Re: Medicare's Future: Whose Side Is AARP On?

Medicare Drug Benefit Isn't a Nice Bill to Swallow
Saul Friedman (NY Newsday)
November 15, 2003

My mail over the past few weeks poses a mystery. Despite the initial demand
for a drug benefit among Medicare beneficiaries who struggle to buy the
drugs they need, not a single senior who has written is looking forward to
the prescription drug bill being fashioned in secret by the
Republican-dominated House-Senate conference committee. Rather, leaders of
senior groups tell me that Medicare beneficiaries fear the outcome.
So the mystery: Why the rush to pass a bill before next year? Where is the
pressure coming from? If most Medicare advocates say they would rather have
no bill, who wants it? President George Bush and Republican leaders want
election-year credit for a drug bill, which gives them cover to begin
privatizing Medicare. Drug companies are happy with the Republican bill
because it prohibits price controls and they're financing a push for
passage with the help of right-wing senior groups.
Most Democrats have been excluded from sessions of the conference
committee. But some Democrats, notably Sen. Edward Kennedy (D-Mass.), hope
that moderate Republicans will force the ideologues to retreat from efforts
to kill Medicare. And organizations such as AARP and Families USA, which
have invested time, money and lobbying energies trying to wring out the
best deal possible, think even a bad bill that gives some drug coverage
could be a good beginning.
These people ought to read my mail.
Anthony A., of Windemere Ponds, a retired New York cop and World War II
vet, notes that millions of retirees may lose their present drug coverage:
"My wife and I receive secondary insurance from NYC as part of our
retirement. To lose it ... would be devastating. ... It seems lately all we
seniors hear is how this administration is going to change Medicare and
Social Security. ... Our protests are being ignored because we don't have a
far-reaching future and God knows the past is forgotten."
Anita Borow, who moved with her husband to South Carolina last summer from
Nassau County, which they could no longer afford, has some drug coverage
from her Medigap policy. But she asks, "Why can't all these experts in
government and the AARP understand their fixes will only hurt the
average-income senior? ... If Medicare is ruined or compromised and an
illness strikes, we could be wiped out in no time." 
Walter S., of New Canaan, Conn., e-mails: "During the last three years I
had two extended hospital stays which also involved medical providers of
many specialties, all of which was covered by Medicare Part A and B and my
own AARP Medigap plan F. As it is, Medicare works. It is ... not in need of
any fixing or finagling by the vote buyers in Washington. They should ...
enact an optional prescription drug program as a supplement to the existing
Medicare to provide some relief from the greedy drug companies consistent
with our society's ability to pay with reasonable deductibles and co-pays.
We don't need smoke and mirrors." 
Anthony L., of Naples, Fla., writes, "I will be one of those who will opt
out of Medicare if they start to base premiums on my wealth and earnings. I
have paid higher income taxes all my life, FICA and Medicare taxes, and
still have saved so as not to be a burden on anyone, including the
government. The message out of Washington seems to be ... 'Tough, Buddy.'" 
Louis Brunelli, the retired associate dean of Juilliard, who has survived a
struggle with cancer and heart problems that included implanting a
pacemaker and defibrillator, wrote, "Medicare paid $49,770.71 for the job.
No doubt a private carrier would not have sanctioned the procedure since I
was considered a borderline case."
And David G., of Manhasset, says, "AARP is so absorbed with having Congress
pass any prescription coverage that it is not considering the consequences
on those of us that presently have coverage."
Actually, AARP is painfully aware that the prescription drug bill as it now
stands is widely unpopular with its members. A top AARP lobbyist told me,
"It will be a very tough sell. But it has some worthwhile features. It sets
aside $400 billion over 10 years for drugs. And it provides benefits for
poor Medicare beneficiaries."
But most AARP members are not poor and he acknowledged that the possible
loss of retiree drug benefits, premium increases for more affluent
beneficiaries, higher deductibles and new co-payments, plus subsidies for
private insurance companies that could undermine Medicare would make the
bill difficult to swallow. "Whether the good outweighs the bad, we don't
yet know. We will decide when the bill comes out of committee," he said.
"We're hoping to improve it."
But if AARP and enough Democrats help pass a bill that includes
means-tested premiums and benefit cuts, said attorney Judith Stein,
director of the Center for Medicare Advocacy, it could go the way of the
1989 Medicare Catastrophic Coverage Act, which was repealed when
beneficiaries rebelled at the imposition of a surtax.
The 1989 bill "had far greater benefits than is currently contemplated,"
she told me. "If history teaches, an income-related payment could again
lead to a rejection of the new package, particularly if the new benefits
are questionable."
And there was this e-mail from George Wechsler of North Bellmore, "If
memory serves, there was a senior citizens revolt some years ago when
Congress tried to exact special charges for coverage. Couldn't this be
repeated? What they are trying to do with Medicare is far worse than the
catastrophic coverage fiasco."