War on Seniors and the Poor?

Current proposals to repeal and replace the Affordable Care Act will cause great harm to  seniors and poor families. The proposals also pit the welfare of seniors against the welfare of  children and poor families. Here’s why:

  • Nearly half of all Medicare members have incomes under $26,000 per year
    • Voucher programs with flat fees could make health services out of reach financially if the voucher is tied to social security income which is lower for low income workers (AARP—Policy Institute)
  • Many people 60 to 64 who buy individual health insurance policies have median incomes around $20,000 (AARP Policy Institute)
  • Simply because of age, many 60 to 64 are more likely to have pre-existing health conditions (AARP Policy Institute) Continue reading
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Taxes on Drug and Device Companies Removed in Repeal Plan: Insurers and Health Care Industry Concerns

Repeal proposes cutting taxes on Pharmaceutical and Medical Devise Companies while raising costs for elderly and those with pre-existing conditions.

 The CEO of Blue Cross of California opposes current reform proposals, citing cost increases for individuals and families and harm for people with pre-existing conditions, such as cancer, diabetes:



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Get Rid of Old Prescriptions–Sat., April 29th-Drug Take Back Day

April 29th is Drug Takeback Day so people will have a place to get rid of unused or old medications.  The DEA (Drug Enforcement Administration) now has a way for you to dispose of your old or unused medications.  Here is the link to find a place close to you:  www.deadiversion.usdoj.gov

A common problem with old or unused prescription medications is how to get rid of them. Flushing them down the toilet is not a good idea, nor tossing them in recycling, much less giving them to friends and family!  (that’s part of the Opioid epidemic problem).

I actually heard a “funny” story in the 1990’s  about how a popular anti-depresant was impacting fish.

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A Must Read Book About the Players That Drove the Opiod Epidemic from the Get Go

Dream Land is an engaging read–well written and well researched.  Sam Quinones, author and journalist, traces the Opiod epidemic from the first distillation of Morphine from opium in 1804 to the present.  He even includes the Opium Wars between the British and China in 1859 and 1957 to showcase what nations and people will do for opium.

The book’s vitality stems from its personal stories whether they are about the early marketing tactics of  marketing and pharmaceutical companies or the stories of  researchers, dealers and addicts. He gives the names, the history and motivations of key players. Seattle and Portland are featured as is Los Angeles, Utah, Arizona and Nayarit, Mexico as the story unfolds.  His short personal stories focus on people, place and motivations that weave seamlessly together to showcase how the epidemic grew and thrived.

Dream Land is a compelling all too human tale of the players, the economic forces and the very personal drivers that rolled this epidemic.  You won’t be disappointed.

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A Call to Conscience-Pre-existing condition changes and Limits on Patient Legal Options

This is a quick blog about some disturbing issues pending in Congress.  First is the new call to eliminate pre-existing condition protection. The intent is to repeal the protection and leave the matter to the states.  In the past there were High Risk Pools but they came with high risk costs for patients.

We are one of the few countries where you can be bankrupt with medical bills when you face cancer or heart surgery or other life saving, but expensive diseases.  I know one family facing cancer with annual pharmaceutical costs of $65,000.  Changes in pre-existing conditions could potentially cost individuals and families with health problems considerably more.


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New Patient-Centered Resource for Patients and Researchers

New healthcare technology is developed every day. But, with all the hope of these innovations comes important questions about safety:  Patients want to know if this technology will work for them? Does it add value or will it just increase cost?  The answers to these questions only come when the patient is a real research partner.  Engaging the patient in research not only makes sure the patient gets the right care, but also that they are involved in planning and directing the research  from the very beginning.

An effective healthcare system depends on asking the right questions and learning from those questions. A learning health care system makes sure the right people get the right care at the right time by the right caregivers. That’s where CERTAIN comes in.

Housed at the University of Washington, the CERTAIN Patient Advisory Networkwww.becertain.org/partner/patient_advisory_network seeks to improve medical research by having patients actively participate in the research process–from identifying research questions to communicating the final research results.

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Health Care Sound and Fury: A Lament

There’s no sense talking to you. It’s just like talking to me, is a line from a Bob Dylan song in the 1960’s.  It was a time of great division over the Vietnam War. There were large marches and demonstrations. Some students were even killed for protesting.  Our health care debate has been every bit as vitriolic since at least Teddy Roosevelt in the 1920’s and the threat of ‘socialized’ medicine. Dylan’s line remains true today.

Health care reform has been demonized as “socialized” or “government run” in one form or another since then.  FDR kept it out of the New Deal for fear his whole program would fail. Campaigns were even waged against Nixon’s call for health reform—a modest reform through employers where most people had health insurance.

We attack taxes to pay for health care. We make rules and set financial limits such as degrees of poverty.  We even take partial truths for examples, latch on to them and hold them up as yet another reason that disasters await if everyone gets health care.

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Current ACA Medicaid: A Quick Guide–Poverty, Children, Disabled and Seniors

Medicaid, Poverty, Children, the Disabled, and Seniors               March 7, 2017

Before examining the proposed changes to Medicaid, here are quick facts about Medicaid as it now exists under the ACA (Affordable Care Act aka Obamacare). And, a cautionary tale.


In 2003 I read a small “Around the States” in a national newspaper, whose name I have now forgotten.  What I have not forgotten was the story.  Mississippi was going to cut 13,000 Medicaid nursing home beds to balance the state budget.

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Medicare 101: New Vouchers and Change to Medicare

My last long article was about the first privatization of Medicare.  Current proposals to privatize  focus on Premium support and Vouchers.   This will change Medicare’s structure, what it covers, and how services are paid. The following is a quick look at the proposal.  Even Fox News has qualms about  this new direction.  Read on:

Medicare, Specific Services  and Vouchers

Medicare currently pays for specific services (defined benefit).  Briefly, Medicare Part A covers hospitals, limited skilled nursing care, hospice, lab tests and home health care. Part B covers doctors and some other providers, outpatient care, home health care, durable medical equipment (such as wheelchairs) and many preventive services, such as flu shots. Medicare did not cover prescription drugs until Medicare Part D became law in 2006.  Medicare Part C created Medicare Advantage (managed care) programs that combine both A and B, and often D.  Medicare Advantage programs receive federal subsidies which ‘traditional’ Medicare does not.  Seniors must use the plan’s doctors and hospitals or pay for services themselves. Most seniors buy a Medicare Part B supplement that covers what Medicare Parts A and B do not, such as co-payments and other services.

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Privatizing Medicare and Me: A Story from the First Privatizing

I was the Medicare Marketing Director at a private for profit health insurance company in the late 1980’s and early 1990’s and the first attempt to privatize Medicare during the Reagan Administration. That job made me the ardent consumer advocate I have been ever since.  What I learned then is happening again now in a slightly different way. It is not good news for seniors. Here’s why:

Congress and Medicare

Congress oversees Medicare coverage as well as mandated commercial insurance coverage.  It required an act of Congress for Medicare to cover preventive services, such as mammograms or prostate screenings. Kidney dialysis coverage for End Stage Renal Disease required an act of Congress. Mental health was added as an insurance benefit in 2008 with the Mental Health Parity act. Expanded mental health and addiction coverage was added as part of the Affordable Care Act. All required Congressional action.  Medicare covers what Congress allows in statutory language or specific legislation. For example, adding prevention coverage or prohibiting Medicare from negotiating prices  with pharmaceutical companies.  Physician fees for doctors who accept Medicare patients are set by a committee that was authorized by Congress.

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