Health Care Reform for the Elderly

321 Satellite teleconference HEALTH CARE REFORM FOR THE ELDERLY THERMAN EVANS, md MARY S. HARPER, PhD RISA LAVIZZO-MOUREY,md,mba WILLIAM LUCY SPERO MANSON, PhD KATHERINE MASSEY, dds, ms VERONICA SCOTT, md, mph MARTA SOTOMAYOR, PhD DONNA YEE, PhD Dr. Evans: Septuagenarians, octogenarians, nonagenarians: these are the terms that will be used much more frequently as we move to the year 2030; indeed, as we move to the year 2000. Our population is getting older. In fact, 13 percent of this nation's population is now 65 years of age or older. The projections are, by the year 2030, that percentage will be 21 percent. Twentyone percent! We're all getting older. In fact, we're older now than we were when I started this telecast. I want to welcome you to a live satellite teleconference on health care reform for the elderly. My name is Therman Evans and I will be moderating. Mary Harper, you've been working with the federal department for about five decades in various areas of responsibility. Can you begin this Dr. Evans, moderator of the teleconference, is Vice President and Corporate Medical Director of the CIGNA Corporation, and President and CEO of Whole Life Association. Dr. Harper is Coordinator of the Long-Term Care Program at the National Institute of Mental Healtli. Dr. Lavizzo-Mourey is Deputy Administrator for the Agency for Health Policy and Research. Mr. Lucy is International Secretary Treasurer for the American Federation of State, County, and Municipal Employees, AFL-CIO. Dr. Manson is Director of the National Center for American Indian and Alaska Native Mental Health Research. Dr. Massey is Professor of Preventive Dentistry and Community Health at the Meliarry Medical College School of Dentistry. Dr. Scott is Director of the Center on Aging at Meliarry Medical College. Dr. Sotomayor is President of the National Hispanic Council on Aging. Dr. Yee is Senior Research Associate at the Institute for Health Policy, Brandeis University. Journal of Health Care for the Poor and Underserved · Vol. 4, No. 3 · 1993 322 Health Care Reform for the Elderly discussion by summarizing the various health care proposals that are out there, with a particular emphasis on the implications for our elderly? Dr. Harper: There are about 34 plans. There have been excellent reviews of about 11. But I will tell you about four major plans. Out of these four, two are market-based/employee-mandated. The third one is governmentbased . Starting with the market-based plans, the Bush Administration proposal has taken care of two of the major problems: cutting costs and increasing access. In order to cut costs, they have developed, through one of the senators who introduced the Health Information and Insurance Act of 1992, a standardized form for all claims, which will be entered into a computer. This alone will save the federal government $24 billion. This plan includes neither government regulations nor rationing. As you may know, at least 52 percent of all states have some form of rationing now. There is no provision for malpractice. But it does give a competitive, allencompassing price list, which will be published. Therefore, medical care will be put into competition. The Bush plan also does away with clauses governing preexisting conditions. As you know, this is a tremendous problem, especially for minority elderly. No one will be excluded by virtue of preexisting conditions. The plan provides a $3,750 certificate for the poor, which is very good. Families with less than $80,000 gross annual earnings will also receive a $3,750 certificate. The bill has a problem, however, in that it does not cover those with incomes greater than $80,000. This bill provides for access and it provides for cost-reduction—an immediate $24 billion cut—by virtue of computerizing. The second major plan, by the Heritage Foundation, would eliminate all tax breaks by employers. Under this plan, a new tax code would give credit to families who buy their own health insurance. Poor people who cannot buy their own insurance would receive $3,750 for the purchase of insurance. Regarding the elderly, it would abolish Medicare taxes and premiums, and it would implement a long-term-care insurance plan. As...