Dear Colleagues:
I have just returned from a reporting trip to Southeast Arkansas, where the folks I visited have very little. They certainly don’t have good health. Some are crippled by bad knees messed up from on-their-feet jobs. Most have diabetes. Some have had strokes. They are lucky, though, that they have Medicare. Without it, they probably would have died ages ago.
Last week, speaking to business leaders in Detroit, GOP presidential candidate Mitt Romney mentioned that Medicare-eligible Americans ought to wait longer for their benefits. The media glossed over Romney’s remarks; but I kept thinking about them as I was chatting with a woman who had one leg, amputated because of complications from diabetes. And they stayed in my mind as I talked to another woman—a 67-year-old who had a stroke last year, and had had to quit working as a presser for a local dry cleaner ten years ago, when she was 57. She had a seizure, and a hot press fell on her hand. A long scar shows how her work life ended. She qualified for a Social Security disability check—all of $795 a month that’s been her only income ever since. How on earth could someone like her pay for medical care if she had had to wait a few more years?
Romney’s views on entitlement spending have been clear for quite some time. A few weeks ago, at the Conservative Political Action Conference, he said: “We’re going to have to recognize that Social Security and Medicare are unsustainable, not for the current group of retirees, but for coming generations. And we can’t afford to avoid these entitlement challenges any longer.” We’re going to have to raise the retirement age for Social Security, he said, and let seniors “have the freedom to choose between Medicare and a range of private plans.”
Hmmm, I thought. Seniors already can choose between Medicare and private plans. I asked my Arkansas host how these private plans were being sold in her county. She told me insurance agents selling private plans had teamed up with local pharmacists, who told seniors that if they didn’t sign up for a particular agent’s policy, the pharmacists whom they trusted said they wouldn’t be their pharmacists any more. Well, you don’t have to be a brain surgeon to know what most of the seniors did. Some of you reporters out there may want to look into those kinds of shenanigans, and ask Romney about them next time you hear him on the stump.
If reporters did ask tough questions, it wasn’t reflected in their reports. The Detroit Free Press, where I learned how to be a reporter, listed a bunch of bullet points telling readers what Mitt would do if he got the job. One noted that he would raise the retirement age for Social Security benefits for younger people and index the growth in benefits for wealthy retirees to inflation instead of wages. The Freep didn’t tell us what that meant. It would not have been that hard to call some Social Security expert at the U of M to find out if Romney was talking about the “progressive” price indexing that George W. Bush proposed. Progressive price indexing would cut benefits and dramatically change the program.
Most local papers seemed to rely on AP dispatches, which varied in length and quality. One story gave a few more details about Mitt’s Social Security and Medicare plans, saying they would be indexed to longevity, so that the benefits could only increase as fast as life expectancy. In plain English, that means smaller benefits. All this stuff about indexing is hard to grasp, I know, but with these terms floating around, it’s easy to conceal what really could happen. I hope you sort this out before reporting on Mitt’s entitlements program the next time he brings it up.
"law did cut payments to hospitals and to sellers of Medicare Advantage plans, but it did not cut basic benefits for seniors"
Oh I get it - the law cuts back $500 billion to the providers of services to seniors, but the seniors still get the same services? Cool!
That's such a great idea I wonder why we don't apply it to everything?
#1 Posted by JLD, CJR on Mon 27 Feb 2012 at 06:59 PM
JLD, the cut is of a subsidy to Medicare Advantage plans, which as a result of that subsidy cost the taxpayer more than Medicare. If the plans cannot offer services comparable to Medicare, seniors can still choose Medicare - hence no loss in services despite the cut.
#2 Posted by Aaron, CJR on Mon 27 Feb 2012 at 10:02 PM
I agree with Trudy that reporters absolutely should be out there talking to ordinary people about what it would mean to them to have to wait longer for Medicare. Most ordinary working Americans are hanging by their fingernails waiting to qualify for Medicare and end the horrendous insecurity of the American health insurance system for people under age 65. What Trudy didn't mention is that Romney and the other GOP candidates also want to repeal the Affordable Care Act and its requirement that private insurers must accept everyone without regard to preexisting medical conditions, offer everyone comprehensive coverage with no exclusions, and price everyone more or less the same. If the Republicans repeal that requirement and raise the Medicare eligibility age, then people who are 65 and 66 (and 67 and 68 and 69, depending on where they end up setting the eligibility age) will have no way of obtaining comprehensive, affordable coverage -- or any coverage. You will have uninsured and sick old people, just like you had before Medicare was created.
#3 Posted by Harris Meyer, CJR on Tue 28 Feb 2012 at 01:23 AM
Another day, another "Trudy's people" story. Such sad (if utterly predictable and completely one-sided) tales of abject woe!
Trudy, where on Earth did you go where "most" of the people are diabetic? An endocrinologist's office?
Your lady who is currently sucking up Gubmint disability payments already has received, and will continue to receive, medical care on somebody else's dime. Someone in her position that doesn't qualify for Medicare could choose to give up the Gubmint disability check and qualify for Medicaid, but guess how many do this?
Can we get a little perspective here? Why is that too much to ask from a "professional journalist"? HUH?
Why don't you cruise on over the unemployment office and interview the thirty-somethings out of a job that are footing the bill for Medicare? Or hop on over to the Chamber of Commerce and interview some of the people who shelling out money for Gubmint boondoggles, instead of limiting your "journalistic" talent exclusively to promote the viewpoints of the people who are sucking up Gubmint money or the lobbyists and advocates who garner livings by exploiting Gubmint programs?
It would mean spending $10.1 billion in the private sector to save $7.6 billion for the government. How’s that for bending the nation’s cost curve?
It's absolutely GREAT! I'll take $10 billion in revenue-generating, economy-boosting private spending vs. $7.6 billion revenue-sucking, deficit widening, debt-increasing payment made on a Gubmint credit card any day of the week! So would any other reasonable person.
#4 Posted by padikiller, CJR on Tue 28 Feb 2012 at 01:12 PM
TrudyLieberman's commentary on healthcare journalism is growing tiresome and repetitive. Now that she has qualified for Medicare, maybe it's time for her to hang up her linotype machine. "When I was a young girl in Detroit, we really knew how to write about this stuff." This is self-parody. She doesn't seem to be able to evaluate the current journalism without putting down the reporter and puffing up her own life's work. And she's tendentious. As padikiller points out, it's always the same hard-left perspective on the news. Couldn't CJR find somebody qualified to write about healthcare who doesn't bring so many preconceptions to the task?
#5 Posted by The Village Voice, CJR on Tue 28 Feb 2012 at 04:52 PM
When I read Trudy's report I thought of the old Bill Moyers interview with Wendell Potter:
http://www.pbs.org/moyers/journal/07102009/transcript2.html
"WENDELL POTTER: I was. I went home, to visit relatives. And I picked up the local newspaper and I saw that a health care expedition was being held a few miles up the road, in Wise, Virginia. And I was intrigued.
BILL MOYERS: So you drove there?
WENDELL POTTER: I did. I borrowed my dad's car and drove up 50 miles up the road to Wise, Virginia. It was being held at a Wise County Fairground. I took my camera. I took some pictures. It was a very cloudy, misty day, it was raining that day, and I walked through the fairground gates. And I didn't know what to expect. I just assumed that it would be, you know, like a health-- booths set up and people just getting their blood pressure checked and things like that.
But what I saw were doctors who were set up to provide care in animal stalls. Or they'd erected tents, to care for people. I mean, there was no privacy. In some cases-- and I've got some pictures of people being treated on gurneys, on rain-soaked pavement.
And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia and Kentucky, Tennessee-- all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth.
There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me.
BILL MOYERS: What did you think?
WENDELL POTTER: It was absolutely stunning. It was like being hit by lightning. It was almost-- what country am I in? I just it just didn't seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me.
BILL MOYERS: People are going to say, "How can Wendell Potter sit here and say he was just finding out that there were a lot of Americans who didn't have adequate insurance and needed health care? He'd been in the industry for over 15 years."
WENDELL POTTER: And that was my problem. I had been in the industry and I'd risen up in the ranks. And I had a great job. And I had a terrific office in a high-rise building in Philadelphia. I was insulated. I didn't really see what was going on. I saw the data. I knew that 47 million people were uninsured, but I didn't put faces with that number."
If there is one service Trudy's reporting does well, it is putting the faces with the numbers we throw about.
And that reporting is nearly completely missing from all these Politico-style reporters who think the most important thing the government can do these days is cut a deficit and hurt the most vulnerable in the process.
That, too me, is a sick mentality.
#6 Posted by Thimbles, CJR on Tue 28 Feb 2012 at 06:22 PM
Deficits and welfare programs are what's hurting the most vulnerable in our society.
Indeed, liberal boondoggles fund every crack house in the country and have created a culture of ignorance, sloth and dependence in low-income Americans.
Those who can't (or won't) take care of themselves should be cared for and supervised in government institutions, where their behavior, diets and activities are restricted and monitored to ensure their health.
All others should take care of themselves.
Liberty and Gubmint dependence are mutually exclusive notions.
You want freedom? Then provide for yourself or get a patron to do it for you with private money.
You want to depend on the Gubmint? Then check into a Gubmint institution, stop smoking, drinking or using illegal drugs, maintain a health BMI and let the Gubmint watch over your activities to make sure you stay safe and healthy unless and until you are able to (or decide to) take care of yourself.
#7 Posted by padikiller, CJR on Wed 29 Feb 2012 at 11:20 AM
Thimbles states the case in Trudy's defense eloquently. Thank you for that. While I don't agree with everything Trudy writes, and I've posted my disagreements, she provides an invaluable service in pushing reporters and editors to focus on the consumer impact rather than the 30,000 foot view of lobbyists and policy shop people (who as one source told me probably have never walked through and smelled a Medicaid nursing home). She may sometimes sound liike a broken record but unfortunately media folks covering health care (and other areas too) keep making the same mistakes in their coverage and need constant reminders to pay attention to the needs and issues of ordinary Americans. While she may sometimes be a little dogmatic, as she can be in her criticism of the Affordable Care Act, Trudy knows more about health care than just about any journalist out there and her ability to provide context is badly needed.
#8 Posted by Harris Meyer, CJR on Wed 29 Feb 2012 at 01:20 PM
Great article by Ms Lieberman. As a physiciann what surprises me is the ridiculous depths to which some people will sink to expound on the glories of Friedmanesque-Reaganomical-comical theories for effective health care delivery.
Mr. Rugged individual -who -doesnt -do -Carck (the libertarian commentator in this discussion) check your facts on crack use, the peak age is 18-25 and drops off after 40 sharply in all US regions (i.e., otherwise relatively healthy people). In my experience when ever I have seen a patient (and its now becoming almost a daily affair) who cant afford ER visits, hospitalization, expensive drugs, high tech tests or devices with this free market for profit health care, they are people over 50 and the closest they will come to any crack is a broken cup or saucer.
So put away your assault weapons, MRE's and autographed Glen Beck picture and do some reading on healthcare systems around the world in countries with higher standards of living than we have here. You may learn something.
Dr. larch
#9 Posted by wilbur larch MD, CJR on Wed 29 Feb 2012 at 11:13 PM
An individual who qualifies for Social Security disability will qualify for Medicare regardless of age. So the 67-year-old woman cited in this article would be Medicare-eligible even if the Medicare eligibility age is increased.
It is amazing how much bad information is written, edited, and published. And this publisher is supposed to be the "watchdog."
#10 Posted by Andy A, CJR on Thu 1 Mar 2012 at 08:44 PM
"An individual who qualifies for Social Security disability will qualify for Medicare regardless of age."
With a two year gap between disability income and medical coverage.
http://www.commonwealthfund.org/Publications/Perspectives-on-Health-Reform-Briefs/2009/May/The-Long-Wait.aspx
http://www.ssa.gov/dibplan/dapproval4.htm
#11 Posted by Thimbles, CJR on Thu 1 Mar 2012 at 10:41 PM