The first report released under this series is entitled, “Medicare: 50 Years of Ensuring Coverage and Care.” The Executive Summary of the report claims, “there is a lot to celebrate. For 50 years, Medicare has accomplished its two key goals: ensure access to health care for its elderly and disabled beneficiaries, and protect them against the financial hardship of health care costs.”
But as one gets a bit deeper into the report, the achievements of Medicare change: “In its first 50 years Medicare has unquestionably achieved its two basic goals: to ensure that Americans 65 and older have access to health care, and to protect them and their families from severe financial hardship from medical bills.” Note that protecting the disabled are no longer part of the achievements.
I’m not sure why the discrepancy. I can say that the second statement is far more accurate. Due to Medicare’s cost-sharing—Medicare Part B, for instance, requires beneficiaries to pay 20 percent of the cost of most services—many disabled people on Medicare have trouble accessing care. While many seniors have some sort of supplemental policy (often called “Medigap) that pays for most of the cost sharing, the disabled are often too poor to be able to afford monthly Medigap premiums. Indeed, about 20 percent of the disabled on Medicare lack supplemental coverage as opposed to eight percent of seniors.
The data shows that the disabled on Medicare have a harder time paying for care. Thirty-three percent of the disabled report major or minor problems paying for care versus about 13 percent of the elderly. A paper from the mid-1990s found nearly three times the number of disabled on Medicare reported not getting health care as the elderly. Seventy-one percent of the disabled cited cost as the major factor. Another study found that as a result of having higher rates of putting off or not getting care, the disabled experienced higher rates of stress and anxiety, physical pain, and the worsening of a medical condition or problems that eventually required medical attention.
None of these studies, naturally, appear in the Commonwealth Fund report. I’ll have some more about how the disabled fare on Medicare Thursday, including what I think is the biggest problem most overlooked by health care researchers.
For now, you can read more about the disabled an Medicare in chapter 3 of my book, “Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patient and Impairs Physicians.” Here are the ordering options:
Paperback at Amazon.com, $14.99.
Kindle at Amazon.com, $6.99.
ePub at Lulu.com, $6.99.
ePub at iBookstore, $6.99.
I’d be remiss in not noting that Barnes & Noble is selling the paperback version for only $11.99. The economist in me realizes that the 20 percent cut in price means demand for the book is lagging. The writer in me can’t help but suffer a blow to his ego.