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Medicare: Hope, not fear, in health care reform

Donna M. Christensen

Medicare: Hope, not fear, in health care reform

One of the most effective strategies used by those who are against President Obama and his health care reform initiative has been to spread misinformation and fear about what would happen to Medicare.

It has been a campaign based on misrepresentations and just out and out lies.

The Congressional Black Caucus has always been the conscience of the Congress and we judge health care reform and every other piece of legislation — large or small — on whether it is good for our community or not. We have also been some of the fiercest defenders of Medicare.

Today we are strong advocates for universal coverage and supporters of the health care reform bills being developed by the president and Congress because they are good for the African American community.

A lot of what has to be done to transform our health care system is to take the money we are now spending to get poor or no results, and shift it around — spend it better and more wisely — to ensure that quality health care is more accessible to everyone, not just those who can afford it today.

That is what we are proposing to do in Medicare: to use what are now excess payments to one special program — Medicare Advantage, which is paid more than any other provider — and, over a three-year period, reduce their payments to the same as any other Medicare provider who gives the same service. Some Medicare Advantage programs that can demonstrate quality patient care and improved health outcomes will be able to continue to exist.

The other money that we are using from the Medicare program will come from clearing up waste, fraud and abuse of this program that so many of you depend on. That money — from the Medicare Advantage program and waste, fraud and abuse — will be put back into Medicare to make the program stronger and better and to lower your out-of-pocket costs. We will be restoring the integrity of the program and your trust in it.

The money that will be saved will be used to close the “donut hole” — that period of time during which Medicare no longer helps you pay for medicines and you have to pay the full cost until Medicare Part D begins to pay again.

We will shorten the gap in coverage and reduce your costs over a period of years until that “donut hole” will no longer exist, there will be no gap in your coverage and Medicare will help pay for your medicines all year. It will reduce what beneficiaries pay for medicines by thousands of dollars every year. There are also proposals to have the Secretary of Health and Human Services negotiate drug prices, which could further lower your out-of-pocket costs.

One of the other problems we want to fix is how care is delivered. To stop having Medicare beneficiaries going to a variety of doctors and other providers with no one person helping them to manage and coordinate it all, we will also create Medical Home and Accountability Care Organizations programs. We will also increase payments to these programs and to all Medicare providers so that more doctors and others will participate in the program and accept Medicare. This will mean more doctors and less out-of-pocket spending on health care for you.

The money we shift from Medicare Advantage will also now — for the first time — let you get preventive care like mammograms, colonoscopies, vaccinations and other examinations without your having to pay one penny.

It is also important to note that those who have Medigap coverage through AARP or other insurance program will be able to continue that coverage with no change at all.

Lastly, we plan to increase payments to your primary care provider and to allow them to be paid for spending more time listening to you and counseling you on a number of important issues. The kinds and levels of treatments you want to have provided for you when you approach the end of your life is one such issue. No one is seeking to do anything more than help you to make those decisions in advance so your family won’t be left wondering what to do. The counseling is there — if you want it — and the decision will still be yours.

Medicare is one of the strongest pillars of our health care system. We know it is important to you — our constituents — and it is therefore important to each and every one of us in the Congressional Black Caucus. On your behalf, we are working with President Barack Obama to make sure that we use the opportunity of healthcare reform to protect Medicare, to make it stronger and to have it serve you better.

Donna M. Christensen represents the U.S. Virgin Islands in the House of Representatives, and serves as second vice chair of the Congressional Black Caucus.