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Will it be good for the 45 million Americans on Medicare?

The possibility that the Congress will eliminate the special subsidies for Medicare Advantage insurers, which could raise the cost of these policies. This could strengthen traditional Medicare and hold Part B premiums down. However, the cynics who have sought the death of Medicare now have the chutzpah to protest these cuts as a threat to Medicare. But Dr. Howard Dean points out that those $176 billion in subsidies will be saved for the beneficiaries of Medicare and the reforms. More important, this may be the beginning of the end of efforts to privatize Medicare that these cynics pushed. Aside from that issue, Medicare advocates have worried lest this most popular health insurance program gets mangled in the maelstrom over health insurance reform. Many of those people screaming against a "public option" seem to forget that Medicare has been working fine as a public option for 44 years.AARP supports gradually eliminating subsidies to private insurance companies, including UnitedHealth. And despite AARP's profits from selling United's insurance, AARP's literature supports a public option that would compete with United and other insurers. The Center for Medicare Advocacy is more explicit.

The center, which provides legal help for Medicare enrollees, also says most of the reform bills would postpone scheduled 21 percent cuts in physician payment and change the payment formula to emphasize primary care. While Medicare covers most cancer screening services, the bills provide that beginning Jan. 1, 2011, no deductibles or co-payments will be required. And as of this January, all vaccines will be covered under Part B.Most of the bills would also provide more help for low-income beneficiaries using Part A (hospitalization), Part B (outpatient visits) and prescription benefits by raising the amount of assets they may retain to be eligible for low-income subsidies. Most bills would gradually eliminate the "doughnut hole," the Part D coverage gap during which many pay the full price for drugs. During the current struggles in the Congress, the more liberal House, with a bill proposed by three committees, and the more conservative Senate, with two committee bills, will sort out the differences under the eyes of the White House, which may weigh in as the legislation comes to the floor of both houses this fall. It's possible there will be other Medicare improvements, such as ending budget restrictions that stunt Medicare's growth, and permitting Medicare to bargain for the best Part D drug prices.

The main question on health reform, so far, is whether the final bill will include a strong Medicare-like public option among the private choices. If it does, most experts believe that it will help strengthen Medicare as a model that could eventually cover all Americans. That's the reason the drug and insurance industries oppose a Medicare-like public plan. Along with thousands of doctors, nurses and other health care professionals, the AFL-CIO has been a powerful supporter of Medicare for All, which carries with it the cumbersome name "single-payer," that is often misunderstood. It merely means that in the case of Medicare, the government pays the bills.
The labor-affiliated Alliance for Retired Americans, whose predecessor, the National Council of Senior Citizens played a leading role in winning Medicare, was organized as a more aggressive voice for retirees . The Alliance is among the advocates worried that Medicare has been maligned in the current battle.

Source: newsday.com

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