All blog posts related to the issue: Health Care
  • Medicare for Future Generations

    Today, we celebrate 48 years since the Medicare and Medicaid programs were signed into law.

    By signing these laws, Lyndon Johnson pledged that the most vulnerable Americans would always have the medical care they needed. Sustaining the promise of Medicare and Medicaid requires stretching every dollar to the fullest, and making sure that the programs keep up with the changing needs of the people they serve.

    These programs have fulfilled their promise, but it’s important to reflect on the challenges ahead.

    Medicare, in particular, is on an unsustainable fiscal path over the long-term. Every day, for the next two decades, we are adding 10,000 new enrollees per day. Yet, if left unchanged, the program will be insolvent in 2026.

    The needs of people being served by Medicare have also changed a great deal over the last 48 years. Americans are not only working longer and living longer, they are generally sicker than their parents were when they first enrolled in the program. Today, it’s far more common for seniors to suffer from multiple chronic conditions like heart disease, high blood pressure, cancer or diabetes.

    To get seniors the best possible care – and the best health outcomes – at the lowest possible cost, there needs to be a shift in the way that Medicare deals with chronic illness. Insurers and providers throughout the country should be allowed, and encouraged, to work in multidisciplinary teams to focus on chronic care. It’s an opportunity to save money and provide better care so that seniors can live healthier lives, with security and dignity. Essentially, it means making good on the Medicare guarantee.

    The Affordable Care Act (ACA) provided some very important steps forward, and we already seeing positive results for millions of Americans. But, our job is far from done. Now, we must build on the forward momentum of the ACA and take additional steps to reach the goal of a fully integrated, patient-centered health care system for all.

  • Wyden Outlines Major Medicare Reforms at Accountable Care Organization Summit

    Today Senator Wyden outlined major Medicare reforms at the Accountable Care Ogranization (ACO) Summit. 

    Through reform of the accountable care program, ACOs can improve the care of Americans with chronic disease while driving down costs. Reform will also be aimed not only at addressing Medicare’s major cost driver, chronic conditions, but also at improving health outcomes and the quality of care for patients.

    ACOmain

    Watch Senator Wyden's speech here or read below:

    Wyden Keynote Speech at Accountable Care Organization Summit by Senator Ron Wyden

  • Wyden op-ed: To Save Medicare, Think Like The Patients

    The Atlantic: Senator Ron Wyden has been an advocate for senior citizens for nearly four decades. Prior to joining Congress, Wyden served as the director of Oregon Legal Services for the Elderly, was a member of the Oregon State Board of Examiners of Nursing Home Administrators and a co-founder of the Oregon Gray Panthers. He penned an op-ed recalling the evolution of Medicare and the pressing need for meaningful reform to keep the promise of Medicare to millions of American seniors.

    "Medicare" means different things to different people. Some say it's the best argument for a national single-payer health insurance system. Others will tell you that it's the federal budget's biggest villain, while election strategists call it a campaign defining issue. However, for the nation's 50 million Medicare beneficiaries, Medicare is neither an ideological argument nor a political talking point. For them, Medicare is their health insurance plan. 

    Of course, it's more than just a health insurance plan. It is a lifeline for millions of our senior citizens. Before Congress created Medicare, in 1965, more than 50 percent of American seniors didn't have health insurance, mostly because the increased health risks associated with aging made health insurance unaffordable. At the time, it was not uncommon for the sick elderly to be treated like second-class citizens, and many aging Americans ended up destitute without necessary health care.

    Medicare changed that. As a rock-solid guarantee of essential health services for every American over the age of 65, Medicare has been our country's most important social safety net. But as a health insurance plan, Medicare has never been perfect.

    From its outset, Medicare only covered essential inpatient (Part A) and outpatient (Part B) services, which has long meant that seniors had to purchase supplemental private insurance to cover what Medicare does not. One of the reasons I ran for Congress in the early 1980s was to help regulate the market for supplemental Medicare insurance plans, because unscrupulous agents were exploiting holes in the Medicare law to sell seniors worthless policies. (In 1990, former Senator Tom Daschle and I passed the "Medigap" law to regulate the market for supplemental Medicare insurance.)

    In 1997, Congress passed Medicare Part C to give Medicare beneficiaries the choice to receive their Medicare benefits through a private health insurance plan. This reform has become a lifeline for seniors in states like Oregon, where Medicare's low reimbursement rates have made it increasingly hard for seniors to find a doctor. Right now, 41 percent of Oregon's Medicare beneficiaries get their Medicare from a private insurance company.   

    In 2003, Congress added Medicare Part D to give seniors a prescription drug benefit that had not previously been available through Medicare. And the Affordable Care Act (ACA), passed in 2010, included a number of provisions to enhance Medicare's preventative care services, while ensuring that more seniors have high-quality private sector options in addition to traditional Medicare.

    Yet some seniors still find that Medicare fails to meet all of their health care needs. While the ACA included an annual out-of-pocket cap and removed lifetime limits for insured Americans under the age of 65, there remains no catastrophic benefit in the Medicare program, and Medicare continues to enforce a lifetime limit on the number of days Medicare beneficiaries can spend in the hospital.  

    Medicare's copays and deductibles are also not insignificant for American seniors, 62 percent of whom currently live on a fixed-income of less than $30,000 a year. For example, while Americans under the age of 65 pay an average of 3 percent of their total income on health care, Americans over the age of 65 are currently spending 16 percent of their total income on their health needs.  

    As a fee-for-service health insurance plan, Medicare, like much of our health care system, promotes quantity over quality, by reimbursing providers for the number of services they perform versus the quality of their care. States that have found ways to lower Medicare costs, like Oregon, continue to be punished with lower reimbursement rates for providers, for the very reason that they have established lower annual costs. Meanwhile, Congress's inability to come up with a long-term solution for Medicare's provider reimbursement problems means that more and more doctors are limiting the number of Medicare beneficiaries they are willing to treat--just at the time when, as of the beginning of this year, 10,000 Americans turn 65 every day, a rate that will continue for the next 20 years. The Congressional Budget Office projects that the Medicare Hospital Trust Fund will run out of money in ten years. If Congress does nothing before that time, we will be reneging on the promise of Medicare to millions of American seniors.

    Yes, Medicare means many things to many people. But upholding the guarantees of Medicare requires each of us to start thinking like the 50 million Americans who rely on it for their health benefits. Those 50 million Americans don't care about talking points or ideological battles nearly as much as they care about being able to find a doctor and get the care they need when they need it. Unless Congress starts looking for meaningful solutions to ensure that every Medicare beneficiary will be able to find a doctor and get needed care, seniors are going to be the ones forced to endure increasingly higher premiums and arbitrary cuts to benefits--until Medicare doesn't guarantee much of anything.

    Learn more about Wyden’s recent Medicare reform proposals: Medicare Better Health Rewards and Wyden-Ryan white paper.

    Tags:
    Medicare
    Seniors
    Wyden-Ryan