Holden needs to get facts straight

By Marc Stier -- Patriot-News Op-Ed

December 31, 2009, 1:26AM

It’s sad but not unusual to find big insurance companies misleading people in their fight against health care reform.

But it’s distressing to see a member of Congress, Tim Holden (D-Schuylkill), repeating these same misleading claims to justify his vote against legislation that would benefit so many people in his district.

Congressman Holden said he voted against the health care reform bill because it included cuts to Medicare and Medicaid benefits. This is what the big insurance want people to believe. It is what their misleading TV ads directed toward seniors say. It is simply not true.

On Medicaid, there is nothing subtle about this. HR 3962 expands Medicaid benefits to people with incomes up to 150 percent of the federal poverty line. It initially covers 100 percent of the cost with the states picking up some of the cost later. It also provides fiscal relief to states for Medicaid for one more year.

The legislation does require savings to be made in the Medicare program. But those savings do not require cuts in benefits. Indeed, the legislation improves Medicare benefits. It eliminates all co-pays for preventive care. And it begins to close the Medicare Part D doughnut hole that burdens seniors with substantial costs for pharmaceuticals. More than 12,300 seniors in the 17th Congressional District will benefit from this provision. So where do the savings come from?

Partly they come from eliminating Medicare Advantage programs that substitute private insurance for traditional Medicare. These programs cost the federal government 15 percent more while not providing better health care coverage. They are, however, a major source of profits for the health insurance companies. Additional reductions in Medicare spending come from providing better care. How does providing better care reduce costs? Here are examples:

If seniors get better preventive and chronic care they will be healthier as small problems are controlled before they become large expensive problems. A diabetic whose illness is managed well will be healthier and cost Medicare less than an out-of-control diabetic who eventually needs dialysis or a kidney transplant.

If we eliminate most hospital-acquired infections — as has been done in some hospitals in the state — seniors will be healthier and suffer and die prematurely far less often and enormous amounts of money can be saved.

If we reduce hospital readmissions by giving seniors better after care when they leave the hospital, they will be healthier and Medicare spending can be dramatically reduced. It is these kinds of cost savings in Medicare — not cuts in benefits — that are central to HR 3962. That is why AARP favors HR 3692. It knows that we can save money in Medicare while also improving care for seniors.

Those savings in Medicare will help pay for the enormous benefits HR 3962 brings people in the 17th Congressional District. Under the bill, more than 25,000 uninsured individuals will get access to quality, affordable health insurance. Another 168,000 households will receive tax credits that make their health insurance affordable. More than 15,000 small businesses that are now priced out of the market will be able to obtain health insurance they can afford and tax credits will reduce the costs of insurance further for 13,000 businesses. And up to 900 families a year will avoid bankruptcy due to health care costs.

Our campaign for health care reform has been saying that members of Congress have to make a choice, between benefiting the people of this country and benefiting the insurance companies.

Holden made his choice. And to justify it, he has been repeating the false statements of insurance companies about Medicare and Medicaid. A conference committee bill is likely to come back to the House, probably in January. Let’s hope that this time Holden sides with the people of the 17th District and not the insurance companies.

Marc Stier is state director for Health Care for America Now

http://healthcareforamericanow.org/

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