About five percent of Medicare beneficiaries account for about half the money spent. Many of these people have multiple chronic diseases. Here again, the Medicare law breaks new ground by adding chronic disease management.
Fifth, we must move toward a prevention model of health care. We can't prevent all disease, but we can do much more to keep people out of doctors' offices and hospitals. This is just what AARP hopes to do in our new partnership with the Centers for Disease Control and Prevention.
Another way to prevent hugely expensive and tragic diseases is to fully support the National Institutes of Health, from which cures and treatments for Alzheimer's, diabetes and Parkinson's, for instance, would prolong healthy life and save billions.
Sixth, we must bring down the high costs of prescription drugs for all Americans. These drugs keep people independent, working and out of hospitals and nursing homes…but not if people can't afford them. We need to invest in evidence-based drug research, greater use of generic drugs, innovative strategies like pooled purchasing, the wise use of pharmaceuticals and safe importation from other countries.
Finally, none of these steps will help without access to the health-care system. Over 45 million Americans lack health insurance; many are working people or kids in families where at least one parent works.
The uninsured tend not to see doctors, and then go to the emergency room when something is serious or life-threatening. This is the most expensive and least effective way to deliver medical care. We absolutely must solve this problem, and not by simply shifting costs from one sector of the economy to another.
Each of these seven things is tough to achieve. None is impossible. They will improve the quality of care for all Americans, and give us much better value for our money. They will help make Medicare and Medicaid sustainable over the long run.
So let's get after it. This investment will make life better for future generations, and we'll pay for it as we go along, not pass it on to our children and grandchildren. AARP can help.
Now, let's turn to economic security. We can enhance our retirement system by strengthening Social Security, creating more pensions and savings and providing employment opportunities for people as long as they want or need to work.
Social Security is the most successful domestic program in our history, a risk-free, guaranteed pension that on average replaces 40 percent of a retiree's wages.
President Bush has put Social Security high on the nation's agenda, which gives us the opportunity to strengthen the program for future generations. By now you are aware of the arguments and the numbers and the ideas that are circulating. And you know that AARP is, and will be, deeply engaged. Now is the time to act, and spread any costs over all generations, rather than leaving it to our kids and grandkids to shoulder the load.
Unlike health care, Social Security does not need a radical overhaul. We don't have to dismantle this successful program in order to save it. There are reasonable, moderate changes we can make to achieve solvency and fiscal soundness, just as has been done before.
The President has said that all ideas are welcome. Here are a couple of examples that, combined, would get us well over half way toward solvency, and there are other possible options to consider:
- Restore the total wages taxed by Social Security to 90 percent of nationwide earnings. This would move the cap from $90,000 in 2005 to $140,000 — perhaps phased in over a decade. It would lower the projected shortfall by some 43 percent.
- Diversify Trust Fund investments in a total market index fund, like most pension funds, to get a higher return, which could fix about 15% of the problem.