Medicare: AARP discusses the politics and potential future of the program

May 26, 2011

The GOP plan to transform Medicare may have been defeated in the Democratic-run Senate on Wednesday, but the Medicare battle is far from over. AARP Legislative Policy Director David Certner discussed the current state of Medicare, what could happen to it on the future, and the effects it could potential have on you.

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Related: Senate Republicans stand by plan to overhaul Medicare

Hello, this is David Certner from AARP, and I am happy to be with you today and ready to take your questions.

There has been a lot of talk about Medicare going bankrupt. What is the truth about what is happening with the program?

Medicare is not bankrupt, however, there is ongoing concern about the rising cost of health care for everyone -- federal and state govt's, employers and individuals -- and the ability of Medicare to be able to be affordable in the future given these ever-rising costs.  We need to tackle the issue of rising health care costs throughout the health care system.

Please be specific, what does AARP suggest we do to help save Medicare? We can't do nothing, as the system is literally bankrupting out country. Some sort of means testing? More co-pays? What?

We cannot focus on Medicare alone.  Medicare is part of the health care system.  To help Medicare, we need to tackle rising health care costs system-wide.  There is no single or simple answer.  we need to improve the heatlh care delivery system -- that means better prevention, better coordination of care, better management of chronic conditions, better use of technology, and better use of evidence based medicine, among other strategies.

I'm 50ish, but very active and in excellent health. Last year I lost my job; but finding another, and gaining access to affordable healthcare is impossible. So I just keep my fingers crossed.

I've read that the new health program will be administered by the IRS? Is it possible that the IRS will create a new form that actually sends money to people who are out of work... to cover the health insurance mandated payments? If such a system is designed, will Medicare and Medicaid be discontinued?

The new health program will be administered mainly by state-based "Exchanges", not the IRS.  The Exchanges will allow individuals to compare policies that are available in the market with greater transparency.  and there will be more rules in place to prevent the denial of insurance based on pre-existing conditions or to charge people who are older much higher prices based on their age.  Subsidies will also be available for those of moderate incomes.

I don't think our politicians will ever agree on a healthcare plan.  However, if it does happen, what will have to be done to achieve that?  I can barely afford healthcare as it is.  I wish they'd just get along!

The health care changes made last year should help to increase access to health care.  We still need do more to hold down the increases in health and prescription drug costs.  We continue to work with Members of Congress on both sides of the aisle to tackle the issue of high health care costs.  We agree we need both sides to work together to address this critical problem.

What is AARP doing to help get healthcare under control?

We continue to push for changes that will hold down costs throughout the health care system.  For example, we continue to work with Congress and the Adminstrative agencies to help improve care coordination for those with chronic conditions.  We also continue to push for measures to lower Rx costs, such as by giving Medicare greater power to negotiate drug prices, to allow for the importation of safe lower cost drugs from abroad, and to speed generic drugs to market. 

There is a perception, especially in Pennsylvania, where the Public Welfare Department budget is being cut because of fraud and waste. Yet, most of the Public Welfare Budget is for health care, residential care, and nursing home care costs to patients needing health care, with most going through Medicaid and Medicare. How much fraud and waste really exists in these health care systems?

I can't speak directly about Pennsylvania, but of course there is fraud and waste in the system -- but there is also a great deal of inefficiency, meaning we do too many tests and procedures that are not necessary or in some cases even harmful.  We need to weed out the actual fraud in the system through greater oversight, but we also need to improve the way we practice health care by encouraging quality rather than quantity of care.

If we don't do something now, I fear health care costs will crowd out a good portion of our national spending, if it doesn't already. Is health care projected to continue rising above the inflation rate and how should we contain these spiraling costs?

You correctly cite the real problem -- that health care costs continue to rise at rates well above inflation.  Part of the debate right now over Medicare often confuses this point -- many of the proposals would simply ask people in Medicare to pay more, rather than tackling the real issue of rising costs.  We need to hold down the costs, not simply shift the higher costs to those in Medicare, many of whom can barely afford health care now.

Last point as time has run out.  We know that millions of people rely on Medicare every day -- it is a critical part of health security.  We will continue to work to weed out waste and inefficiency and achieve smart savings, as well as make quality improvements in Medicare -- but we will also continue to oppose harmful cuts to the program that will reduce health security for seniors.  And we will also work to make sure we hold down costs throughout the health care system -- not just target Medicare. 

Thank you all for your great questions.

In This Chat
David Certner
David Certner is the Legislative Counsel and Director of Legislative Policy for Government Relations and Advocacy at AARP. He has been with AARP since 1982, and serves as counsel for the Association's legislative, regulatory, and policy efforts at the federal and state level, as well as for litigation opportunities before the courts. Mr. Certner has testified numerous times before both Congress and regulatory bodies, and as a designated spokesperson for AARP, has made frequent appearances on TV and on radio, as well as in print publications. Mr. Certner, an attorney, received his law degree from the National Law Center at George Washington University.
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