| Health Insurance Reform and Medicare: Making Medicare Stronger for America’s Seniors
Health Insurance Reform Solutions:
Improve quality and patient safety. Health insurance reform will move Medicare towards a system that rewards high-quality care. Reform will develop national priorities on quality, standardize quality measurement and reporting, and invest in patient safety. Hospitals will have financial incentives to avoid preventable readmissions. In addition, the rates of infections that develop in hospitals must be reported and disclosed to the public. And an investment in patient-centered research will empower seniors and their doctors with information on which treatments work and which don’t, so they can make more informed decisions.
Invest in innovations in primary care. Health insurance reform will invest in innovative models of care such as “patient-centered medical homes” and “accountable care organizations” that rely on teams of primary care doctors, specialists, and nurses working together to coordinate and monitor a patient’s care more effectively. These models are intended to encourage health care providers to better coordinate a patient’s care, track prescriptions, avoid duplication of treatments or tests, and follow a patient’s health progress. This will help improve quality of care, prevent medical complications, and reduce costs by keeping people healthier and out of the hospital.22
Problem with the Status Quo:
There is a persistent long-term care gap. Long-term care is also an area that is not currently affordable or accessible for many seniors. It is estimated that 65 percent of those who are 65 today will spend some time at home in need of long-term care services23, which cost on average almost $18,000 per year.24 However, contrary to popular belief, Medicare and most private health insurance policies only pay for long-term care for a short period of time, meaning that most people pay out of their own income or assets.25
Health Insurance Reform Solution:
Make long-term care services more affordable. Health insurance reform will create a new voluntary long-term care services insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will enable them to remain in their homes and communities.
Will I have a choice of doctor?
Problem with the Status Quo:
Imminent doctors’ payment cut will limit access. In a recent poll, two-thirds of Americans age 50 years and older said they are somewhat or very concerned about how the current system limits their ability to see the doctor of their choice.26 Because of a flawed system for paying physicians, Medicare is scheduled to reduce its fees next year. This would result in a 21-percent cut in payments beginning on January 1, 2010. According to a recent survey by the American Medical Association, 60 percent of physicians report that, if Medicare payments are cut by even half that amount (or 10 percent), they will reduce the number of new Medicare patients they will accept, and 40 percent will reduce the number of established Medicare patients they treat. In addition, more than two-thirds of physicians will forgo investments in their practice, including the purchase of health information technology.27 This all translates to decreased access to needed services for our nation’s seniors.