Tuesday, November 1, 2011


Is Medicare Stuck in the 1960's?

When Medicare was enacted, it was intended to serve as the foundation of the health care system for seniors and people with disabilities. For years it was seen as a highly successful program that saved the elderly and disabled from financial disaster.

Many, if not most people continue to believe in the promise of Medicare. But this is a fallacy, writes Jane Gross, whose opinion piece, How Medicare Fails the Elderly appeared in the Oct 15, 2011, New York Times.

"Here is the dirty little secret of health care in America for the elderly, the one group we all assume has universal coverage thanks to the 1965 Medicare law: what Medicare paid for then is no longer what recipients need or want today,” Gross writes.

This change, suggests the author, is a result of advances in medicine that now keep people alive well beyond what was considered a normal life span in the 1960’s. Today, much of the care Medicare is mandated to provide does little if anything to cure illness and improve the quality of life of seniors in America.

Medicare will pay for “heroic” care for a senior dying from the natural process of aging. It will pay for diagnostic tests, surgery, and emergency room treatment. It will pay for Hospice.

But what it won’t pay for is what most seniors need: long-term care in a safe and well-run facility, and/or home aides and caregivers to help with the tasks of daily living.

Nationwide, the median annual cost of a nursing home in 2010 was $75,000; room and board in an assisted living facility, with no additional help, was $37,500; and the most basic category of home health aide, who can perform no medical tasks, like the dispensing of medication, was $19 an hour.

 “These expenses are left to the elderly (and their adult children) to pay for out of pocket until their pockets are all but empty,” says Ms. Gross.

Ms. Gross proposes that the “mismatch between what is covered and what is useful” is the “essential flaw” in the way Medicare operates today. Today there are 47 million Medicare recipients, a number expected to rise to 89 million by 2050.

Legislative action is needed now, says Jane Gross. Otherwise the health care future for our seniors is bleak. To read the full article by Jane Gross go to:  NYT Article

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