Personal Costs for Medicare H.M.O.'s Rise
The New York Times
February 14, 2002
By Milt Freudenheim
"Elderly and disabled members of Medicare H.M.O.'s used nearly 50 percent more of their own money on average for medical care in 2001 than they did three years ago, health care researchers said yesterday."
"Out-of-pocket costs rose 62 percent to $3,578 in 2001 for people in poor health as their share of spending rose for prescription drugs, premiums and other services not fully covered by Medicare."
Marilyn Moon, a Medicare policy expert at the Urban Institute:
"Many people joined H.M.O.'s to try to reduce out-of-pocket expenses. The bargain was, 'we will give up some of our control over medical services in order to have some of our costs reduced.'"
John Rother, legislative and policy director of AARP:
"No one is looking at H.M.O.'s any longer as a way of saving money for Medicare. The reality is, fixing these problems is going to cost some money."
<http://www.nytimes.com/2002/02/14/health/14CARE.html>http://www.nytimes.com/2002/02/14/health/14CARE.html
Comment: The Medicare+Choice options were able to offer pharmaceutical coverage and lower out-of-pocket expenses primarily because of their success at enrolling relatively healthy patients. For several reasons, they no longer have the margins that will allow this largess.
The administration and some members of Congress now want to increase funding for these private sector plans which would allow them to continue to offer richer benefit packages. But these plans are not available to everyone, and they vary in their generosity. Why should those that remain in the traditional Medicare program be denied benefits that the private plans provide? They shouldn't. They should have the same pharmaceutical coverage and reduced out-of-pocket expenses. We know that the plans would not be able to provide identical services at the same price, and they would likely go away.
If the administration really believes that the enrollees of private plans are entitled to these extra benefits, then they must believe that those in the more efficient traditional program should be entitled as well. We do still believe that our taxes should be used equitably. Don't we?