Bush White House: Stick the Old People in HMOs

With the holiday season now in full swing, one might expect the traits of charity and benevolence would be the marker of our time. Yet in the Thanksgiving issue of The New York Times we learn from Robert Pear that the Bush administration wants to reduce the health benefits going to many of our nation's seniors and shove them into unresponsive and overly bureaucratic HMOs.

A federal advisory panel says that long-term care for aging baby boomers threatens to bankrupt Medicaid, and it recommends sweeping changes to rein in costs, including greater use of managed care for the sickest Medicaid recipients.

The proposals set up a likely clash between the new Democratic Congress and the Bush administration, which has sent strong signals that it will seek big savings in Medicaid next year.

Panel members adopted the recommendations last week, by a vote of 11 to 1, and are drafting a report to be submitted next month to Michael O. Leavitt, the secretary of health and human services. Mr. Leavitt created the panel in May 2005 and is receptive to many of its proposals.

There is little question that the government must endeavor to rework some of the federal entitlement programs to ensure that they are sufficiently funded and not excessively costly. This far Democrats and Republicans agree.

However in their ideological battle to destroy almost all things government, Republicans want to take this move one step further, either privatizing the programs that have helped America prosper for the last several decades or decreasing their level of service to the point at which they are both unuseful and unpopular with voters. Whether it is sucking the lifeblood out of Social Security through so-called "private accounts" or forcing ill seniors out of nursing homes and into unwieldy HMOs, the aim is the same: undermining the legacy of Franklin Delano Roosevelt and making America a fundamentally less efficient and less fair country.

Of course the plan laid out by the President's commission would be dead on arrival in the Democratic Congress. In fact, it would have been dead on arrival even during the current Republican Congress, just as was the partial privatization of Social Security.

While the American people want to see the long-term deficits in these programs substantially reduced, they are clear in their determination to do so without placing all of the burden on the needy, as the aforementioned panel recommends. Though there is not a large amount of polling on Medicaid or even the Medicare program in general, the numbers regarding Social Security are likely indicative of Americans' general sentiments towards the entitlement programs. Looking at the somewhat recent surveys on the subject, Americans overwhelmingly trust Democratic plans for the program over Republican ones, opposing private accounts while strongly supporting an increase to the cap on income subject to Social Security taxes and slowing the rate of growth in benefits for the well-to-do, for instance.

Thanksgiving or not, the American people are a benevolent people. And the more often Republicans suggest policies that would punish the poor to help pay for the disastrous policies of the current administration (much of which has predominantly favored the wealthy and the extremely wealthy), the less likely the GOP will be able to return to the governing majority it enjoyed for the better part of the last decade.

Tags: Entitlement Reform, Medicaid, Medicare (all tags)



Persons with Disabilities hurt, NOT Just Elderly
Persons with disabilities would bear the brunt of these changes as well, as Gwen Gillenwater, who was the one commissioner to vote against the final report notes. See this excerpt of Pear's article "The commission said states should be able to place all types of Medicaid recipients in managed care without getting "a waiver or any other form of federal approval." But, it said, individuals should be able to "opt out" of managed care. Gwendolyn G. Gillenwater, a commission member who is policy director of the American Association of People With Disabilities, an advocacy group, voted against the report. "People with disabilities have not had good experience with managed care," Ms. Gillenwater said. "We need federal protections and safeguards. People with disabilities should at least have a choice of two managed care plans. And what are your choices if you opt out of managed care? The alternatives are getting more and more limited." "
by dandem 2006-11-23 10:46AM | 0 recs
Re: Bush White House: Stick the Old People in HMOs
Republicans have railed about Social Security since it's beginning.  Why do they hate seniors so much as to deny them dignity and make them live on the streets and dig in the garbage for food is beyond me.  It's beyond dencency
But, no republican has been so obsessed with destroying the New Deal and especially Social Security as Bush.  It is his only thing on his domestic agenda.
Since he failed to get Social Security shut down and privatized last year, he is going to go after it thorugh medicare.  
What a heartless sleaze.
by vwcat 2006-11-23 04:44PM | 0 recs
Re: Bush White House: Stick the Old People in HMOs

FrontLine jsut did a piece on aging.  Problem is keeping people alive beyond usefulness.  Life isn't life when medicine is involved.  It is medicine. There is a season.  And when it is gone, it is time to end it.  

by dkmich 2006-11-24 01:55AM | 0 recs
Re: Bush White House: Stick the Old People in HMOs

by dkmich 2006-11-24 01:56AM | 0 recs
How much of the 'long term deficits' projected ...

... for Medicare is due to failure to apply payroll tax to all executive compensation?

It makes sense to me that if the strongest wage growth is in the top 1% of income earners, and a substantial share of that escapes making its contribution to Medicare, then that will result in a higher projection of deficits than if (1) wage growth returns to the "bottom" 80% and/or if (2) all executive compensation contributes.

by BruceMcF 2006-11-24 08:31AM | 0 recs
Re: Bush White House: Stick the Old People in HMOs

The funny thing is that HMOS and hospitals are pushing the sick elderly into nursing homes because they still need medical attention but usually they can't properly be taken care of in a nursing home. Then pressure from the nursing home's corp and insurance providers push these people back home.  its crazy.  There needs to be more government money sent to nursing homes, not more unneeded burden.

by SleepingIn 2006-11-24 09:57AM | 0 recs
Re: Bush White House: Stick the Old People in HMOs

dkmich is right. Medicare spends 66 percent of all its money in the last three months of people's lives.  Managed care IS necessary to keep Terry Schiavo situations from happening to all of us.  Properly regulated HMOs work.

by gas28man 2006-11-26 04:50PM | 0 recs


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