6 A
SIUSLAW NEWS ❚ SATURDAY, MARCH 18, 2017
Consequences of Medicare gaps with ACA repeal
The 57 million people
enrolled in Medicare, (includ-
ing, in 2015, 98.9 percent of
adults age 65 or older), face
cost and benefit uncertainties if
the Affordable Care Act (ACA)
is repealed without specific
provisions enacted to replace
the resulting Medicare gaps.
ACA significantly strength-
ened Traditional Medicare sol-
vency by adding revenue
sources to the Medicare Trust
Fund and removing statutory
impediments to lowering the
expensive Medicare Advantage
subsidies paid to private health
insurers.
The current proposals to
repeal the ACA would “reform”
Medicare
by
expanding
“Medicare Advantage” (built
on private insurance companies
with limited HMO/PPO net-
works), ultimately transforming
Medicare from a “defined ben-
efit” to a “defined contribution”
membership plan.
The devil of the reform is in
the details of nebulous terms
like “choice,” “flexibility,”
“modernization,” “vouchers”
and “premium support.”
We are being told reform is
necessary because of traditional
Medicare’s impending “insol-
vency.”
These predictions ignore
Medicare’s long history of
improving healthcare quality at
reduced costs. According to a
2016 AARP finding, “The
Medicare Part A Trust fund is
solvent until 2028, due in large
part to changes made in ACA
…without shifting costs to ben-
eficiaries or cutting benefits…”
On a more immediate health-
care quality level, Medicare
rules tying care quality to pay-
ments has effectively lowered
hospital costs and improved the
costs are increasing and insur-
ers are bailing. Looking again
to basic insurance principles,
so far no replacement that has
been proposed will be work-
able or affordable.
The “Repealers” have got
themselves a tiger by the tail.
As for Medicare enrollees, I
suspect they mostly are
unaware that, without the
enactment of a carefully tai-
lored bullet proof vest, repeal
of ACA’s direct and indirect
Medicare supports will likely
bring
the
collapse
of
Traditional Medicare.
— Arnold Buchman retired as
GUEST VIEWPOINT
B Y A RNOLD B UCHMAN
CIGNA H EALTHCARE ’ S WESTERN DIVISION
RETIRED HEAD OF LEGAL SUPPORT FOR
quality of hospital care by
imposing reimbursements cuts
for high rates of patient injuries
from infections, bed sores and
falls. In 2015, 769 hospitals
were penalized.
According to healthcare
economist, Uwe Reinhardt,
“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. Private insurers simply
lack Medicare’s leverage.”
At the individual level,
repeal of ACA would take with
it the phased reduction of the
prescription drug “doughnut
hole” for prescription drugs (to
be closed by 2020) that signifi-
cantly lower the amount that
seniors on Medicare have to
pay for their medicines.
ACA’s constraints on out-of-
pocket drug prices will be elim-
inated and preventive health
services no longer will be free.
In reforming Medicare with
“premium support” vouchers to
enable a “free market” for
enrollees to shop among com-
peting policies, Speaker of the
House Paul Ryan’s proposal
would also increase Medicare
eligibility age — and conse-
quently instantly shrink the risk
pool to a higher proportion of
more costly, sicker members.
Basic insurance principles
dictate that this would require
premium increases to cover
increased benefit costs.
Vouchers paid from the
Medicare Trust Fund to subsi-
dize Medicare Advantage
would attract the younger and
healthier from traditional
Medicare, exacerbating higher
cost-sharing in a smaller risk
pool — the definition of an
insurance “death spiral” and
collapse of the risk pool.
At the same time, ACA
repeal would restore higher
payments for services per-
formed
under
Medicare
Advantage managed care. The
repeal of ACA’s mandate that
preventive services be provided
free to patients could also raise
premiums, out-of-pocket costs,
or both.
All in all, Medicare enrollees
are quite likely to receive less
care and pay more for it.
The bottom line?
An analysis by CNN Money
said that ACA “slowed the
growth of payment rates to hos-
pitals and other providers,
reduced payments to Medicare
Advantage plans and improved
benefits for enrollees.”
According
to
the
Congressional Budget Office
(CBO), repealing ACA would
increase Medicare spending by
$802 billion over 10 years. As a
result of repeal, Medicare bene-
ficiaries would pay more
because
premiums
and
deductibles are tied to the
growth of federal outlays.
This would leave seniors to
face higher deductibles and co-
payments for Part A and higher
premiums and deductibles for
Part B. Enrollees would no
longer have free screenings for
breast and colorectal cancer,
heart disease, diabetes and free
flu and pneumonia vaccina-
tions.
Clearly, ACA is imperfect.
As was Social Security and
Medicare when they first were
enacted. But as the flaws in
these earlier programs became
apparent, bipartisan fixes were
enacted.
In ACA’s eight years, there
has been no such bipartisan
approach. Instead, there has
been a steady partisan effort to
weaken, undermine and under-
fund it.
It’s
no
wonder
that
exchanges are failing, premium
head of legal support for CIGNA
Healthcare’s western division. He
is a Senior Advisor to The
Margolin Group, a designer of
integrated health care systems.
THE PIONEER MUSEUM
NEEDS YOU!
Th e Siuslaw Pioneer Museum is putting together a
history of Th e Rhododendron Festivals from 1908 to
the present.
Look in your closets and attics and fi nd all your pic-
tures, slides, scrapbooks, souvenirs and fun memories
that we can use in the printing of our book, and bring
them to the museum, preferably on Wednesdays, for
noon to four o’clock.
Th ank you in advance for helping make this project a
success.
Sandy Zinn, 541-997-7884 ext. 1
Frank’s 101 Barbershop
WELCOMES
JEFF STONELAKE
Jeff was raised in Florence. He is a Air force
Veteran of 27 years. Jeff recently lived in
Bend, but is HAPPY to be living back in
Florence. Stop by and say hello!
Reno ‘Select’ at Westminster
Jeffs hours are:
Tuesday - Saturday 8am-5pm
(cell) 530-575-8251
(shop) 541-902-9588
396 Highway 101, Florence
S IUSLAW N EWS
Spruce Point Assisted Living
& Memory Care
Living, Loving, & Thriving
T
g
Caring
for a a loved
loved
be very disease
overwhelming.
Caring for
one one
with can
Alzheimer’s
or other memory
related
illnesses
can
be
very
overwhelming.
We’re
here to help.
We are here to help.
TUESDAY, MARCH 28, 2017 @ 2PM
WEDNESDAY, DECEMBER 17, 2:00 PM
Managing Challenging Behaviors & Support Group
Holiday Tips for Families & Caregivers
TUESDAY, APRIL 25, 2017 @ 2PM
WEDNESDAY, Communication
JANUARY 21, 2015, &
2:00
PM
Successful
Support
Group
Alzheimer’s Disease: The Truth Behind the Myths
TUESDAY, MAY 23, 2017 @ 2PM
PHOTO BY MARK BRENNAN/SIUSLAW NEWS
Reno, a Miniature American Shepard, and her
owner Ginny Verville, recently went to New
York to compete in the 2017 Westminster Club
Dog Show. Reno recieved the ribbon for finish-
ing ‘Select,’ or second place overall. Verville is
the owner of Aloha Pet Grooming, located in
Florence.
Siuslaw
News
+
240
Nutritional
Needs 18, 2015, 2:00 PM
WEDNESDAY, FEBRUARY
All seminars are free and
open to the public.
All seminars are free and
open to the public.
Refreshments provided.
Refreshments provided.
To register for these free
To register for these free
events
please call
call
events please
(541) 997-6111
997-6111
(541)
or
or email
email us
us at
at
rkilfoy@prestigecare.com
ldouda@prestigecare.com
Dementia Drugs; Facts and Myths Exposed
TUESDAY, JUNE 27TH, 2017 @ 2PM
Maximize
Enjoyment
WEDNESDAY , MARCH 18, 2015, 2:00 PM
Successful Communication Tips & Strategies to
TUESDAY, JULY 25, 2017 @ 2PM
Learn the “Best Friends” Approach to Caring for a Loved
Communicate with Someone Affected by
one with Dementia
Prestige Senior Living
Memory Loss
Spruce Point Assisted Living
& Memory Care
375 9th Street
Florence, Oregon 97439
an assisted living and
memory care community
www.spruce-point.com
HOURS
Spring is on it’s way...and so are the new class
offerings at LCC Florence!
Is your family prepared?
Drop by the Florence Center or go online to
register today! Classes start April 3!
If an emergency happens in your community,
it may take emergency workers some time to reach you.
You should be prepared to take care of yourself and
your family for a minimum of 240 hours.
Get your emergency fi rst aid kit started with these essentials:
❑ First aid manual
❑ Aspirin or pain relievers
❑ Laxatives, diarrhea medicine
❑ Rubbing alcohol, petroleum jelly
❑ Soap, salt, baking soda
❑ Sanitary napkins, matches
❑ Triangular bandages
❑ Elastic bandages, pressure dressings
❑ Cotton balls, disposable diapers
❑ Scissors, needles, tweezers
❑ Popsicle sticks, splints, heavy string
❑ Thermometer, paper tape
❑ Syrup of Ipecac
❑ Personal prescription medications
This message brought to you by the West Lane
Emergency Operations Group. www.wleog.org
www.shoppelocal.biz
IDENTIFY • PREPARE • SURVIVE
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