Most Want a Year of Nursing Home and
Dental Coverage Added to Medicare
How to fix Medicare? Kaiser Health
News asked the public
23, 2014 – A mini-survey by Mary Agnes Carey of Capsules, the
Kaiser Health News Blog, indicates that a vast majority of Americans,
when asked about changes they would like to see in Medicare, want the
program to add dental coverage and, secondly, a year of nursing home
Below is her report on this survey
and links to the original story with public comments, where readers can
share their ideas on making Medicare better.
Marge Ginsburg decided to ask ordinary Americans how they would
change the federal entitlement program.
Seventy-seven percent of participants in her
“MedCHAT” group sessions said Medicare should cover at least one
year of care in a nursing home, in supportive housing or at a person’s
home. Eight-five percent wanted “modest coverage” of dental, vision and
hearing services. To help Medicare last another half-century - it turns
50 next year - 85 percent were willing to reduce program spending on
current and future beneficiaries.
the past year, Ginsburg’s group, the nonprofit, non-partisan
Center for Healthcare Decisions, conducted 82 three-hour “MedCHAT”
sessions in California with 810 participants to discover what changes
they would make to the federal entitlement program.
groups of eight to 15 people gathered in community centers and churches
to use the “MedCHAT” tool on computers with guidance from facilitators.
The groups included seniors, young adults, health care professionals and
community and senior service leaders, and the interactive simulation
tool explored Medicare options among 12 categories of coverage. If
participants wanted to add benefits, they had to eliminate others or
impose new restrictions on current coverage.
participants did not eliminate benefits, they accepted stricter criteria
or new limitations on current coverage. For example, 82 percent
supported the use of defined networks of providers, but allowed the use
of a provider outside the set network if approved by a primary care
Eighty-eight percent supported “value-based coverage” but also agreed
with patients picking up at least half of the tab if research showed the
benefits of a treatment “was small, unlikely or more expensive than an
equivalent treatment.” Forty-eight percent backed using both penalties
and rewards to encourage compliance with medical advice.
findings fare in Washington where entitlement reform is the “third
rail” of politics — touch it and your career dies?
care experts offered their thoughts at a Sept. 19
forum sponsored by the American Enterprise Institute and the
Engelberg Center for Health Care Reform at the Brookings Institution
where Ginsburg presented her findings.
confuse what took place in California with what will happen in
John Rother, a longtime Washington health care policy expert who is
now president and chief executive officer of the
National Coalition on Health Care. While many changes could be made
to Medicare to make it more efficient, “we’ve got to figure this out in
a way that minimizes political difficulty,” he said.
in other parts of the country might not agree with the views of the
Ginsburg’s groups in California, warned
Robert Moffit of the Heritage Foundation.
Kavita Patel of the Brookings Institution said patients facing
end-of-life issues first-hand might have different responses than those
contemplating end-of-life care while in good health.
Joseph Antos, who moderated the panel discussion, warned that any
changes to Medicare would need time. “You need a sensible transition if
you are going to change policy,” he said.
Ginsburg said she would love to take her show on the road and run
MedCHAT discussions all over the country, but she needs more funding to
make that happen.
I actually expect Congress to change what they do based on 800
Californians? No. But this is a gradual process of enlightenment,” she
said in an interview. “Enlightenment of the public, enlightenment of
legislators, of community and health care leaders. … The future of
Medicare is not going to be solved tomorrow.”
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