"Once the door is open a crack, it's easier to open all the way," Shannon Benton, executive director of TREA Senior Citizens League, told United Press International. Means testing is "leading the way toward privatization as a whole."

Those in favor of means testing say it is a more fair way to distribute the skyrocketing costs of the Medicare program, while those opposed say it will change it from social insurance to welfare -- without saving much money.

Beginning in 2007, singles whose income in 2005 was over $80,000 and couples who earned more than $160,000 will be charged higher premiums for Medicare Part B, which covers doctor visits and outpatient services, based on a sliding scale.

This marks a profound shift for a program which has, until now, offered essentially the same package of benefits for the same price to all beneficiaries, regardless of income.

The initial increases will be relatively modest for most seniors. Those with incomes below the cutoff will pay a projected premium of about $98, while those above it will likely pay between $111 and $170, according to Centers for Medicare and Medicaid Services estimates.

However, once the means testing is fully phased in, seniors with incomes above $100,000 will likely face a scale between $246 and $395 - meaning the wealthiest seniors will be paying more than four times what they currently pay.

The actual premiums are expected to be announced later this month, and by December Social Security will inform seniors how much they will be expected to pay.

Advocates of means testing say the Part B change is a step in the right direction, but the plan, projected to save about $2 billion per year, does not go far enough.

"Medicare is facing a lot of very, very severe fiscal problems," Robert Moffitt, director of the Center for Health Policy Studies at the Heritage Foundation, told UPI.

Healthcare costs keep rising, life expectancy has continued to increase, and there are now more retirees to each person in the workforce, he said.

Paying for the estimated $30 trillion in benefits that Medicare has already promised to retirees and future retirees without making changes to the benefit structure of the program would require an increase in payroll taxes from 2.9 percent to 13.4 percent, Moffitt said, citing a recent Heritage Foundation study.

Combating the impending fiscal crisis will take much more than just the limited means testing in the current Medicare law, he said. Instead it should be the beginning of expanding income requirements to the rest of Medicare, and then , ultimately, other programs like Social Security.

"As a society we have to make a decision about whether we want to pay a retiree with a six-figure income living in Boca Raton, Fla., the same amount that we pay a retired librarian," he said.

The result of the introduction of means testing is a likely spread to other programs, Benton of the seniors citizens' league agreed, but that makes it that much more important to look very carefully at its possible effects.

"Medicare wasn't intended to be a welfare system in which the rich give to the poor," she said. "That's not what we want to see happen in Medicare."

If that does become what the program is about, she said, wealthy seniors will likely be tempted away from the program by private insurance companies, leaving the program stuck with the poorest and sickest seniors and seriously undermining its integrity.

"It's supposed to be about equal benefits for equal pay," Benton said.

Benton and other advocates also question the motives of a bill that was, like the rest of the Medicare Modernization Act of 2003, negotiated largely behind closed doors and "won't actually save that much money anyway."

But the fact that healthier, wealthier seniors might leave the Medicare program is not necessarily bad, Mark Pauly, a health economist at the Wharton School at the University of Pennsylvania, told UPI.

Even at the top of the sliding scale, seniors will still be receiving an approximately 20 percent subsidy from the federal government -- so their departure could still save money, he said.

And there are also ways to prevent that from happening in the first place, like watching carefully to make sure that premiums do not go too high or possibly means testing for benefits instead of premiums.

In addition, though there are problems with means testing, it is "the best of a bad lot" of possible solutions, which include raising taxes or leaving the program as it is and taking increasing amounts out of general federal revenues.

In order to truly be effective, however, this needs to just be the beginning of means testing, Pauly said. "there are few filthy rich people on Medicare. Eventually there will need to be more (means testing). The current law is just a drop in the bucket, but it can be a sentinel for what needs to be done in the future. The bottom line is the bottom line."

But there may be better ways to shore up Medicare's finances, said Robert Hayes, president of the Medicare Rights Center, a New York-based group that helps poor seniors navigate the program.

"There are far more obvious and revenue-rich ways of doing it," Hayes said, like modest tax increases, a cutting out overpayments to HMOs, which have been estimated at 11 percent.

"The current strategy is cynical and potentially sinister to the future of Medicare," he said. "What has made Medicare a national treasure is that rich, poor, healthy and sick were in the program together."

The fact that everyone is in the same boat in Medicare in part explains why the program has functioned better than Medicaid, which is open only to low-income and disabled individuals, he said.

"Poor folks benefit so much from Medicaid because it is not just a program for the poor."

Community
Email This Article
Comment On This Article

Related Links
Hospital and Medical News at InternDaily.com
Hospital and Medical News at InternDaily.com

Memory Foam Mattress Review

SPACE MEDIA NETWORK PROMOTIONS Solar Energy Solutions Tempur-Pedic Mattress Comparison ... Newsletters :: SpaceDaily :: SpaceWar :: TerraDaily :: Energy Daily XML Feeds :: Space News :: Earth News :: War News :: Solar Energy News