(Source: Mike Segar/Reuters)
It's Lieberman versus Lieberman at CJR, where analyst Trudy Lieberman
eviscerates the Lieberman/Coburn plan to raise the eligibility age for Medicare, a plan that the White House seems to have embraced as a bargaining chip.
Leave it to Connecticut Sen. Joe Lieberman to speed along the process of making seniors on Medicare pay more for their care—the cost control method of choice at the moment, since it doesn’t disturb the profits of major stakeholders. After all, it was Lieberman who sealed the death warrant for the public option during the health reform debate. So the legislation he has proposed along with Senator Tom Coburn is consistent with his political MO. Lieberman’s proposal along with others like it may well slip into the bill, authorizing an increase in the debt ceiling with nary a word from the seniors who depend on the program. It would be grand if they knew what was afoot.
The plan is deceptively referred to as “Medicare benefit simplification,” says Joe Baker, who heads the Medicare Rights Center, a New York City advocacy group. “What they are proposing is not simplifying the benefit to help consumers but to save the federal government money, and they do that by increasing costs to consumers and providing a disincentive to use medical services.” Lieberman et al want to create a single deductible of $550 for all Medicare services, replacing the separate hospital deductible—this year $1132—and the separate medical deductible of $162. They also want to cap out-of-pocket spending for people with low to middling incomes at $7500.
Those with higher incomes would have to pay more out-of-pocket in a further effort to means-test the program. There’s already some means testing in Medicare, but Lieberman’s proposal would add more.....
Making people pay a lot more is precisely what Lieberman and other pols want. He cites studies showing that when people have to pay more for their care, they will use less of it, and claims his proposal will reduce the debt and “save more than $600 billion over 10 years.” In his press release he says: “We can only save Medicare if we change it. Our plan contains some strong medicine but that’s what it will take to keep Medicare alive.”
What will it take to keep seniors alive? That’s a good question for the press to explore. Half have annual incomes under $22,000, and the median income for older women on Social Security is only about $15,000. A recent RAND study, also missed by the press, found consumers with high-deductible insurance and lots of cost sharing did economize on going to the doctor even for preventive care covered by their policies.
“This has a perverse effect,” says [Bonnie Burns, a policy specialist with California Health Advocates]. “The older you are the more likely you’ll pay those high out-of-pocket expenses. They would hit women the hardest and shift more of them into Medicaid.” Given that states are having trouble paying for Medicaid and there’s talk of cutting the feds’ contribution through block grants, it’s fair to ask how will these women pay for their care. It’s also fair to ask how they will pay for it if proposed changes in Social Security’s cost-of-living formula now discussed as part of the deficit reduction package, become law. COLA changes are likely to result in smaller increases for many. Folks, this is really about the kitchen table connection.
It hurts seniors without really saving that much money for the program, relatively, since the major costs for the program hit older people. And if it also meant seniors put off getting medical treatment for the extra two years until they got Medicare, then their costs could also be higher. It was a bad plan when Lieberman and Coburn introduced it, and it's a bad plan for the White House to have offered up.