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Health Care - The Bush Record

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http://www.fightforthefuture.org/bushrecord/bush_healthcare.cfm

 

Health Care - The Bush Record

 

America urgently needs a national plan to fix health

care, and a president who will lead the way.

 

Under President Bush, the number of Americans without

health insurance has risen by more than 4 million.1

According to the Labor Department, benefits costs are

far outstripping wage gains for American workers.

Benefit costs were up 1.2% in the fourth quarter of

2003, while wages were up less than half that.2 And

the Consumers Union warns that the president's

Medicare drug plan may accelerate already skyrocketing

drug prices.3

 

Too often, President Bush's health care initiatives

seem designed to protect the profits of drug companies

and HMOs -- not to cure the root causes of our health

care crisis.

 

Insurance and the Uninsured

 

Today, more than 43 million Americans have no health

insurance -- 4 million more than when President Bush

took office.4 And because of the nation's patchwork

health insurance system -- in which many people

temporarily lose coverage when they leave jobs -- far

more than 43 million Americans are without insurance

for some part of each year. A March 2003 Families USA

study found that 72 million Americans had no health

insurance for all or part of 2001 and 2002. That's 30%

of all Americans under 65.5

 

Bush plans would not provide affordable health care

for working families. President Bush's proposed $1,000

individual tax credit for the purchase of health

insurance is not a realistic subsidy to help most

uninsured people obtain health insurance. A recent

Families USA investigation found that, in 48 states,

there were no standard $1,000 policies available for a

healthy, non-smoking 55-year-old woman. Even healthy,

non-smoking, 25-year-old women could not buy a $1,000

policy in 19 states. Those plans that were available

for less than $1,000 had high deductibles and very

limited benefits. Services like prescription drugs,

emergency services, inpatient hospital visits, and

mental health were either severely restricted or not

provided at all.6 See statistics on the uninsured in

your state.

 

The biggest losers in the health-care lottery are

middle-income folks and the working poor, who are

least able to afford to pay for medical services. In

fact, if you are uninsured and are admitted to a

hospital in an emergency, you will be charged at a

higher rate than seniors covered by Medicare or

working people with health insurance through their

employers. And if you fail to come up with the money,

you may lose your house or have your wages attached.7

 

 

 

State and Local Health Care Funding

 

The Bush tax cuts are draining resources for state

health care programs. The Bush tax cuts are causing

severe budget crises in the states. That's because

state tax codes are tied to the federal tax code -- so

when cuts are made to the federal code it triggers

reductions at the state level too. The drain of

resources has forced 49 states to cut funding for

Medicaid, the joint federal-state program that funds

care for low-income Americans and provides vital

support to hospitals, clinics and nursing homes.8

Federal tax cuts are among several policies estimated

to cost states and localities about $185 billion over

the four-year course of the fiscal crisis (state

fiscal years 2002-2005).9

 

Thirty-four states, in every region of the country,

have adopted cuts that are causing low-income families

and individuals to lose health insurance. States have

adopted policies that will lower enrollment in

Medicaid, SCHIP and state-funded health programs (like

MinnesotaCare or Washington's Basic Health program) by

approximately1.2 million to 1.6 million people. The

cutbacks that states adopted affect diverse types of

low-income beneficiaries: children, parents, seniors,

the disabled, pregnant women, childless adults and

immigrants.10

 

President Bush's 2004 budget would cut Medicaid by

converting it into a " block grant " program. Under the

current Medicaid system, as a state's health care

needs increase, federal funding rises in tandem. But

block-grants give states a fixed amount of money, so

even if a state's Medicaid costs rise, its federal

funding won't rise to meet those costs. An analysis of

11 social service programs that were converted to

block grants shows that their inflation-adjusted

funding fell by an average of 11 percent between 1982

and 2003.11

 

The Bush administration has opposed relief for

hospitals struggling to care for the uninsured. The

Bush administration has repeatedly proposed

eliminating important federal support for a Medicaid

program that helps hospitals pay for treating the

uninsured. He opposed legislation that would have

prevented $1.2 billion in cuts to hospitals that care

for a disproportionate share of the uninsured.12

 

Prescription Drug Prices

 

President Bush's Medicare drug plan does not rein in

the prices charged by drug companies, and it even

forbids Medicare officials from negotiating for lower

drug prices for seniors. An analysis by the Consumer's

Union found that even with the new Medicare drug plan

most Medicare beneficiaries will pay more

out-of-pocket for prescription drugs in 2007 than they

do today.13

 

The pharmaceutical industry will reap a $139 billion

windfall profit since the legislation does nothing to

control drug prices-and even forbids Medicare from

negotiating with drug companies for lower prices for

seniors.14

 

Even with the new benefit in place, the middle 20% of

seniors with average annual income of $18,000 will be

paying almost 60% more for prescription drugs when the

bill takes effect in 2006 then they did in 2000. By

2013 middle-income seniors will be paying more than

two and a half times as much for prescription drugs

(adjusting for inflation) as they did in 2000.15

 

And low-income Medicare beneficiaries who qualify for

Medicaid and now receive prescription drugs either

free of cost or at a nominal fee, will have to begin

paying for these drugs. Perhaps worse off are those on

Medicare and Medicaid and have incomes modestly above

the poverty line: they will see their co-payments rise

at the same rate the drug costs rise per Medicare

beneficiary, projected at a minimum increase of 10%

per year. Social Security checks, meanwhile, rise with

the general inflation rate, of about 2-3% per year.16

 

The Bush drug plan pressures seniors to enroll in

risky health plans with private insurance companies

and HMOs. To get drug benefits under the Bush plan,

seniors are pressured to get Medicare coverage through

private insurance companies and HMOs.17 The

legislation essentially forces many beneficiaries who

otherwise want to remain in traditional Medicare so

they can retain their choice of doctors, to switch to

managed care plans in order to secure the broader drug

coverage and other expanded benefits that the private

plans can offer.18 American seniors have already been

burned once by a similar plan called Medicare + Choice

that encouraged seniors to sign up for private plans.

But when the private insurers found they couldn't make

enough profit under Medicare + Choice, they canceled

coverage for 2 million seniors.19

 

The Future of Medicare

 

Medicare is being inadequately funded by the Bush

administration. To justify his tax cuts, President

Bush's budgets have projected an extraordinarily low

rate of growth in the costs of Medicare, the federal

program that funds care for America's seniors. " There

is a direct link between the administration's

affluent-friendly tax cuts and the growing crisis of

Medicare underfunding, " Princeton economist Paul

Krugman wrote in the New York Times. Bush's massive

tax cuts for corporations and the rich have created

" intense pressure to keep actual Medicare payments

low, despite rapidly rising costs in the private

sector. " 20

 

The Bush administration would turn Medicare over to

private insurance companies and HMOs. President Bush's

Medicare drug plan forces seniors into private plans,

turning over increasing control of Medicare to

insurance companies and HMOs, and laying the

foundation for privatizing the entire Medicare

system.21 Starting in 2010, about 2 million seniors in

six metropolitan areas will be able to choose between

traditional Medicare and private plans during a

six-year experiment. The test areas have not been

chosen, but affected seniors might have to pay up to

5% more a year if they opt to stay in Medicare instead

of switching to cheaper private insurers.22

Privatizing Medicare would not lower costs, since

private insurer's administrative costs are far higher

than the government's.23

 

Bush plans to privatize Medicare threaten to disrupt

coverage for seniors. American seniors have already

been burned once by an experiment with Medicare

privatization called Medicare + Choice. Much like

Bush's current drug plan, Medicare + Choice used the

promise of expanded benefits to encourage seniors to

sign up with private HMOs and insurance companies. But

when the private insurers found they couldn't make

enough profit under Medicare + Choice, they canceled

coverage for 2 million seniors.24

 

Sources

 

1 Kaiser Family Foundation, " Rising Unemployment and

the Uninsured, " January 2002; SEIU Research Department

Calculations.

 

2 CNN, “Lou Dobbs Tonight,” 1/29/04

http://www.cnn.com/TRANSCRIPTS/0401/29/ldt.00.html

 

3 Consumers Union, " Statement by Gail Shearer, of Health Policy Analysis, " 6/27/03.

 

4 Kaiser Family Foundation, " Rising Unemployment and

the Uninsured, " January 2002; SEIU Research Department

Calculations.

 

5 Families USA, " Going Without Health Insurance, "

March 2003.

 

6 Testimony by Ronald F. Pollack, Executive Director,

Families USA, at the Hearing on Covering the

Uninsured, before the Democratic Policy Committee,

United States Senate, January 6, 2004.

 

7 Time online edition, " Has your life become too much

a game of chance? " 1/25/04.

http://www.time.com/time/covers/1101040202/bintro.html

 

8 Center on Budget and Policy Priorities, " Why Are

States' Medicaid Expenditures Rising? " 1/13/03.

 

9 Center on Budget and Policy Priorities, " A Brief

Overview of State Fiscal Conditions and the Effects of

Federal Policies on State Budgets, " 12/30/03.

 

10 Center on Budget and Policy Priorities, " Losing

Out: States are Cutting 1.2 to 1.6 Million Low-Income

People from Medicaid, SCHIP and Other State Health

Insurance Programs, " 12/22/03.

 

11 Georgetown University Institute for Health Care

Research & Policy and the Center on Budget and Policy

Priorities, " Less Money, Greater Risks for States

Under Medicaid Block-Grant Proposal, " 6/3/03.

 

12 BNA Health Care Policy Report, " Bush Administration

Opposes Senate Bill's DSH, Child Health Provisions, "

6/23/03.

 

13 Consumers Union, " Statement by Gail Shearer, of Health Policy Analysis, " 6/27/03.

 

14 Report by Health Reform Program at Boston

University's School of Public Health

 

15 Center for Economic Policy Research, " Still A Pain:

the Cost of Prescription Drugs to Seniors With the

Medicare Drug Benefit. "

http://www.cepr.net/medicare_drug_benefit.htm

 

16 Center on Budget and Policy Priorities, " The

Troubling Medicare Legislation, " 12/8/03.

http://www.cbpp.org/11-18-03health2.htm

 

17 New York Times, " Medicare Aide Voices Doubts on

Adding Drug Benefits, " 6/7/03.

 

18 Center on Budget and Policy Priorities, " The

Troubling Medicare Legislation, " 12/8/03

http://www.cbpp.org/11-18-03health2.htm

 

19 Families USA, " Private Plans: A Bad Choice for

Medicare, June 2003.

 

20 New York Times, " Wealth Versus Health, " 4/19/02.

 

21 New York Times, " Medicare Aide Voices Doubts on

Adding Drug Benefits, " 6/7/03.

 

22 USA Today, " Benefits start in '06, but help

available sooner, " 11/25/03

 

23 Families USA, " Private Plans: A Bad Choice for

Medicare, " June 2003.

 

24 Ibid.

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