REFLECTIONS: Philandering
GAY AND GRAY: A Tangled Web of Gender

What's in Health Care Reform for Elders

category_bug_journal2.gif Throughout the protracted debate for health care reform, my concern was mainly for midlife people – those not yet old enough for Medicare.

As I often said, Medicare for All would have been the better and easier way to go (or, at least, a public option in the bill) but here we are with a beginning and importantly, the principle, now set in legislative stone, that every American has a right to affordable health coverage.

That, in time, will become as accepted as women's suffrage and civil rights are now and, perhaps, will shift to the more enlightened view in other advanced countries that health care is the right of every citizen.

Although I'm disappointed overall (or maybe just exhausted from the year-long fracas), there are good things in the bill (that carries the ungainly name, “The Patient Protection and Affordable Care Act”) – and some, to which I had not paid close attention in the final draft, are for us old folks.

Medicare physician payments can now be increased through rewards for improved quality of care.

A nationwide database will be created that, with background checks, will help prevent repeat predators from being hired in nursing homes.

Better consumer information on quality of care and enforcement of standards will make it easier to choose good nursing homes.

You can read more about these and others changes here (pdf) and here.

Many subscribers are concerned about potential cuts to their Medicare Advantage plans or increased premiums or cuts in benefits such as free gym memberships. On the other hand, the bill requires that 85 percent of revenue be used for actual health care rather than administrative costs like high executive salaries and bonuses.

Also, I would like to remind Advantage subscribers that your low premiums or, in some cases, free coverage, come out of the hides of those who purchase traditional Medicare. Our premiums are higher than they would otherwise need to be to help subsidize Medicare Advantage.

Personally, I don't think my total cost for traditional Medicare B, D and supplemental of $271.90 per month is unreasonable (given the U.S. system) for the care I receive. (I'm sure the Medicare Advantage changes will be argued vehemently.)

There are two immediate benefits for all Medicare members: one - a free annual physical is now included, something that makes both health and fiscal sense, along with free preventive services, such as screenings for colon, prostate and breast cancer.

The other is a gradual closing of the infamous doughnut hole in the drug benefit, Medicare Part D, important to many elders whose prescription drug costs stretch or are beyond their means.

Here is a short video from Senate Leader Harry Reid's office explaining the Part D change:

DENTURE ADVENTURE UPDATE: For those of you who have asked, the fatigue from my teeth extractions has finally lifted. Healing is going well and I'm making daily visits to the dentist this week for fit tweaks and adjustments.

I've been off pain pills since Monday and although I'm not ready to chew anything challenging, I had dinner at a restaurant two evenings ago with no mishaps. Mussels and scallops were easy to chew; salad greens not so much. That, I assume, will come in time.

Like the old saying goes, “If I'd known I would live this long, I'd have taken better care of my teeth,” but they have plagued me since childhood, so maybe it wasn't up to me and, anyway, it's too late now. Given the alternative of toothlessness, the denture isn't so bad and as I gradually become accustomed to it, it doesn't feel quite as much like a boulder in my mouth.

At The Elder Storytelling Place today, Lois Cochran: Rose


Good to hear you're doing well after the denture ordeal. But then I never doubted it would be otherwise:)From the sound of your writing you seem to be back to speed which is a good thing. Dee

Thanks Ronni,

Your information on benefits for Elders in the Health Care Reform Bill (or whatever the official title is maybe we should have an acronym contest) is welcome and deserves more widespread promulgation. A lot of my teabagger friends need to know more about how it will affect them.

I too was plagued with plaque from early childhood- dentists and their hygienists were always telling me that I wasn't brushing enough or not in the right way but in was all about my "blue genes" or more accurately "green" (for Irish) genes. My mother had bad teeth too. You'll get used to your new choppers. Make sure you always have a tube of "Fixodent Control" handy in case you bite into something hard and need to re-fix. (It has happened to me a few times in restaurants)

Regarding the benefits which now come to elders with the Health Care bill, we mustn't be fooled. The free annual physical and preventive services are items which should have been in Medicare all along, and could have been added by the Bush administration, or Clinton's. But they weren't. They could have been added during the "first hundred days" of Obama's and Pelosi's tenure, but they were held back -- for political reasons. They were withheld so they could be added to sweeten the pill of the Health Care Bill which, although indisputably highly beneficial in many ways was, in many other ways, very bitter indeed for many years to come. Some of these flaws, like the other reductions in Medicare, the tax burden to our children and grandchildren, and the continued inflation of bureaucracy, and the withholding of costly treatment from the less productive members of society (i.e., the elderly) will plague us for many years to come.

I'm glad your denture problems are going well. I am headed in that direction. Right now it's one tooth at a time, but I am sure it won't be long until it's wise to get rid of all of them.

I am on the Advantage plan and know my co-pays will go up, but I fought long and hard for reform on a personal level. My daughter has no insurance and needs medication that costs $450 a month. She cannot afford it and I will willingly pay more for my medical care so she, and others like her, can get coverage.

As is invariably the case, what you say in your latest posting is both timely and useful. And of course well written.
Ben Franklin is credited with having said, early in the Revolution, "If we do not hang together, we will certainly all hang separately." This idea seems to apply to health care. Those with good health care coverage who resent contributing to anyone's else's seem oblivious to what such an attitude means for the future.

Excellent news on the tooth front. Like others here, I'm impressed with how short a time you are feeling no pain.

The public has not heard enough about the consequences to regular Medicare subscribers of special benefits to Advantage subscribers. Dividing seniors into different "classes" definitely met the needs of reform opponents.

Great to hear that you are doing better after your dental encounter.

On the health care front, My daughter currently works in Japan. Even though she is a legal resident and not a citizen, she qualifies for the Japanese health system. Like all other advanced countries they have a national health system. She pays a monthly insurance premium and has full access to the system. This occurred as soon as she started working there. No muss or fuss. It just works.

I view the current reform as the starting point and I hope that we will get to Medicare for all.

Thanks for the medical care updates, and for the teeth news. By the time you meet your furniture at the other end, you will probably be able to eat anything.

$271.90 a month is not unreasonable? It most certainly is for someone whose fixed income (SS) is $800 a month! (don't qualify for any help as have $7,000 in savings)

Your $ that a Plan F?
I don't remember seeing that mentioned here. It has been a real boon to my partner. She pays a flat rate per month, then Plan F pays her Medicare deductible, her B, and ALL of her co-pays, etc.
She pays only for her Plans D & F, nothing else.
It's one of the 'Medigap' plans. Info is here (and claims to be updated)

We didn't hear about it from any regular channels; our life insurance man told us about it.

I apologize if this is old news; I don't remember seeing it here, but that could be just me. lol

I'm confused by the news of a free physical exam ...I went on Medicare in 2005...I was advised of & received a free physical exam at that time...

Ronni--Yours is the best concise description I've seen of what the health insurance revisions mean to elders. Thanks for putting it together so well.

Others--Obviously, from the comments here and elsewhere health care in the U.S. remains controversial. I think, however, that Barry Knister's comment cuts to the heart of the matter.

We Americans at least give major lip service to being a nation founded on pillars of high public morality. Historically, we have failed miserably very often to measure up to our founders' ideals, and the founders didn't do an impeccable job of being altruistic, either.

Once we became the world's wealthiest major nation, and that was years ago, there was no justification for supporting a system that kept millions of our fellow citizens from getting reasonable medical care.

That's the crux of it, I think. We just made a huge step toward meeting our collective obligations. Whatever God or gods you venerate should be smiling upon us. As usual, there's more work to be done.

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