With much of the budget debate in Washington centered around the spiraling costs of Medicare and changes from the health care overhaul passed in 2010 beginning to take effect, Missouri senior citizens have been left with a lot of questions.
To help provide some answers, sponsored a seminar held Wednesday night at the Lodge Des Peres titled "Separating Fact from Fiction—The Impact of Health Care Reform on Seniors." Speakers for the event were former Missouri Governor Bob Holden, who now runs the Holden Public Policy Forum at , and Missouri Foundation for Health President and CEO Dr. James Kimmey.
Eighty-three-year-old Dan Faber was one of the attendees and came because he wanted to see what all the "brouhaha" about health care reform was about. Faber also had a more pressing concern—the supplemental insurance provided by his former employer was phased out, leaving him entirely dependent on Medicare.
"You think you have everything under control, but then you find out you don't," Faber said.
Faber said he didn't have an opinion about the highly politicized law and instead just wanted to find out if Medicare by itself would be enough to provide the quality of care he wants for himself and his wife.
Faber was joined by an estimated 150 other people who filled into the Lodge Des Peres Wednesday night to find out more about the new health care law, officially called the Affordable Care Act (ACA), and its effect on Medicare. A complete video recording of the broad-ranging discussion, which also included a Q and A session, can be found in here.
Holden and Kimmey focused their speeches on explaining some of the definite benefits of the ACA and how it changes and doesn't change Medicare.
"No. 1, your existing benefits will not be reduced or taken away or your ability to choose a doctor," Holden said.
Other positives of the law outlined by Holden included yearly government rebates to help cover the prescription drug "doughnut hole," no deductible on preventative services, a prohibition on insurance companies imposing lifetime caps on coverage and cost savings that will extend the life of Medicare to 2029.
In an interview with Patch prior to the event, Holden said that words like "cost savings" have been used as a political scare tactic in the debate surrounding the ACA.
"People think that if you put in some of these cost containment measures, it means availability will be diminished," Holden said, adding that such worries are natural. "I think all of us get nervous or get scared when someone says we are going to change something so fundamental as your health care."
Kimmey also addressed what he called the "distortions" that have been aimed at seniors at the event. One of the ways the ACA will extend the life of Medicare is by reducing some of its cost by $500 million, but Kimmey argued that this will be taken out through measures such as eliminating government overpayments to private insurance companies, not by compromising care.
After hearing from Holden and Kimmey, the floor was opened up for questions from the audience. One of the queries, submitted on pieces of paper to a moderator, asked if the ACA would change how health care providers decide which treatments and procedures to perform.
"We are increasingly going to see practice guidelines that say what are the best ways to treat patients and payment will be tied to those guidelines," Kimmey said. "They work, some major medical providers are already using them and using a lot less drugs and a lot less tests."
This does not mean, Kimmey said, that there will be situations where a panel or committee decides who gets to have this procedure and who doesn't. Instead, it's an effort to curb one of the contributing factors to escalating costs.
Modern medicine is constantly creating new technologies and procedures to treat diseases. In Kimmey's view, some of these are very effective, some are not, but all are expensive.
"We need to use technology in ways that are cost effective and proven to prolong life and prevent disease," he said.
Such efforts are aimed at something almost all proposals to overhaul health care, whether they come from Republicans or Democrats, try to do: slow the rapidly rising price of health care.
"Cost control is essential for the future of Medicare, Medicaid and private insurance. We cannot continue to sustain the increases in terms of cost," Kimmey said in an interview prior to Wednesday's event.
Finding effective ways to do just that is going to be a huge political challenge, Kimmey said. However, rather than focusing on repealing the ACA, he and Holden urged the audience to take a more studied approach.
"We can see over time what is working and what is not," Holden said. "Don't take the attitude that it is all perfect or all wrong."