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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (Feb. 4, 2017)
4 A ❘ SATURDAY EDITION ❘ FEBRUARY 4, 2017 Siuslaw News P.O. Box 10 Florence, OR 97439 NED HICKSON , EDITOR ❘ 541-902-3520 ❘ EDITOR @ THESIUSLAWNEWS . COM Opinion A Brexit-style exit from Medicare Legacy is reason for concern T he new administration’s promise to move toward “Medicare Reform” and repealing the Affordable Care Act (ACA) will be costly in ways that stretch well beyond dollars. The ACA, passed in 2010, significantly strengthens Traditional Medicare. Revenue sources were added to the Trust Fund. The ACA removed Congressional blocks to lessen expensive subsidies paid to private health plans. Payments were reduced and benefits improved. This includes clos- ing Enrollee Part D drug “doughnut hole” costs by 2020. Repeal of the ACA under- cuts Medicare solvency, raises Enrollee costs and shrinks ben- efits. An institution since 1964, Medicare cares for 57 million seniors and people with dis- abilities. Enrollees, future sen- iors, along with their adult children, must cope with grave uncertainties if this radical transformation goes ahead. Over six major GOP propos- als seek direct ACA repeal, either disposing of Medicare improvements in whole or part, or radically transforming Medicare away from a “defined benefit” institution to a “defined contribution” mem- bership plan. This re-centers Medicare around private insurance com- panies with limited provider networks similar to HMO/PPO’s, such as an expanding “Medicare Advantage” program. President Trump’s Secretary of Health and Human Service nominee, Rep. Tom Price, introduced the “Empowering Patients First Act” in May, 2015, repealing all ACA provi- sions. The Republican Study Committee, in January, intro- duced “The American Health Care Reform Act,” fully repealing the ACA. Then, In 2016, Speaker of the House Paul Ryan intro- duced his policy memorandum “A Better Way...” setting out Medicare transformation via premium “support” payments and promoting Enrollees to search out competing policies. This was documented by the GUEST VIEWPOINT B Y R AND D AWSON F LORENCE RESIDENT , RETIRED LITIGATION LAWYER FOR INSURANCE COMPANIES non-partisan “Kaiser Family Foundation” (Jan. 18, 2017) in a table outlining GOP repeal proposals. One can be excused for not appreciating “back-door” details repealing Medicare via the ACA. “Repealers” are silent as to specific impacts. Instead, their gilded language touts buzz words like “choice,” “flexibili- ty,” “modernization,” “vouch- ers,” “premium support,” all the while forecasting “insol- vency” if traditional Medicare continues. All the while, Medicare’s long history offering defined benefit levels and improved national healthcare quality at reduced costs is being ignored. AARP (formerly American Association of Retired Persons) took due notice in its December 2016 “Letter to Congress,” in which it spoke against ACA repeal, saying: “The Medicare Part A Trust fund is solvent until 2028, due in large part to changes made in ACA. We urge you to main- tain provisions ... that ... strengthened Medicare’s fiscal outlook without shifting costs to beneficiaries or cutting ben- efits...” Medicare is our most ambi- tious platform seeking effec- tive health cost and quality controls. Internationally respected healthcare econo- mist, Uwe Reinhardt, said, “Per capita health costs for people with Medicare have grown (annually at) 1.5 per- centage points less than private insurance from 1969 through 2012. This is something the “conservative” American Enterprise Institute calls “Soviet-style pricing.” Payment rules are tied to care quality. In 2017, six Oregon hospi- tals face cuts after high rates of patient injuries from infec- tions, bed sores, falls and nationwide, 769 hospitals were penalized. Private insurers lack this leverage. At individual level, it plays a vital role. In 2015, 98.9 per- cent of adults age 65 or older had health coverage, account- ing for nearly one-fourth of U.S. personal health expendi- tures. Enrollees are not “free rid- ers.” From average annual incomes under $25,000, they spend one of every six dollars on health care. A stable Medicare national membership “risk pool” forms the essence of sustainable risk- sharing, lowering average costs. Insurance history teaches primacy of the “80-20 Rule.” in which 20 percent of sicker members account for 80 per- cent of costs. Keep in mind that 5 percent of U.S. popula- tion consumes 50 percent of health care spending. Narrowing the Medicare Enrollee “risk pool” promotes insolvency. Ryan’s Medicare age increase instantly shrinks the “risk pool” leaving more cost- ly, sicker members, and rising premium. Another Ryan element is private plans such as Medicare Advantage, subsidized by the public trust, attracting younger, healthier Enrollees out of Medicare. In Oregon, 44 percent of Medicare-age Americans are in private plans, the second high- est nationally. This promotes an “adverse selection” trend: as pool size shrinks, doctors decline new Medicare patients; Ryan’s lim- ited “premium support” is unlinked to health cost infla- tion. As such, a death spiral ensues from a shrinking, more sickly membership, facing higher cost-sharing. Political support for tradi- tional fee-for-service Medicare then withers. The Public should be alarmed and community lead- ership should take notice. — Rand Dawson is a Siltcoos resident with long interest in health care reform. LETTERS T HINGS EACH OF US CAN DO As part-time residents of Florence for the past 25 years, nothing has made us prouder of our fair city than to see how many of our fellow citizens took to the streets to peacefully express their beliefs in the values on which this country was founded. USPS# 497-660 And we were particularly heartened by Bob Orr’s guest editorial (Jan. 25) which helped remind us all that there is more at stake here than differing political opinions, and that there are things each of us can do every day which improve everyone's quality of life. Carole and Mike Babcock Florence 97439 HEADLIGHTS Now that I almost got broadsided by a fast- moving powder blue pickup in the gray rain, I have to ask: Why don’t more people use their headlights in this town? Apart from the safety factor related to limit- Copyright 2017 © Siuslaw News Publisher, ext. 327 General Manager, ext. 318 Editor, ext. 313 Marketing Director, ext. 326 Office Supervisor, ext. 312 Production Supervisor Press Manager DEADLINES: Wednesday Issue—General news, Monday noon; Budgets, four days prior to publication; Regular classified ads, Monday 1 p.m.; Display ads, Monday noon; Boxed and display classified ads, Friday 5 p.m. Saturday Issue—General news, Thursday noon; Budgets, two days prior to publication; Regular classified ads, Thursday 1 p.m.; Display ads, Thursday noon; Boxed and display classified ads, Saturday 5 p.m. Soundings, Tuesday 5 p.m. NEWSPAPER SUBSCRIPTION RATES: In Lane County — 1-year subscription, $71; 10-weeks subscription, $18; Out of Lane County — 1-year subscription, $94; 10-weeks subscription, $24; Out of State — 1-year subscription, $120; Out of United States — 1-year subscription, $200; E-Edition Online Only (Anywhere) — 1-year subscription, $65. Mail subscription includes E-Edition. Website and E-Edition: www.TheSiuslawNews.com WHERE TO WRITE Published every Wednesday and Saturday at 148 Maple St. in Florence, Lane County, Oregon. A member of the National Newspaper Association and Oregon Newspaper Publishers Association. Periodicals postage paid at Florence, Ore. Postmaster, send address changes to: Siuslaw News, P.O. Box 10, Florence, OR 97439; phone 541-997-3441; fax 541-997-7979. All press releases may be sent to PressReleases@TheSiuslawNews.com. John Bartlett Jenna Bartlett Ned Hickson Susan Gutierrez Cathy Dietz Ron Annis Jeremy Gentry U SE ed visibility based on the weather and natural light — particularly on cloudy and gray days — isn’t it a law that people will use their head- lights when it’s dusk, dark, early morning, rain- ing... or just because? Thank you for considering my question. Ivy Medow Florence Pres. Donald Trump The White House 1600 Pennsylvania Ave. NW Washington, D.C. 20500 Comments: 202-456-1111 Switchboard: 202-456-1414 FAX: 202-456-2461 TTY/TDD Comments: 202-456-6213 www.whitehouse.gov 202-224-5244 541-431-0229 www.wyden.senate.gov U.S. Sen. Jeff Merkley 313 Hart Senate Office Bldg Washington, DC 20510 202-224-3753/FAX: 202-228-3997 541-465-6750 www.merkley.senate.gov Gov. Kate Brown 160 State Capitol 900 Court St. Salem, OR 97301-4047 Governor’s Citizens’ Rep. Message Line 503-378-4582 www.oregon.gov/gov U.S. Rep. Peter DeFazio (4th Dist.) 2134 Rayburn HOB Washington, DC 20515 202-225-6416 541-269-2609/ 541-465-6732 www.defazio.house.gov U.S. Sen. Ron Wyden 221 Dirksen Senate Office Bldg Washington, DC 20510 State Sen. Arnie Roblan (Dist. 5) 900 Court St. NE - S-417 Salem, OR 97301 503-986-1705 FAX: 503-986-1080 Email: Sen.ArnieRoblan@state.or.us State Rep. Caddy McKeown (Dist. 9) 900 Court St. NE Salem, OR 97301 503-986-1409 Email: rep.caddymckeown@state.or.us West Lane County Commissioner Jay Bozievich 125 E. Eighth St. Eugene, OR 97401 541-682-4203 FAX: 541-682-4616 Email: Jay.Bozievich@co.lane.or.us
