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Kathleen Sebelius: What's in Health Reform for You

We can secure Medicare and improve health care now.

The other day I got a letter from a senior named Maureen who wrote that she “counted the months and days to my 65th birthday because I could be enrolled in Medicare. Medicare is WONDERFUL.”

Most seniors I talk to, including my father, who is 88, couldn’t agree more. They don’t think Medicare is perfect. But they wouldn’t trade it for any other health plan in the world. So they can’t help but wonder, “If I already like my insurance, how will reform help me?”

First, you’re going to save money on your medicines. In 2007, 8 million seniors got stuck in the so-called prescription drug “doughnut hole.” That means they had to pay full price for their medicines out of pocket—hundreds or even thousands of dollars a month. But with health insurance reform, seniors in the doughnut hole will get half off on all brand-name drugs.

Second, reform is going to strengthen Medicare’s finances so your benefits don’t get cut. Unless we make a change, the Medicare Part A trust fund will be gone in eight years. Under reform, we’ll make easy choices now—like ending subsidies to private insurers—so we don’t have to make hard choices later.

Third, reform will stop private insurance abuses against older Americans. Today, a 60-year-old can pay $7,000 more a year than a 27-year-old for the same coverage. Or a person can be denied coverage because he or she has high blood pressure or diabetes. Health insurance reform will make it illegal to charge older Americans exorbitant premiums or to discriminate based on preexisting conditions.

Fourth, reform will help crack down on Medicare fraud. Last month, the administration won a record $2.3 billion fraud settlement from Pfizer. Earlier this year, a new antifraud initiative called HEAT led to the arrest of doctors and executives who had cheated Medicare out of $16 million. Reform will help the administration prosecute Medicare fraud and prevent it from happening in the first place.

Finally, reform will make sure you can keep your doctor. The current law requires a 21 percent cut in the fees paid to doctors for Medicare services—21 percent! Health reform will eliminate this pay cut so seniors can keep their doctors.

Many of you are hearing some scary claims about reform, about cuts to Medicare benefits. They are not true. Or rumors about so-called “death panels.” That’s just ridiculous. But don’t take my word for it. Ask your local AARP representative. Get the facts.

Some of us remember similar attacks more than 40 years ago when Medicare was being debated. People called it “socialized medicine.” They said it would lead to rationing. And the first time it came up for a vote in the House, it passed by only 45 votes.

But today, like Maureen, most of us see Medicare as one of America’s greatest accomplishments. This fall, we have a chance to take another big step forward as a country—and secure Medicare’s future at the same time. We shouldn’t waste it.

Kathleen Sebelius is U.S. secretary of Health and Human Services.

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