health care has on our aging population and their families impassioned me to co-sponsor this legislation. As Congress continues to explore the broad reforms needed in the Medicare and Social Security programs, the specific need of long-term health care must not be overlooked. Our nation’s seniors who spent their lives embodying the American work ethic have truly earned it
Wednesday, July 16, 2008
Medicare
By ROBERT PEAR
Published: July 16, 2008
WASHINGTON — President Bush on Tuesday vetoed a bill protecting doctors from a Medicare pay cut, but both houses of Congress swiftly overrode the veto with large bipartisan majorities, so the bill is now law.
Brendan Smialowski for The New York Times
Representative John D. Dingell addressed the many Medicare beneficiaries there.
The vote in the House was 383 to 41, with 153 Republicans defying the president. In the Senate, the vote was 70 to 26, with 21 Republicans voting to override.
The bill won more support on Tuesday than when it was first approved. The tally in the House last month was 355 to 59, with 129 Republicans voting for passage. The crucial vote in the Senate was 69 to 30, with 18 Republicans voting yes.
The measure is the fourth bill to be enacted over the president’s veto, and two of those were farm bills.
Mr. Bush has been getting his way on many foreign and national security issues, obtaining money for the Iraq war, persuading Congress to pass new wiretapping legislation and fending off restrictions on harsh interrogation techniques like waterboarding.
But Democrats have gained the upper hand on many domestic issues, passing a water projects bill over the president’s veto and forcing the White House to accept new education benefits for veterans who fought in Iraq and Afghanistan.
After experiencing many setbacks on health legislation in recent years, Democrats rejoiced in a resounding victory on Tuesday.
The vote “renews the light of hope for those who need our help the most, senior citizens who depend on Medicare,” said Senator Harry Reid of Nevada, the majority leader.
The House speaker, Nancy Pelosi of California, said: “Seniors’ organizations and disabilities groups support this legislation. Just about every health-care-providing group in our country supports this legislation, except one, and that is some in the health insurance industry. I guess the president is voting with them and not with America’s seniors.”
The political dynamic was illustrated by Representative Marilyn Musgrave of Colorado, a conservative Republican who boasted that she was voting against the wishes of her party. “I am proud to continue my fight against the White House on behalf of Colorado doctors and seniors,” Mrs. Musgrave said. The votes on Tuesday ended a long string of victories for the health insurance industry.
In his veto message, Mr. Bush said he objected to the bill because it would cut federal payments to Medicare Advantage plans and slow the growth of such plans, offered by insurance companies as an alternative to traditional Medicare.
“I support the primary objective of this legislation, to forestall reductions in physician payments,” Mr. Bush said. “Yet taking choices away from seniors to pay physicians is wrong.”
Many independent studies have found that the private plans, sold by insurers like Humana and UnitedHealth, cost the government more per person than traditional Medicare. But Mr. Bush said that reducing payments to the plans would force them to “reduce benefits to millions of seniors.”
The bill also sets strict standards for the marketing of private plans, to curtail high-pressure sales tactics that have prompted complaints from beneficiaries and state insurance regulators.
The main purpose of the bill is to cancel a 10.6 percent cut in Medicare payments to doctors that took effect on July 1.
Little-noticed provisions of the bill would reduce the beneficiary’s co-payment for mental health services and increase assistance to low-income people on Medicare. In addition, the bill would delay a competitive bidding program for suppliers of medical equipment like oxygen tanks and power wheelchairs.
Competition “should be expanded, not diminished,” Mr. Bush said.
The American Medical Association and AARP, the advocacy group for older Americans, lobbied for the bill, deluging members of Congress with messages warning that doctors would be less likely to take Medicare patients if their fees were cut.
Four Republican senators switched sides and voted for the bill on Tuesday. The senators — Christopher S. Bond of Missouri, Richard G. Lugar of Indiana, and Thad Cochran and Roger Wicker of Mississippi — had voted against consideration of the bill on three previous occasions.
Representative Lois Capps, Democrat of California, said the veto showed that Mr. Bush “would rather cozy up to his friends in the insurance industry than improve access to health care for seniors and those with disabilities.”
But Representative Jim McCrery, Republican of Louisiana, said the bill “just kicks the can down the road” and does not fix fundamental flaws in the formula for paying doctors. In 18 months, Mr. McCrery said, doctors will face a 20 percent cut in their Medicare payments.
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Past Coverage
DOCTORS PRESS SENATE TO UNDO MEDICARE CUTS (July 7, 2008)
DEMOCRATS PRESS HOUSE TO PUSH TO EXPAND HEALTH CARE BILL (July 23, 2007)
Bush Threatens Veto of Medicare Drug Bill, but a Senator Is Seeking a Middle Ground (January 12, 2007)
BUSH VOWS VETO OF ANY CUTBACK IN DRUG BENEFIT (February 12, 2005)
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Published: July 16, 2008
WASHINGTON — President Bush on Tuesday vetoed a bill protecting doctors from a Medicare pay cut, but both houses of Congress swiftly overrode the veto with large bipartisan majorities, so the bill is now law.
Brendan Smialowski for The New York Times
Representative John D. Dingell addressed the many Medicare beneficiaries there.
The vote in the House was 383 to 41, with 153 Republicans defying the president. In the Senate, the vote was 70 to 26, with 21 Republicans voting to override.
The bill won more support on Tuesday than when it was first approved. The tally in the House last month was 355 to 59, with 129 Republicans voting for passage. The crucial vote in the Senate was 69 to 30, with 18 Republicans voting yes.
The measure is the fourth bill to be enacted over the president’s veto, and two of those were farm bills.
Mr. Bush has been getting his way on many foreign and national security issues, obtaining money for the Iraq war, persuading Congress to pass new wiretapping legislation and fending off restrictions on harsh interrogation techniques like waterboarding.
But Democrats have gained the upper hand on many domestic issues, passing a water projects bill over the president’s veto and forcing the White House to accept new education benefits for veterans who fought in Iraq and Afghanistan.
After experiencing many setbacks on health legislation in recent years, Democrats rejoiced in a resounding victory on Tuesday.
The vote “renews the light of hope for those who need our help the most, senior citizens who depend on Medicare,” said Senator Harry Reid of Nevada, the majority leader.
The House speaker, Nancy Pelosi of California, said: “Seniors’ organizations and disabilities groups support this legislation. Just about every health-care-providing group in our country supports this legislation, except one, and that is some in the health insurance industry. I guess the president is voting with them and not with America’s seniors.”
The political dynamic was illustrated by Representative Marilyn Musgrave of Colorado, a conservative Republican who boasted that she was voting against the wishes of her party. “I am proud to continue my fight against the White House on behalf of Colorado doctors and seniors,” Mrs. Musgrave said. The votes on Tuesday ended a long string of victories for the health insurance industry.
In his veto message, Mr. Bush said he objected to the bill because it would cut federal payments to Medicare Advantage plans and slow the growth of such plans, offered by insurance companies as an alternative to traditional Medicare.
“I support the primary objective of this legislation, to forestall reductions in physician payments,” Mr. Bush said. “Yet taking choices away from seniors to pay physicians is wrong.”
Many independent studies have found that the private plans, sold by insurers like Humana and UnitedHealth, cost the government more per person than traditional Medicare. But Mr. Bush said that reducing payments to the plans would force them to “reduce benefits to millions of seniors.”
The bill also sets strict standards for the marketing of private plans, to curtail high-pressure sales tactics that have prompted complaints from beneficiaries and state insurance regulators.
The main purpose of the bill is to cancel a 10.6 percent cut in Medicare payments to doctors that took effect on July 1.
Little-noticed provisions of the bill would reduce the beneficiary’s co-payment for mental health services and increase assistance to low-income people on Medicare. In addition, the bill would delay a competitive bidding program for suppliers of medical equipment like oxygen tanks and power wheelchairs.
Competition “should be expanded, not diminished,” Mr. Bush said.
The American Medical Association and AARP, the advocacy group for older Americans, lobbied for the bill, deluging members of Congress with messages warning that doctors would be less likely to take Medicare patients if their fees were cut.
Four Republican senators switched sides and voted for the bill on Tuesday. The senators — Christopher S. Bond of Missouri, Richard G. Lugar of Indiana, and Thad Cochran and Roger Wicker of Mississippi — had voted against consideration of the bill on three previous occasions.
Representative Lois Capps, Democrat of California, said the veto showed that Mr. Bush “would rather cozy up to his friends in the insurance industry than improve access to health care for seniors and those with disabilities.”
But Representative Jim McCrery, Republican of Louisiana, said the bill “just kicks the can down the road” and does not fix fundamental flaws in the formula for paying doctors. In 18 months, Mr. McCrery said, doctors will face a 20 percent cut in their Medicare payments.
More Articles in Washington »Need to know more? 50% off home delivery of The Times.
Past Coverage
DOCTORS PRESS SENATE TO UNDO MEDICARE CUTS (July 7, 2008)
DEMOCRATS PRESS HOUSE TO PUSH TO EXPAND HEALTH CARE BILL (July 23, 2007)
Bush Threatens Veto of Medicare Drug Bill, but a Senator Is Seeking a Middle Ground (January 12, 2007)
BUSH VOWS VETO OF ANY CUTBACK IN DRUG BENEFIT (February 12, 2005)
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Tuesday, July 15, 2008
Long term health care at home
A Balancing Act: State Long-Term Care Reform, is the first to examine Medicaid spending on long-term care for older people and adults with physical disabilities, separate from other LTC users such as people with mental retardation/developmental disabilities (MR/DD).
Nationally, 75 percent of Medicaid LTC spending for older people and adults with physical disabilities pays for institutional care in nursing homes. In contrast, states have done a much better job balancing Medicaid LTC for people with MR/DD, spending just 39 percent on institutional care. The majority of funds now supports people in home and community-based settings.
"We recognize the success state Medicaid programs are having providing home and community based services to people with mental retardation/developmental disabilities," said AARP Pennsylvania State Director Dick Chevrefils. "It proves that balancing long-term care is doable and should be used as a model to help states provide home and community based services for older adults."
As part of its Commonwealth Long-Term Living Project, Pennsylvania set a goal of 50 percent home-based care to 50 percent institutional care for all long-term care populations by FY 2011-12. Unfortunately, the recently passed 2008-09 state budget included no new spending to reduce existing HCBS waiting lists for Pennsylvania's lottery-funded OPTIONS program.
The report examines Medicaid LTC funding because it is the primary payer for LTC in the country. "This underscores the need for better government and private sector financing options for long-term care. Americans have few options to plan and pay for their long-term care. Balancing Medicaid LTC options will require a commitment from our state officials and cooperation from federal authorities. HCBS can be both cost-effective and responsive to the preferences of older people and adults with disabilities," said Chevrefils.
The new report includes state rankings and can be found at: http://www.aarp.org/research/longtermcare/programfunding/2008_10_ltc.html.
Nationally, 75 percent of Medicaid LTC spending for older people and adults with physical disabilities pays for institutional care in nursing homes. In contrast, states have done a much better job balancing Medicaid LTC for people with MR/DD, spending just 39 percent on institutional care. The majority of funds now supports people in home and community-based settings.
"We recognize the success state Medicaid programs are having providing home and community based services to people with mental retardation/developmental disabilities," said AARP Pennsylvania State Director Dick Chevrefils. "It proves that balancing long-term care is doable and should be used as a model to help states provide home and community based services for older adults."
As part of its Commonwealth Long-Term Living Project, Pennsylvania set a goal of 50 percent home-based care to 50 percent institutional care for all long-term care populations by FY 2011-12. Unfortunately, the recently passed 2008-09 state budget included no new spending to reduce existing HCBS waiting lists for Pennsylvania's lottery-funded OPTIONS program.
The report examines Medicaid LTC funding because it is the primary payer for LTC in the country. "This underscores the need for better government and private sector financing options for long-term care. Americans have few options to plan and pay for their long-term care. Balancing Medicaid LTC options will require a commitment from our state officials and cooperation from federal authorities. HCBS can be both cost-effective and responsive to the preferences of older people and adults with disabilities," said Chevrefils.
The new report includes state rankings and can be found at: http://www.aarp.org/research/longtermcare/programfunding/2008_10_ltc.html.
Monday, July 7, 2008
Massachusetts FY '09 State Budget Update
Massachusetts FY '09 State Budget Update
Dear Howard,
Last Thursday, before departing to observe the July 4th holiday, Massachusetts legislators approved next year's state budget.
The Commonwealth is facing fiscal challenges. However, the Massachusetts Legislature chose to fund critical programs and services for our residents.
Prescription Drug Costs
-New program and funding for evidence based outreach and education program.
Prescription Advantage
- Full funding.
- Maintained structural integrity and hold enrollees harmless by keeping cost sharing at 2007 levels and prohibiting increases without legislative approval.
- Ongoing open enrollment.
Long Term Care Continuum
- Adequate funding for a long term care continuum, that includes high quality, affordable skilled nursing facilities, assisted living facilities, senior housing, and home and community based services, to meet the needs of our aging population.
- Adequate funding to provide home and community based care that enables older and disabled persons to remain healthy and independent.
- Adequate funding of skilled nursing facilities -- which often care for the most frail and vulnerable individuals; including the nursing home criteria known as "Score 3".
- New funding to rebalance the system to allow for more home and community based care.
- Increased funding for the Councils on Aging and Senior Centers.
Health Care Reform
- Adequate funding to implement the new health care reform law so that consumers will have access to affordable insurance products with meaningful benefits.
- Outreach grants to educate residents and assist in enrolling them in health care insurance coverage.
Money Management Program
- Maintained funding to operate the program statewide.
Please make 2 important calls today!
1. Contact Representative Christopher Fallon and Senator Richard Tisei at (617) 722-2800 and thank them for continuing to support important programs and services that help our residents remain healthy, independent and economically secure.
2. Contact Governor Patrick at (617) 725-4000 and urge him to approve the budget as submitted.
Thank you again for your continued advocacy on these very important matters.
Dear Howard,
Last Thursday, before departing to observe the July 4th holiday, Massachusetts legislators approved next year's state budget.
The Commonwealth is facing fiscal challenges. However, the Massachusetts Legislature chose to fund critical programs and services for our residents.
Prescription Drug Costs
-New program and funding for evidence based outreach and education program.
Prescription Advantage
- Full funding.
- Maintained structural integrity and hold enrollees harmless by keeping cost sharing at 2007 levels and prohibiting increases without legislative approval.
- Ongoing open enrollment.
Long Term Care Continuum
- Adequate funding for a long term care continuum, that includes high quality, affordable skilled nursing facilities, assisted living facilities, senior housing, and home and community based services, to meet the needs of our aging population.
- Adequate funding to provide home and community based care that enables older and disabled persons to remain healthy and independent.
- Adequate funding of skilled nursing facilities -- which often care for the most frail and vulnerable individuals; including the nursing home criteria known as "Score 3".
- New funding to rebalance the system to allow for more home and community based care.
- Increased funding for the Councils on Aging and Senior Centers.
Health Care Reform
- Adequate funding to implement the new health care reform law so that consumers will have access to affordable insurance products with meaningful benefits.
- Outreach grants to educate residents and assist in enrolling them in health care insurance coverage.
Money Management Program
- Maintained funding to operate the program statewide.
Please make 2 important calls today!
1. Contact Representative Christopher Fallon and Senator Richard Tisei at (617) 722-2800 and thank them for continuing to support important programs and services that help our residents remain healthy, independent and economically secure.
2. Contact Governor Patrick at (617) 725-4000 and urge him to approve the budget as submitted.
Thank you again for your continued advocacy on these very important matters.
Wednesday, July 2, 2008
CARING FOR AN AGING AMERICA
Caring for an aging america act
1. Sen. Boxer Introduces Health and Long-Term Care Workforce Bill
Sen. Barbara Boxer (D-CA) introduced S. 2708, the Caring for an Aging America Act, on March 5. The bill would address the emerging gap between the increasing number of older Americans and the serious lack of providers trained in caring for their medical, health, and social support needs. NCOA supports the proposal.
The bill would provide $130 million over five years to recruit and retain trained healthcare professionals and direct-care workers by providing them with loan forgiveness and career advancement opportunities. Specifically, the legislation would:
• Establish a Geriatric and Gerontology Loan Repayment Program for health professionals who complete specialty training in geriatrics or gerontology and agree to provide full-time clinical practice and service to older adults for a minimum of two years.
• Expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.
• Offer specialty training in long-term care services through the existing Career Ladders Grants Program.
• Create a Health and Long-Term Care Workforce Advisory Panel for an Aging America to identify incentives for recruitment and retention of new populations of clinicians and providers to serve vulnerable older adults
1. Sen. Boxer Introduces Health and Long-Term Care Workforce Bill
Sen. Barbara Boxer (D-CA) introduced S. 2708, the Caring for an Aging America Act, on March 5. The bill would address the emerging gap between the increasing number of older Americans and the serious lack of providers trained in caring for their medical, health, and social support needs. NCOA supports the proposal.
The bill would provide $130 million over five years to recruit and retain trained healthcare professionals and direct-care workers by providing them with loan forgiveness and career advancement opportunities. Specifically, the legislation would:
• Establish a Geriatric and Gerontology Loan Repayment Program for health professionals who complete specialty training in geriatrics or gerontology and agree to provide full-time clinical practice and service to older adults for a minimum of two years.
• Expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.
• Offer specialty training in long-term care services through the existing Career Ladders Grants Program.
• Create a Health and Long-Term Care Workforce Advisory Panel for an Aging America to identify incentives for recruitment and retention of new populations of clinicians and providers to serve vulnerable older adults
Friday, June 27, 2008
Recomended Federal Programs to Support Seniors
10 Government Programs You Can Access for Mom or Dad
By Leonard J. Hansen
Caregiving for a parent may stretch the budget as well as your endurance -- that is, if you aren’t aware of scores of federal, state and even local government programs.
Access to assistance is as close as your computer, and, in most cases, you can apply online. Start by accessing two sites:
www.Govbenefits.gov - Gather up all the information you can on your parent’s health, disability, income, wealth (as in property owned), whether a military veteran, education level and more. Access this site and answer every question that you can. Then, push the button and, within minutes, the site will respond with a list, details and access information for many, even scores, of beneficial government programs, supplements and/or services.
www.Benefitscheckup.org - This non-profit site will ask many of the same questions but may report added programs, details and contacts.
Here is a guide to the top 10 programs everyone who is caring for an aging parent should know about:
1. Medicare
There is more to Medicare than just the Part A hospital and Part B medical insurance coverage. If your parent is 65 or older and collecting Social Security, the insurance premiums are deducted from monthly benefits. Part D prescription drug coverage is subsidized by Medicare through payments to private company insurers who then fund an average of 90 percent of the cost of prescription drugs. If your parent is considered low income, receiving only Social Security, Medicare may subsidize all but about $10 of the monthly premiums. Ask and you may find a great cost saving for your parent.
Medicare: www.medicare.gov Medicare Part D: www.medicare.gov/pdphome.asp
2. Social Security
If your parent’s Social Security benefits were earned based on lower-paying jobs, and if the benefits are the only source of income, there may be a larger monthly benefit available by applying for its Supplemental Security Income (SSI) program. The program may be operated federally or in conjunction with your state government. The welfare-based Medicaid program is also administered through the Social Security Administration, though the operation may be directed by your state government.
www.socialsecurity.gov/OP_Home/handbook.21handbook-2100.html
3. Administration on Aging (AoA)
The AoA administers many national programs and services for elders, including health insurance counseling, legal assistance, protection from elder abuse and long-term care. The banner on the website has a link to Elders and Families, your starting point. This section also offers a specific link and service For Caregivers (see the left hand column.)
www.aoa.gov
4. Department of Veterans Affairs (VA)
If your parent is a military veteran and has a service-related disability, you may be able to apply for an increase in benefits, particularly if the disability has worsened over time. If he or she needs continuing medical care because of the disability, an application for medical benefits, hospitalization and prescription drugs may be submitted. There are several types and levels of VA disability compensation and pension programs. The VA has been slow in processing claims the past few years, but there is continuing pressure by Congress and the Administration to speed up its service.
www.va.gov
5. HIPAA
The Health Insurance Portability and Accountability Act of 1966 provides your parent privacy of his or her medical records. It is a regulation and restriction program on health care providers. The protection should be of concern to you and other family members because, unless your parent signs a form designating each of you as approved to discuss your medical concerns with the physician, he or she cannot do such, even if you prove your family connection. Better sooner than later, access the HIPAA website for the information and forms, or secure the forms from a physician, and file copies with every health care professional involved in your parent’s care.
www.hhs.gov/ocr/hipaa/consumer_summary.pdf
6. United States Department of Justice
If your parent has a disability, particularly with physical movement, learn about the Americans With Disability Act administered by the U.S. Department of Justice. Its website offers briefings and cost-free publications on the regulations to grant universal access to the disabled.
www.ada.gov/publicat.htm#Anchor-14210
7. Food and Drug Administration
Your parent is probably taking five to as many as 10 different prescription drugs, perhaps prescribed by different doctors. As caregiver, you should be aware of every one of the drugs, know its mission in the body and, particularly the side effects and conflicts with other medications. The federal Food and Drug Administration offers a giant database on every drug approved by the agency, listing active ingredients, purpose or mission of the medication, dosing recommendations and the side effects and conflicts.
www.fda.gov/cder/index.html(At the top right hand on the opening page, click the link to Drugs@FDA)
8. Your U.S. Senator
Every senator has a staff specialist on elder affairs, programs and services, probably in major cities of your state plus in Washington, D.C. The staff person can both advise and advocate for benefits or services for your parent. Know that bureaucrats listen immediately to an aide for a United States Senator.
www.senate.gov
Click the Senators link.
9. Your Congressional Representative
Most Representatives in the United States Congress also have staff specialists on elder affairs, programs and services and can provide both information and advocacy.
www.house.gov(Click the Representatives by State link)
10. Area Agency on Aging
There is a federally-mandated Area Agency on Aging in your county or city. This agency is staffed by professionals who know every elder program and service, including available funding sources, in your area. Staff is often aided by volunteers who serve as drivers for transport and Meals-on-Wheels, for respite services and other duties. Gather up the same information you collected for the two sites detailing the national, and even state, programs for which your parent may qualify and make an appointment to meet with a counselor at the Area Agency on Aging. The staff person can advise regarding programs and qualifications and even help prepare the necessary applications and documentation. Often, the counselor will even call a recommended agency, program or service to advise that your application is headed their way. Access your Area Agency on Aging through your telephone book and call the office for an appointment, at which time you should also ask if they have a website that you can access in advance of an in-person visit.
In Summary
Use these resources and you may gain a world of vital information as well as increased income and services for your parent. And you just may find your caregiving less stressful and demanding.
--------------------------------------------------------------------------------
Leonard J. Hansen is recognized as the pioneer journalist and author writing to, for and about mature adults, founding, publishing and editing Senior World newspapers and a syndicated newspaper columnists. He has received 106 professional awards and fellowships for his journalistic and creative work. Access his website at: www.lenhansen.com
Comments (1 to 3 of 3)
skoder
Jun 11, 2008
Suggest Removal
I am caring for my aging disabled father in myhome and want to now if you can get compensated for it to cover some of the bills, we live in Phoenix, AZ. Ifanybody hasiany answers please let me know.
Valerie
4 days ago
Suggest Removal
My aunt is elderly (89) and only has social security income. She is not able to pay her Minnesota property taxes. Are there any tax assistance programs in Minnesota that could help?
HisPony
4 days ago
Suggest Removal
As a recent Retiree from the Navy I would like to add a few things about the VA:
1) If the person was released from the military for a Disability or Retired after 20 years of service, you will need thier DD 214 before contacting the VA Hospital for Medical appointments. If you don't have one, you can still contact them for a starting place to receive a replacement.
2) To increase the person's Disability Compensation you will need a Medical History from the time of departure to the present. You will also need the original Disability Rating Letter issued from the VA.
3) The biggest misconception is that a Disabled/Retired Millitary member has to go to a VA hospital to be seen!! This is not true, the person can sign up for TRICARE Prime and see a doctor that accepts TRICARE in thier home town. TRICARE has a list of approved doctors for your area. I pay $460 a year for a Family Plan that allows me to see a doctor who is only 5 miles from my home. If the person is on Medicare/Medicad the regular TRICARE will pick up all copays. Contact TRICARE and they will explain all of the details.
4) Most states now have a state sponsored Veteran Office that help Veterans and thier families through the paperwork process. A quick internet search or phone call to the VA should help you get in touch with the right people.
I am in no way affiliated with the VA or any other organization, just a retired Vet that is trying to help people get pointed in the right direction.
Jack
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