Health Affairs
May/June 2003
High Out-Of-Pocket Health Care Spending By The Elderly
High spending coupled with the erosion of insurance coverage expose the
elderly to great financial risk.
by Dana P. Goldman and Julie M. Zissimopoulos
Disturbing Trends:
* Erosion of managed care – For the near-poor, who rely most on Medicare HMOs, benefits have probably eroded…
* Declines in drug coverage – The share of M+C enrollees in plans with drug coverage declined… Copayments have increased… (and 98% face caps on coverage)
* Cuts in retiree benefits – …provision of retiree benefits declined steadily… (with) a decrease in the generosity of benefits.
With the erosion of market areas and the generosity of Medicare HMO benefits, the risks of large catastrophic expenses have likely increased among a group least able to afford it. In addition to imposing additional private costs on less affluent seniors, these changes may also impose public costs. They will make Medicaid a more attractive option to the near-poor elderly, and some may spend down assets to qualify. This will increase Medicaid’s costs, while exposing other elderly people to more financial risk.
http://www.healthaffairs.org/1130_abstract_c.php?ID=/usr/local/apache/sites/healthaffairs.org/htdocs/Library/v22n3/s26.pdf
Comment: Are these our American values? We establish a health benefits program for our retired seniors. But then we gradually shift more of the costs to the beneficiaries, making health care unaffordable for many. We then drive them into poverty in order to allow them to regain affordable access to health care.
What kind of a nation are we? We already know how to provide affordable, comprehensive benefits for everyone. Why do we continue with inhumane policies that require financial ruin for so many with significant health care needs?
