Wednesday August 1, 2012

NORTH ADAMS

R
ecently I came across this joke on Facebook:

"Two patients limp into two different medical clinics. The first is a Golden Retriever taken to a vet. The second is a senior citizen on Obamacare. Both have the same complaint. Both have trouble walking and appear to require hip surgery. The first patient is examined within the hour, is x-rayed the same day and has a time booked for surgery the following week. The second sees his family doctor after waiting 3 weeks for an appointment, then waits 8 weeks to see a specialist, then gets an x-ray, which isn’t reviewed for another week and finally has his surgery scheduled for 6 months from then pending the review boards decision on his age and remaining value to society. Why the different treatment for the two patients? The first is a Golden Retriever taken to a vet. The second is a senior citizen on Obama care. In November if he wins, we’ll all have to find a good vet!"

The only problem with the above story is there is no truth to it. For elders the Affordable Care Act has actually strengthened their Medicare benefits, as Medicare beneficiaries can now get key preventive services for free, including annual wellness visits, mammograms, and a range of other no-cost screenings for cancer, diabetes, and other chronic diseases. In addition, seniors who reach the coverage gap in their Medicare Part D drug plan now receive a 50 percent discount when buying brand name drugs and a 7 percent discount on generic drugs.


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And despite dire predictions to the contrary, premiums for Medicare enrollees Medicare Advantage plans have been declining, while Part B premiums have been rising at their slowest rate in years.

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With the Supreme Court now having found that the Affordable Care Act is constitutional, the law’s opponents are attempting to put fear into the minds of voters, as they see the election as their last chance to keep the Affordable Care Act from being fully implemented.

Bill Keller, writing in the New York Times about the "Obamacare Myths" recently observed: "You don’t hear the phrase ‘death panels’ much any more, but variations of that fallacy persist, like sightings of Sasquatch. The new law establishes an Independent Pay ment Advisory Board of health care professionals to propose ways to curb the growth of Medicare spending. It operates in public and makes systemic recommendations, which Con gress can overrule. The board can reduce the amount Medi care pays health care providers for services and propose innovations to cut waste. It has no say in the treatment of any individual; it cannot change eligibility for Medicare, reduce benefits or raise premiums."

The goal of health reform is to protect patients and to make health coverage more affordable for the millions of Amer icans who can’t afford health insurance. Two mechanisms for doing this won’t be implemented until 2014. They in clude a Medicaid expansion, which is now optional for states, and similar to Massa chusetts, a nationwide health insurance requirement. To help individuals pay for coverage, subsidies will be provided to families with incomes be tween 100 percent and 400 percent of the federal poverty guidelines ($40,688 for one, $92,208 for a family of four) who cannot otherwise access affordable and adequate insurance.

Many significant benefits have already been implemented, three key ones include:

* Young adults can stay on their parent’s health insurance plans until they turn 26 years old. A recent Commonwealth Fund survey indicates that as many as 6.6 million young adults stayed on or got on their parents’ health plans in the first year and a half after the law was signed.

* Up to 4 million small businesses can receive tax credits to help them provide health insurance to their workers.

* Health insurers now must spend 80 percent to 85 percent of the premiums they collect on medical care instead of their own profits and overhead costs. Insurers that haven’t met the new federal standard must give their customers a rebate for the difference. This year, health insurers will distribute $1.1 billion in rebates to 12.8 million Americans.

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Someone said the only thing more difficult than passing health reform, is implementing it. Given the long ACA roll-out period, along with the strident political dialogue, this task is even more challenging. We should keep in mind that no major public policy reform ever works out exactly as predicted and adjustments are always required. This is an ongoing process.

The Affordable Care Act though, holds the promise of helping millions of Americans access health coverage and protecting them from financial harm when receiving needed medical care.

Charles Joffe-Halpern is the executive director of Ecu-Health Care in North Adams.