Listening to the articulate and knowledgeable Kate McEvoy of the Connecticut Agency on Aging discuss the forthcoming changes in the Federal Health Care Program at a recent Guilford VNA symposium, I was both excited and concerned.
Excited because many of the proposed changes which will take effect this coming January will benefit older adults, middle-income individuals, those with pre-existing conditions and seniors who would prefer to receive care at home instead of in a nursing home.
However, I am very concerned that because of the law’s complexities, false information about some of the provisions, our present stalemate in Congress, which will have to approve funding, that hopes for improving our flawed health-care system could be stymied or permanently shelved.
We spend about $7,681 per person on health care ... more than double the spending of European countries, Japan and other industrialized nations. We have the best emergency system, but not the best health-care system, and we are the only wealthy industrialized country in the world that lacks some form of universal health care.
Total government spending per capita in the United States on health care is 23 percent higher than Canada (which is funded by a mix of 70 public and 30 percent private) yet life expectancy is longer in Canada and they enjoy a lower infant mortality rate.
The new law would expand Medicaid coverage to those not historically qualified and by emphasizing preventative care, lower-income individuals would not be using the costly emergency room as their health-care provider. Also of note in this health-care reform is the elimination of deductibles and co-payments for Medicare and covering preventative services. It will also include an annual “wellness” doctor visit and establish tax credits for those with incomes above Medicaid limits. Additionally, as of January 2011, a voluntary, public long-term care insurance program with lower premiums than private insurance and not related to health status, would become available to working individuals.
The average monthly premium would be $123 and offer a benefit of up to $27,000 a year that the individual could decide to use for home care or home modification, as they choose.
To address the increasing shortage of health care workers, there are provisions for scholarships, loans and state grants to providers in medically underserved areas as well as graduate medical education initiatives.
And, (hurrah!) there will also be a schedule in which the coverage gap or doughnut hole, will be gradually closed.
Effective, starting this year, plans cannot impose lifetime or annual coverage limits for a list of essential benefits, and they may not rescind policies.
Premiums may no longer be determined according to health or gender, although they may be higher for the aged. Other excellent provisions include:
-Streamlined access to information rating nursing homes.
-Requirements for national and state criminal background checks for certain employees of home-care and nursing-home providers.
-Continuation of the Children’s Health Insurance Program in Connecticut. This funds the Husky program which helps grandparents raising grandchildren.
None of the proposed changed limit your choice of doctors. However, we certainly need to control spiraling costs. Older women who outlive men by five years or more, are especially at risk since they are more likely to need care, but usually have less income to cover the cost.
The affordable Care Act, signed into law by President Barack Obama, seeks to change the system in which doctors and hospitals get paid for each service they provide to a comprehensive system whereby they are paid to achieve healthy outcomes in patients, regardless of the number of tests or procedures.
These are all important issues which affect our lives and our pocketbooks. Be sure before voting on Nov. 3 that you know where the candidates stand on these important topics. It might be well to recall the words of Mahatma Ghandhi who said, “A nation’s greatness is measured by how it treats its weakest members.”
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