The hospitals and the elders should be friends


By Al Norman

In the movie Oklahoma, the farmer and the cowman were encouraged to be friends:

“One man likes to push a plough, the other likes to chase a cow. But that’s no reason why they cain’t be friends.”

The same advice should apply to people in the health care system, and their elderly consumers. The hospitals like to keep folks well, the seniors like to keep costs low — but that’s no reason why they can’t be friends.

But the “Territory Folks” did not stick together when the American Hospital Association recently announced that they were lobbying Congress to raise the age of Medicare eligibility from 65 to 67. This upset many senior rights groups, who have been arguing for years for the opposite idea: create a Medicare for all to let younger adults qualify for Medicare.

A Medicare for all approach would increase the beneficiary pool that allows risk to be spread over a larger population base of covered individuals. It would also lower health care administrative costs because Medicare is more efficient at delivering care than private insurance companies.

In his most recent deficit reduction plans, Pres. Barack Obama proposed a series of cost-shifting measures that would hit elders on Medicare:

•An increase in Medicare Part B and D premiums by 15 percent until 25 percent of beneficiaries under Parts B and D are subject to these premiums.

The White House said this would reduce the Federal subsidy of Medicare costs for those beneficiaries who can most afford them, and would shift $20 billion over 10 years to Medicare beneficiaries.

•Modifying the Part B deductible for new beneficiaries by adding a $25 increase in the Part B deductible in 2017, 2019 and 2021 for new beneficiaries. This proposal would cost seniors $1 billion over 10 years.

•Introducing new home health co-payments for new beneficiaries. This proposal would create a home health copayment of $100 for home health episodes with five or more visits not preceded by a hospital or other inpatient post-acute care stay. This proposal would save approximately $400 million over 10 years.

The hospitals, worried that their Medicare rates would be cut, tried to pass the pain over to their patients. The head of the Mass Hospital Association told The Boston Globe that hospitals “have been giving and giving and giving, and will give more. But the beneficiaries also have to be touched even though politicians feel like that’s a third rail.”

President Obama is “touching” people on Medicare with billions in cost shifting. Seniors have been “giving and giving” too. But imagine the outcry from hospitals if elderly groups told Congress to cut rates for hospitals. “This is really self-defeating for the hospitals,’’ said Ron Pollack of Families USA. “Because ultimately a lot of these 65- and 66-year-olds will wind up joining the ranks of the uninsured. So when they go to the hospital and are unable to pay for it, it’s going to cause hospitals to eat those costs.” Congressman Ed Markey put it plainly in The Globe: “Raising the Medicare age would shift health care costs onto the backs of seniors.”

If the farmers and the cowmen should be friends — so should the hospitals and the seniors. But the most recent lobbying by the Mass Hospital Association has not helped the Territory Folks one bit.

Al Norman is the Executive Director of Mass Home Care. He can be reached at 413-773-5555, or at