Sunday, March 05, 2017 By Eleanor J. Bader, Truthout | Report
Several years ago, 62-year-old Michael Kaufman, a disabled resident of Bovina, New York, accidently drilled through one of his fingers. He quickly went to the closest Emergency Room where the wound was treated and bandaged. He thought this was all that he needed to do; unfortunately, the next morning, he noticed red streaks traveling up his arm — a sign of possible blood poisoning — so he returned to the local ER where medical staff immediately inserted an IV of antibiotics and suggested that he go to a bigger hospital 50 miles away to see a hand specialist, which he did.
Shortly thereafter, the bills started to arrive, and Kaufman found himself saddled with $600 in charges: a $200 co-pay for each of the three ER visits. Lest you think Kaufman was uninsured, he was not. He was — and still is — on Medicare, a federally supported health insurance plan provided to the 56 million Americans who receive Social Security Disability or Retirement benefits. Kaufman relies on this insurance to pay for the majority of his medical needs.
“I worked for 40 years and had at least a few years of middle-income earnings,” Kaufman told Truthout. “I cared about my work and was hoping to do more of it, but life sets limits. Things happen. I had to leave work much earlier than I planned, but at least there was a backstop. I’ve been on Disability since 2012 and right now I probably spend an hour or two a week dealing with charges, bills. There’s a lot of turnover in medical offices, and records disappear. It’s gotten harder and harder to deal with the stress of it. So much depends on having a good memory and keeping good records, but memory diminishes with age.”
Despite his obvious frustration with the current health care system, Kaufman makes two things clear: He values Medicare and is adamant about protecting it. He also wants to see it expanded, not cut. “Medicare is a step in the right direction but it is inadequate,” he continues. Part A covers only hospitalization. Part B covers only 80 percent of other costs, including outpatient care. “If you don’t go to the doctor often, this might not come to much, but if you go a lot, the 20 percent adds up really fast,” he says.
What’s more, Kaufman stresses that recipients pay for their Part B coverage — the program operates without a cent of support from federal tax revenues and is instead funded exclusively by employee and employer contributions. The standard Part B premium is presently $134 a month [although the cost is means tested and can run up to $389.80 a month for high earners] while the average enrollment fee for Part D, Medicare’s prescription drug plan, is $35.63. There are also hefty hospital deductibles: $1,288 for the first 60 days, and between $322 and $644 a day for each additional 24 hours.
These are significant sums, Kaufman says. Still, when he hears Republican lawmakers denounce Medicare and propose reducing benefits, he becomes livid and cites a statistic he saw on the website of the National Committee to Preserve Social Security and Medicare. Already, he reports, 45 percent of retirees spend more than one-third of their Social Security benefits on health care, from co-pays for care, to premiums, deductibles and out-of-pocket fees for services — such as going to the eye doctor, dentist or audiologist — that are not provided. “We should be on the offensive, pushing for something better,” he says. “What we need is a single payer or socialized health care system.”
Republican-Initiated Cuts Likely
Needless to say, the Trump administration seems disinclined to consider either of these options and although we do not yet know exactly what the Republican-controlled Congress has in mind, they have indicated that the repeal of the Affordable Care Act (ACA) and changes to Medicare, Medicaid and Social Security are high on their agenda. “It’s a sequencing thing,” says Alex Lawson, executive director of Social Security Works. “They’ll first go after Medicaid, then Medicare, and then Social Security.”