Posts tagged ‘Medicare’

Why Medicare Cards Still Show Social Security Numbers – NYTimes.com


Why Medicare Cards Still Show Social Security Numbers – NYTimes.com.

A Medicare identification card.The New York TimesA Medicare identification card.

Images of a woman waving her Medicare card on television at the Democratic convention last week in Charlotte, N.C., prompted the folks at Credit.com and others to ask: Why do Medicare cards still have Social Security numbers on them anyway, when access to the numbers can post a risk of identity theft?

The answer is that the federal government has been dragging its heels for years on making a change, because, according to various reports from the agency that oversees Medicare, the Centers for Medicare and Medicaid Services, it would be both expensive and complex technologically to re-issue cards with new identification numbers.

According to testimony from a C.M.S. official before Congress in August, “transitioning to a new identifier would be a task of enormous complexity and cost and one that, undertaken without sufficient planning, would present great risks to continued access to health care for Medicare beneficiaries.”

About 48 million Americans carry Medicare cards that use their Social Security number as part of their health-claim number.

In a report issued in 2006, C.M.S. said it would cost $300 million to remove SSNs from Medicare cards. Then, in an updated report last November, it said it would cost at least $803 million, and possibly as much as $845 million, depending on the option chosen. Much of the cost, the agency said, was for upgrading computer systems not only at the federal level, but also at the state level, for coordination with Medicaid systems.

But the Government Accountability Office said in its testimony to Congress in August that the methods and assumptions that C.M.S. used to develop its costs estimates “raise questions about their reliability.”

“Lack of action on this key initiative leaves Medicare beneficiaries exposed to the possibility of identity theft,” the G.A.O. said. It recommended that C.M.S. select an approach to modify or remove the numbers from Medicare cards and develop an “accurate, well-documented cost estimate.”

According to the G.A.O., C.M.S. agreed with its recommendations and will conduct a new estimate with improved methodology. That’s likely to take some time. So don’t expect Medicare cards free of the numbers anytime soon.

Meantime, the AARP and the Privacy Rights Clearinghouse suggest making a photocopy of your Medicare card, cutting it to wallet size and cutting out the last four digits of your Social Security numbers. Carry the photocopy in your wallet instead of the actual card. (You’ll still need your original card the first time you visit a provider, because they’ll likely want a photocopy of it).

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The Real Retirement Crisis » Counterpunch: Tells the Facts, Names the Names


 

“The lifespan of any civilization can be measured by the respect and care that is given to its elderly citizens, and those societies which treat their elderly with contempt have the seeds of their own destruction within them.”

—Arnold J. Toynbee

The astounding, and potentially tragic, aspect of Washington’s three-plus-decade Social Security debate is that it carries on with little regard to the challenges facing the program’s participants. Politicians on the right and center-right feel free to decry resistance to even “modest cuts” in Social Security benefits while ignoring the vulnerability of seniors who are living the effects of reductions already mandated in the program’s last major overhaul, in 1983.

But the situation for seniors – and future retirees – is becoming alarming. A new, supplemental poverty measure introduced by the Census Bureau last November nearly doubled the official estimate of Americans over 65 living in poverty, to 15.9%, mainly due to medical costs not counted in the official numbers. More than 34% were either poor or near-poor—defined as having family income less than twice the poverty line. Half of all retirement-age persons who were no longer working—that is, who were receiving Social Security—had total yearly income of less than $16,140—only a fraction more than the federal minimum wage.

Even small reductions in benefits, or slower growth over a period of years, could tip many of these people into poverty. Countless others, who once believed their personal savings, 401(k)s, employer-sponsored pensions, or the equity in their homes made their retirements secure, are finding out that this isn’t the case either. Meanwhile, the White House, Republicans, and centrist Democrats are reportedly negotiating a Grand Bargain built on the deficit-cutting Bowles-Simpson proposals, which would include deep reductions to Social Security. And state and local governments are scrounging for ways to cut back the rest of the safety net for seniors—targeting Medicaid funds for nursing homes and home health care, housing subsidies, and other benefits.

A true retirement crisis is looming in the U.S., but politicians, obsessed with Social Security projections decades into the future, are disinclined to address it. Financially vulnerable older workers will be affected almost as soon as they retire; workers in their 20s, 30s, and 40s today will be hit much harder.

The Social Security “deficit”—the amount by which annual old-age and Disability Insurance benefits are expected to exceed revenues—was projected in 2011 to total about $6.5 trillion over the next 75 years. But for all the political attention focused on it, the economic impact of that shortfall will be quite moderate, equaling just .7% of GDP. Even the Baby Boom retirement wave wouldn’t make a very big dent in the economy, according to the Social Security trustees, whose 2011 Annual Report estimated that the annual cost of benefits will rise gradually to 6.2% of GDP by 2035, decline to about 6% by 2050, then stabilize at about that level.

By contrast, the U.S. faces a “retirement income deficit” of $6.6 trillion—larger than Social Security’s projected 75-year shortfall and five times the size of the current-year federal deficit. The Retirement Income Deficit is a new measure unveiled in fall 2010 by the Center for Retirement Research at Boston College. It lumps together all the resources that Americans in their peak earning years will have to retire on: Social Security and pension benefits, retirement savings, home equity, and other assets. It calculates the income people will need in retirement, based on tax scenarios as well as the income replacement targets that Americans at different income levels will likely need to meet.

Social Security and Medicare are perhaps the only ingredients in the Retirement Income Deficit calculation that the elderly can still rely upon. Nearly two-thirds depend on Social Security for more than half their income, and roughly one in five for all of it. Without Social Security, nearly half of Americans over 65 would be living in poverty. If anything, dependence on Social Security has increasing since the latest economic slump, thanks to the collapsed housing market, the recession, decades of stagnating wages, and the disintegration of other elements of the social safety net, among other factors.

Not that it’s a lot to lean on. Social Security only replaces 37% of the average worker’s pre-retirement income at 65. More than 95% of recipients get less than $2,000 a month from the program. Women average less than $12,000 a year in benefits, compared to $14,000 for retirees overall, thanks to the gender pay gap—partially explaining why 75% of old people living in poverty in the U.S. are women. While this seems to merit little discussion in deficit-obsessed Washington or on Wall Street, it draws an alarming picture for anyone familiar with what’s happening in the rest of the country, where a Gallup poll found 90% of people aged 44 to 75 agreeing that the country faces a retirement crisis.

Even before the economic slump, however, there were reasons to worry about the erosion of Social Security.

The Real Retirement Crisis » Counterpunch: Tells the Facts, Names the Names

How to Fix Health Care Without the Mandate: Put Single-Payer On the Table by Sarah van Gelder


What happens if the Supreme Court strikes down the “individual mandate” in the health care reform law?

Commentators ranging from former Labor Secretary Robert Reich to Forbes Magazine columnist Rick Ungar agree: Such a decision could open the door to single-payer health care—perhaps even make it inevitable.

We don’t need to assume that our health care policy must be designed to maintain the health-industrial complex.

This may be the best news about health care in years. Because ever since Republicans convinced the Obama administration to drop the “public option” in the Affordable Care Act, health reform has been in trouble. True, most Americans favor many of the provisions of Affordable Care Act. But the overall plan rests on forcing you and me to buy insurance from the same companies that have been driving up the costs of health care all along—the same companies that have been finding creative ways to avoid covering needed care, shifting costs on to patients, and endlessly increasing premiums and out-of-pocket expenses for all of us.

Forcing all Americans into a failed system is bad policy, and it’s not just President Obama’s opponents who say so.

What the Doctors Ordered

When the Supreme Court agreed to hear a challenge to the Affordable Care Act brought by 26 state attorneys general, one of the supporting briefs came from an unexpected source—a group of 50 doctors who believe that single-payer health care is the way to cover everyone and contain costs. As a model for a revamped health care system, they point to Medicare, which covers millions of seniors while devoting just 2 percent of expenditures to overhead (compared to as much as 16 percent for private insurers).

In spite of all the fear about government involvement in health care, Medicare is enormously popular; in a recent poll, two-thirds of Americans oppose changing Medicare to something more like private insurance. In the Medicare model, as in Canada’s single-payer system, health care providers are in private practice, but the government acts as insurer, covering everyone. The money for the program comes from payroll taxes.

This model is just one of a variety of ways that industrialized countries provide universal coverage; only the United States does not yet offer universal coverage at all, and the impact of our fragmented, privatized approach ripples throughout the economy and into the lives of families that face bankruptcy and exclusion from needed treatment.

While we in the United States spend far more on health care, per person, than any other nation, we’re way behind other wealthy countries when it comes to our actual health. The residents of 25 other countries—all of which spend less on health care than we do—can expect to live longer, on average, than U.S. residents. In a recent study of 19 industrialized countries, the United States came in last when it came to averting preventable death. Researchers say that amounts to more than a 100,000 avoidable deaths each year.

We devote 15 percent of our economy (by GDP) to paying for health care (or $6,402 per person each year), and still leave millions without coverage. In contrast, the French spend 11 percent of GDP on health care (or $3,374 per person) and cover everyone; the French live two years longer, on average, than Americans, and have better health by all key measures.

Follow the Money

If we’re spending so much for poor results, where is all the extra money going? Private, for-profit health insurance companies spend big on overhead: covering the paperwork and arguments about who will cover what, finding ways to avoid covering people who might require costly services, disputing charges from health care providers. They spend money on marketing and on lobbying Congress, federal regulators, and state lawmakers. They pay dividends to shareholders and they pay executives six- or seven-figure compensation packages. No wonder premiums keep rising.

None of these costs are incurred by Medicare or other national insurance programs.

Asking each of us to choose among competing plans is like playing against the house in a casino—it might seem as though you’re getting choices among slot machines, but really, the odds are stacked against you.

Some argue that patients are better off with competing insurance companies because that gives them a choice. Perhaps this is true of a patient who spends many hours required to read the small print in competing insurance plans, producing spreadsheets to track the multiple variables, guessing what sort of coverage they and their family will need in years to come, and hoping that they made the right choice when an unexpected accident or illness means their life depends on the bet they made. On the other side, insurance companies have battalions of lawyers and adjusters making bets about coverage, co-pays, and deductibles—coming up with ways to cover less.

Asking each of us to choose among competing plans is like playing against the house in a casino—it might seem as though you’re getting choices among slot machines, but really, the odds are stacked against you whatever choice you make.

Where choice really matters to most people is in choosing health care providers. In France, where public financing of health care is the rule, patients actually have more choices among doctors than do Americans, who must choose among health care providers preferred by their insurance company.

So the doctors who are calling on the Supreme Court to strike down the individual mandate are on to something. Instead of locking us in even more tightly to an inefficient private insurance system, which has built-in incentives to take more of our money and do less for us, they argue we should switch gears. We’re spending $200 billion more per year than we would need to under a single-payer system, they say. We pay more out-of-pocket than other countries, and the Obama Affordable Care Act wouldn’t fix that.

What do Americans Want?

In poll after poll, a majority of Americans have expressed support for single-payer health care or national health insurance. This is true in spite of the near media blackout on this topic, and the failure of most national politicians to even consider single-payer as an option (the Obama administration and Democratic leadership in Congress excluded single-payer advocates from the key summits and hearings leading up to the passage of the health care bill).

In Massachusetts, which has had time to try out policies very similar to those in the Affordable Care Act, over 5 percent of the population remains uninsured. And, according to the doctors’ brief, local initiatives calling for single-payer health care passed by wide majorities in all the Massachusetts districts where they were on the ballot.

Vermont has adopted a single-payer health care plan, and the California Assembly twice passed single-payer, only to have it vetoed by the governor.

Single-payer health care, in short, is far more popular than the political establishment likes to admit—while requiring individuals to purchase health coverage from private insurance companies is wildly unpopular across the political spectrum. According to a recent poll, only a third of Americans favor the individual mandate, but 70 percent favor expanding the existing Medicaid program to cover more low-income, uninsured adults.

Here’s something to ask yourself: If you’re on Medicare now, would you give it up to move to a private insurance plan? If you’re not now covered and you could sign up for Medicare today, would you?

Medicare for All

That contrast offers a good starting point. We don’t need to assume that our health care policy must be designed to maintain the health-industrial complex and their lobbyists in the manner to which they have become accustomed. Instead, we can expand Medicare to cover more and more age groups, until everyone is covered. We could all then have access to a program that keeps overhead low, is wildly popular among its clients, and is similar to programs in Europe, Canada, Japan, and elsewhere that have excellent records of cost containment, universal coverage, and great health outcomes.

So what happens if the Supreme Court overturns the individual mandate or—as now seems possible—rejects the entire package? Such a move could turn out to be a great boon to those who doubt the wisdom of relying on private, profit-focused insurance companies to cover us when we get sick. It could offer us the opportunity to get the sort of proven universal coverage we can count on.


Sarah van Gelder wrote this article for YES! Magazine, a national, nonproifit media organization that fuses powerful ideas with practical actions. Sarah is co-founder and executive editor of YES!.

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Reader Comments

Universal Health Care

Posted by Dilys Collier at Apr 06, 2012 08:14 PM
We Canadians love it even if it isn’t perfect. USA Republicans seem to consider Canadians “socialists.” We aren’t; our country is still run on a capitalist economic system (unfortunately). Socialism is an entirely different economic system. That’s not us. Our geographical circumstances determine our culture. During our extreme Canadian temperatures, we literally can live or die depending on whether we co-operate with one another. We don’t believe in leaving an injured Samaritan on the side of the road and passing by on the other side. Instead, we believe in offering assistance to everyone (regardless of colour, gender, or religion) by ensuring basic available health care to all.

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How to Fix Health Care Without the Mandate: Put Single-Payer On the Table by Sarah van Gelder.

Only In America Could This Happen The RICH Will Let A Poor Person Die From Hunger


Extreme Poverty Has Double In The USA Since 1990


By Pat Garofalo  on Mar 6, 2012 at 2:05 pm

According to the latest Census Bureau data, nearly 50 percent of Americans are either low-income or living in poverty in the wake of the Great Recession. And a new study from the National Poverty Center shows just how deep in poverty some of those people are, finding that the number of households living on less than $2 per day (before government benefits) has more than doubled in the last 15 years:

The number of U.S. households living on less than $2 per person per day — which the study terms “extreme poverty” — more than doubled between 1996 and 2011, from 636,000 to 1.46 million, the study finds. The number of children in extremely poor households also doubled, from 1.4 million to 2.8 million.

 

While extreme poverty doubled overall, it tripled amongst female headed households. Of course, there’s always the tact taken North Carolina Republican State Representative George Cleveland last week, who simply denied that anyone in his state lives in extreme poverty. As we noted at the time, “the 728,842 North Carolinians who are classified as living in deep poverty might take issue with that assessment.”

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Don’t Tell Me That Social Security Is Going Broke


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The Insanity Of Texas Gov. Rich Perry That Social Security And Medicare Violate The 10th Amendment Of US Constitution


“Governor of Texas Rick Perry writing new legislation to amend the 10th Amendment of the Constitution to end Social Security, and Medicare as we know it for none other than Newt Gingrich; Rick Perry beliefs that it violates the US CONSTITUTION. That how deranged these REPUBLICANS are. This is an insurance policy to protect workers from a serious illness, a serious accident, that can disable you for the rest of your life, or retirement due to old age. Without this protection you would live in poverty, in misery, and very ill until your death unless you were very rich.” Life without Social Security was extremely difficult for the disabled and seniors to survive and especially for those who were seriously ill that, that they often committed suicide.