| * |
Medicare is essentially compulsory. People who refuse to
join Medicare Part A are not allowed to receive their earned Social
Security benefits. |
| * |
Medicare patients cannot pay cash for care. A 1997 law
(the Balanced Budget Act, section 4507) forbids private contracts
between patients and doctors. With few exceptions, Medicare recipients
cannot pay cash for a Medicare-covered service that Medicare denies. |
| * |
Initially refusing to enroll in Medicare Part B leads to costly
penalty. Seniors are automatically enrolled in Medicare Part B.
Those who refuse and later change their minds pay higher premiums - 10
percent higher for EACH year they were not enrolled. |
| * |
Citizens do not have a right to their Medicare contributions
(payroll taxes). There is no binding contract between the
government and citizens for future payment of Medicare benefits.
Congress can alter or eliminate Medicare benefits at their discretion. |
| * |
Medicare comes in three parts. Medicare Part
A (hospitalization insurance) is funded through payroll
taxes. Medicare Part B (supplemental medical
insurance for physician services, diagnostic tests, and other services)
is funded approximately 73 percent by federal income taxes and 25
percent by Medicare recipients. Medicare Part C
(Medicare+Choice) created in 1997, has turned into primarily a HMO
managed care option. |
| * |
Medicare dependency is growing. While there are about 40
million people now enrolled in Medicare, approximately 77 million
babyboomers will begin entering Medicare in 2011. |
| * |
Medicare faces insufficient funding. While there are
approximately 4 workers/taxpayers for each Medicare recipient today,
there will be only 2.3 workers/taxpayer for each Medicare recipient in
2030. |
| * |
Medicare is heading toward bankruptcy. According to
current estimates, it will be insolvent by 2026. |
| * |
Medicare is not a catastrophic health insurance policy.
It doesn't pay for hospitalization longer than 150 days, and there is
no cap on out of pocket expenses. "Medigap" insurance is often
purchased to protect against huge medical bills not covered by
Medicare. |
| * |
Medicare does not cover the cost of long term care and nursing
home care - unless it is related to a hospitalization or other
urgent medical care. |
| * |
Medicare pays only about half of all health care costs of
seniors. In 1997, 39,840 seniors paid an average of $22,124,
either in out of pocket costs or through supplemental insurance. |
| * |
Medicare frequently denies payment. In 2001, 3.7 million
appeals were filed for denial of payment by Medicare Part B. Despite a
2000 law requiring swift processing of appeals, a 2003 report by the
General Accounting Office found significant delays in appeals
processing. |
| * |
Medicare has not significantly decreased out of pocket payments
for seniors. In 2000, a study by the American Association of
Retired Persons (AARP) found seniors paying an average of $2,510 per
year - about 19 percent of their income - on out of pocket costs. This
does not include home care or nursing home care. In 1964, a year before
Medicare passed, seniors were paying 20 percent of their income on
health care. |
| * |
Medicare wastes taxpayer money. Over the past 7 years,
almost $107 billion in improper payments have been made for services
provided to recipients of the traditional fee-for-service Medicare
program. CCHC calculated that the $13.3 billion loss in 2002 equals
$36.4 million per day. |
| * |
Doctors, hospitals and others who accept Medicare patients are
at enormous risk. There are over 130,000 pages of Medicare
regulations that must be meticulously followed. In 1996, Congress made
health care fraud a federal crime - a felony. Even minor billing errors
can be considered fraud. Fines start at $10,000 per violation. |
| * |
Medicare threatens patient privacy. The federal
government requires home health agencies to regularly send private data
on Medicare recipients. This is called the Outcomes Assessment
Information System (OASIS) In addition, doctors and hospitals that make
inadvertent errors in billing Medicare can be forced to hand over the
patient's entire medical record for investigation of fraud. |
| * |
Scarce Medicare dollars are used to fund medical
education. In 1996, Medicare paid $7.1 billion toward the
training of physicians. |
