Statement
from Robert M. Hayes, president, Medicare Rights
Center, on the Medicare Trustees
Report...Medicare is the Solution
Today’s Medicare Trustees report will give the
Bush Administration an excuse to continue to
raise false alarms about the financial health of
the program. Transitory predictions must not be
allowed to damage one of the most successful
domestic programs in American history.
Medicare is the solution to our soaring health
care costs, not the problem. Americans are
living healthier and longer lives, in large part
thanks to the reliable and affordable health
care provided by Medicare. Independent economic
analyses show that Medicare could cover all
Americans—including the 45 million Americans
currently uninsured—and still cut annual U.S.
health expenditures by $60 billion[1]
to $200 billion[2].
Medicare can achieve what for-profit
insurers cannot: it reduces the high
administrative costs of our fragmented
health care system and cuts the paperwork
that prevents us from getting health care to
the people who need it.
Responsible leadership would meet the health
care needs of people with Medicare—and all
Americans—efficiently and directly by making
Medicare available to everyone living in the
country.
The original design of the Medicare program—its
universality, shared risk, simplicity and
dependability—created the foundation for its
success.
A key prediction of this year’s report is that
the surplus in Medicare’s Part A trust fund,
containing revenue from workers’ payroll
deductions that pay for inpatient care
(hospitalization and skilled nursing care) will
be gone in the next decade.
Don’t be so sure. These predictions are based
on the interplay of a number of factors. If
economic growth exceeds the cautious forecasts
used by Medicare trustees, or increased use of
prescription drugs proves an effective
substitute for expensive surgery, then the trust
fund will be financially more secure then it now
appears.
In 1997, the trustees reported the reserve
would be depleted by 2001. In 1998, they said
the reserve’s demise would come in 2008. Then,
just three years ago, they said there would be
enough money until 2026.
Keep in mind that even if the reserve is
completely depleted, money coming in from
payroll taxes will continue to cover about
two-thirds of the estimated costs of the
Medicare Part A program.
In addition, Congress has the ability to take
measured steps, as it has in the past, to shore
up the trust fund. Payment adjustments enacted
in 1998 averted the solvency crisis predicted
for 2001. Overpayments to private, mostly
for-profit Medicare Advantage plans, which cost
between 12 and 19 percent more per enrollee than
coverage under Original Medicare, are the first
place Congress should look.
In addition, the Administration claims the
rising expenditures in outpatient care (known as
Medicare Part B) and in prescription drugs (Part
D) are reasons to cut back care. These programs
are paid for from general tax revenue, not the
Medicare trust fund..
The Administration’s claims of Medicare’s
impending “bankruptcy” (used by this
Administration as a word of propaganda, not of
law or finance) will be all the more shrill
because the trustees report predicts that in the
next decade some 45 percent of the cost of
Medicare will be related to care that is largely
provided outside a hospital. That is a false
alarm, worthy of a shrug. People with Medicare
should not panic and neither should members of
Congress.
When Congress looks at ways to shore up
Medicare’s finances, it should keep in mind the
promise of health security for older adults and
people with disabilities that Medicare embodies.
Proposals to restrict eligibility for Medicare
or to transform Medicare from a universal social
insurance program into a means-tested program
for the poor are a betrayal of that promise. If
we are committed to ensuring quality, affordable
health care for older adults and people with
disabilities, then we should be willing to
secure the tax revenue, whether from the payroll
tax or from general funds, that will enable us
to meet that commitment.
If the government paid the insurance companies
offering private Medicare Advantage plans the
same amount it costs to care for someone in the
government-run Original Medicare program, we
would save $8.1 billion in 2008 and $159.8
billion by 2017.[3]
Also, it is estimated that if Congress required
Medicare to use its huge buying power to
negotiate lower drug prices directly with
pharmaceutical companies it could save $30
billion a year.[4]
As long as this country believes that it should
provide reliable and affordable health care to
our mothers and fathers and grandparents,
Medicare is not in jeopardy.