Sunday, March 05, 2006

Medicare needed for young, old Americans

By PAUL SORUM
First published in the Albany Times Union on Sunday, March 5, 2006

Medicare Part D represents a turning point in our health care system. The passage of Medicare Part D, which deals with prescription drugs, shows that even our political leaders realize that, for the American public, "health insurance" no longer means merely insurance against possible future major losses (that is, unforeseen illnesses or accidents).

It means coverage of the cost of medications and other care needed to maintain and improve their health.

Preventive care already has crept into Medicare. For example, it now covers flu shots, mammograms and colonoscopies. With the addition of Part D's medication benefits -- even if these benefits are limited -- Medicare is moving closer to people's expectations, becoming more of a "health maintenance organization" for seniors and the disabled.

The implementation of Medicare Part D, however, belies these expectations. If Part D was intended to create jobs for health care administrators, it is a success. If it was intended to increase the profits of pharmaceutical and insurance companies, it is a success. But if it was intended to provide needed medications to seniors and the disabled -- especially if it was intended to do this in a straightforward and inexpensive fashion -- it is a failure.

Its implementation demonstrates that adding layers of insurers and pharmaceutical benefit managers results only in unneeded cost, complexity and confusion.

Some have gone so far as to suggest that the underlying objective of the Bush administration is to discredit Medicare and thus hasten its demise. If so, this use of Part D is backfiring. The American people -- especially those who already benefit from Medicare -- see Part D for what it is and what it should be.

In their loud complaints about Part D and, in many cases, their refusals to enroll, they are demonstrating that the Medicare they want to preserve and expand is the Medicare before Part D, with a drug benefit that works.

A recent Wall Street Journal Online/Harris Interactive Health-Care Poll found that 79 percent of seniors approve of a Medicare prescription drug benefit, but only 36 percent are pleased that the specific Medicare bill was passed. Of those seniors enrolled in a Medicare drug plan, 60 percent agree it was difficult to choose a plan and 63 percent that it was difficult to understand the benefits.

The Medicare they want -- the Medicare we all want -- is simple and straightforward to use and inexpensive to administer. Financed by a combination of payroll and general taxes, this Medicare can be a model for providing comprehensive care to Americans of all ages. The expense of providing universal coverage will be more than offset by the savings from lower administrative costs. The lesson of Part D is that the time has come for serious, in-depth analysis and debate about the desirability and feasibility of an expanded Medicare for all Americans, young and old.

Paul Sorum is chairman of the Capital District Chapter of Physicians for a National Health Program. He is a professor of internal medicine and pediatrics at Albany Medical College.

HEALTH COVERAGE
What: "Medicare for All," a series of forums sponsored by the Capital District chapter of Physicians for a National Health Program and the New York State League of Women Voters
When: Noon-2 p.m. this Tuesday, April 10, April 24; 1-3 p.m. on March 27
Where: Linda Norris Auditorium, 339 Central Ave., Albany
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