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AARP's SHAARP Session blog dispels common health reform mythsAARP replies to U.S. Rep. Brown-Waite: Just the facts, please
AARP Florida State Director Lori Parham sent the letter below to U.S. Rep. Ginny Brown-Waite, R-Brooksville, on Thursday:
September 17, 2009
The Honorable Ginny Brown-Waite
Member, United States House of Representatives
16224 Spring Hill Drive
Brooksville, FL 34604
Dear Congresswoman Brown-Waite:
We have received a mailed copy of your letter of September 9th dealing with health-care reform, and let me thank you for your detailed response. I hope to be able to provide you with a few points of information that you may find useful.
First, a minor correction: Our national president’s name is Jennie Chin Hansen. Your letter refers to her as “Ms. Chin,” a simple error that some may misinterpret as demeaning. Also, you mentioned AARP’s name. AARP changed its name from the American Association of Retired Persons to AARP because more than half of our members are still in the workforce. Retaining the word “retired” in our name did not accurately convey the experience of those members who go to work every day.
Despite the fax confirmation receipt that we have on file, you apparently received neither a faxed copy of our September 1, 2009 letter nor the mailed copy that was sent to your office in Brooksville. A copy of that letter is enclosed, as is a copy of our July 28 letter to you, which we mailed to you. We still await your response to that letter. Perhaps it would be advisable to review your office procedures on receipt of faxes and mail.
Our goal in sharing our feedback with you has been the same throughout our correspondence: To encourage careful attention to the facts when debating the health-care reform issue. Let us agree to disagree when we encounter differences in approach or priorities. But let us all strive for accuracy, responsibility and fairness in all of our communication. As observers from all points on the political spectrum agree, our current health system is unsustainable. If the current reform initiative fails, it may fall to you and
your Republican colleagues to lead another charge for a sustainable health system in just a few years.
Those elected officials who are the targets of misleading and bitter attacks today may choose to respond in kind tomorrow. None of us wants a deeply divided America that fails to resolve what must be resolved. With the greatest respect, regardless of who wins and who loses politically, America must heal its broken health system. AARP is committed to preserve what is right and fix what is wrong with our health-care and health-insurance systems.
It is with this commitment in mind that I am compelled to respond to numerous statements made in your September 9 letter. First, let me respond to your inquiries about why AARP favors health-care reform.
AARP was founded in response to the fact that seniors had no voice on matters of health and financial security, at a time when an overwhelming number were forced in to poverty in their retirement years. The truth is that we are fighting for reform because our members tell us that they want us to. Our unpaid, all-volunteer Board of Directors also has directed that we advocate strongly for reforming the health system. We fought for
Medicare in the 1960s, and have fought to protect it ever since. We fought alongside Republicans in 2003 to create the Medicare Part D prescription-drug benefit. We plan to keep fighting for better health care for all generations. It’s in our DNA.
In your September 9 letter, you repeatedly ask for details of AARP’s finances and “profits.” We are a non-profit entity. Our Annual Report, with the relevant financial details, is available at http://www.aarp.org/aarp/About_AARP/annual_reports/ . We would note that some of our AARP-licensed products – products we have never “resold”, by the way – are offered by companies that are vigorously pursuing their own interests in the health-reform debate. We are fighting for reform because our members’ interests always come before business interests at AARP. In fact, there is nothing we would like more than to be put out of business thanks to a system that ensures the health and financial security of older Americans.
Now let me turn to some of the other statements you make in your letter. At the bottom of Page 1, you refer to $30 billion in Medicare savings achieved by requiring drug manufacturers to accept the same discounts for drugs provided to dually eligible Medicare/Medicaid beneficiaries that are now provided to Medicaid recipients.
You suggest that this is not a savings but a “cut” to beneficiaries, noting a passage from an August 28 Congressional Budget Office analysis citing increases in beneficiaries’ premiums. If you would continue reading in the CBO analysis to the next sentence, you would see this statement: “However, beneficiaries’ spending on prescription drugs apart from those premiums would fall, as would their overall prescription drug spending (including both premiums and cost sharing).”
In regard to your concern that H.R. 3200 would empower the Secretary of the Department of Health and Human Services to negotiate drug prices provided under a public-option health plan, AARP has long supported secretarial negotiating authority for prescription drug prices. This is not specific to the public option, but for Medicare Part D as well.
We would note that your Florida Republican colleagues Representatives Jeff Miller of Ft. Walton Beach and Vern Buchanan of Sarasota have also supported this common-sense measure, as do the vast majority of older Americans. This authority is already granted to the Secretary of the Veterans Administration.
In regard to health-care rationing, you suggest that language in Section 121 of H.R. 3200 prohibits health plans in the proposed Health Exchange from establishing plan restrictions unrelated to clinical appropriateness.
On this point, your logic is unclear to us. Directing health plans to abandon coverage decisions based primarily on cost – all too common today – and requiring coverage decisions to be based on clinical appropriateness seems to be the opposite of cost-based rationing.
You also refer to Page 33, Section 123, suggesting that a Health Benefits Advisory Committee would “clearly” be rationing care if it approved minimum standards for health-benefit plans. We don’t understand the logic. Why would establishing minimum standards for coverage under qualified plans prohibit those plans from providing coverage in excess of the minimum? The language would protect consumers from insufficient policy coverage and would ensure access to preventative and primary care services among many others. Again, this seems to be the opposite of limiting care.
This same point applies to your reference to Section 203. Again, establishing a minimum standard for coverage doesn’t prohibit a plan from covering more than the minimum. Failure to provide a minimum standard for coverage definitely would permit insurers to deny coverage – surely that is rationing.
You are critical of multiple sections dealing with insurance reform that provide multiple consumer protections for those who are currently underinsured or uninsurable in the private market. These include Section 112, providing for guarantee issue of health policies to consumers; Section 113, prohibiting insurer discrimination on the basis of age; Section 116, requiring insurers to pay consumers a rebate if they fail to spend at least 85 percent of premium dollars on patient care; Section 121, setting standards for insurers inside and outside of a health exchange; and Section 122, limiting cost-sharing (co-payments), prohibiting annual or lifetime caps on benefits, and prohibiting cost-sharing for preventive care. You also mention Sections 123 and 124, establishing an advisory committee controlled by physicians and patients, not government bureaucrats or insurance-company officials.
If you are alleging that AARP supports broad-ranging private health insurance reform that will provide affordable access to middle class families, again, you are quite correct. So do the vast majority of Americans.
In your reference to Section 1122, AARP policy analysts read this section as allowing doctors to be paid more on the basis of their skill and qualifications. We see this section as positive not only for our members but for physicians.
In your reference to Section 1401, regarding a “Comparative Effectiveness Research Committee,” you suggest that this section empowers government employees to decide what treatments are most effective. This commission would have 17 members. Two are required to be government employees, and a controlling majority, nine members, must be doctors, other health providers or patients. The Comparative Effective Research Commission is prohibited from mandating coverage, reimbursement, or other policies to any public health program or private insurer. AARP sees knowledge as power. If doctors and patients have better information on which treatments work best, they will surely make appropriate choices.
In regard to Medicare Advantage plans, perhaps the best course is to agree to disagree. Your Town Hall handouts suggest that Medicare Advantage plans would be destroyed if they could no longer be paid 14 percent more than government pays to care for patients in traditional Medicare. AARP believes Medicare Advantage plans are receiving subsidies that would be better spent on caring for beneficiaries, not increasing insurance-company profits or executive salaries. We also favor provisions that reward Medicare Advantage plans for providing higher-quality care than patients in traditional Medicare receive, as well as provisions that establish new consumer protections for Medicare Advantage patients, such as allowing patients to switch plans outside of the open enrollment period if their Medicare Advantage plan changes drug formularies or increases out of pocket costs in mid-year.
On Page Three of your letter, you suggest that AARP favors providing insurance coverage to illegal aliens. AARP’s position has been, and remains, that health reform should provide better access to care for those lawfully in the United States.
Far from turning its back on our members, as you suggest, AARP is fighting for our members. Over the past two years, I have traveled throughout Florida meeting with
members who have pleaded with me to support health reform. One is Oscar Atwell, 60, of Pensacola, who lost his computer programming job in the bad real-estate market soon after learning he had bladder cancer. His COBRA coverage is costing him $1,800 per month – and it’s running out. Without health reform, Mr. Atwell would be uninsurable in the private market. Under health-reform proposals now before Congress, Mr. Atwell would be able to get affordable, quality coverage despite his pre-existing condition.
We are fighting for health reform for Mr. Atwell, and the other 600,000 Floridians age 50-64 who are currently uninsured. We also are fighting for the 300,000 Floridians who fall
into the Medicare Part D “doughnut hole” every year, but who would get help under health reform proposals; the tens of thousands of Medicare beneficiaries who must be re-hospitalized within 30 days of release because of inadequately coordinated follow-up care, but who would get better care under health reform; and the millions of Floridians of all generations who believe, wrongly, that their flawed health coverage will shield them when they become seriously ill. We see no mention of these people in your letter, your Town Hall handouts, or any other documents we’ve seen from you.
Finally, in the postscript to your letter, you suggest that Social Security Administration has announced that the program will become insolvent in 2010. The last 5 Trustees Reports have suggested that Social Security's trust funds would become exhausted between 2037 and 2041. Repeating this untruth could terrify the numerous Floridians who rely on Social Security for all or part of their fixed retiree incomes.
We are writing you this letter, as we did the previous two, because we seek to encourage an accurate, mutually respectful, and above all productive debate on health reform. For the sake of those we both serve, Representative Brown-Waite, there couldn’t be a more critical time to stick to the facts.
Sincerely,
Lori K. Parham
State Director
AARP Florida
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