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Medicare Celebrates 30 Years With Cake, Reform Warnings But Seniors Voice Opposition To Changing A System They Like

About 100 seniors gathered at the Spokane Public Library at an event staged to honor the 30th birthday of Medicare.

What they got, in addition to punch and cake, was a warning that Congress is licking its chops at the idea of slicing billions from the country’s primary senior health insurance program.

“What we’re trying to do is remind them that Medicare won’t remain the same for too much longer,” said Bill Decker, a health care analyst who spoke to the group.

Hosting the get-together was the American Association of Retired Persons, the nation’s most powerful lobbying and service group for seniors. AARP has attacked proposals by congressional leaders to slice $280 billion in Medicare costs over the next seven years.

Supporters of the cuts say Medicare will go bankrupt without serious reforms.

The Spokane meeting was one of 30 events being held across the country to both celebrate Medicare’s three decades and to sound the alarm about potential cuts.

After hearing Decker describe four Medicare changes under consideration, most at the meeting stood up and voiced strong opposition to changing a system they like.

Congress won’t announce specific Medicare reduction proposals until next month. It must send a budget bill to the president by the end of September.

Decker said the proposals range from making those with more money pay more for their insurance to a voucher system that would give citizens a fixed yearly amount to finance their health insurance.

“Vouchers would provide a windfall for the insurance companies,” asserted Spokane resident Stan Robinson. “As individuals, we have nowhere near the bargaining power with insurance companies” that workers get when they join company group health plans, Robinson pointed out.

Resident Andree Sciamanda, 79, had even harsher words for the voucher plan: “It’s absurd. They are asking people to regulate their medical conditions. I could only use the voucher one year but not save it and use (the unspent amount) the next year if I become sick,” she said.

Decker said Spokane’s seniors are responding to the Medicare changes much like those elsewhere.

“People like the voucher plan least, and are least bothered by the plan to increase premium costs on those with more income,” he said.

AARP’s position on the Medicare reductions is to oppose the $280 billion goal as “too much, too fast,” Decker said.

Democratic leaders, President Clinton and Medicare administrators say the program can remain solvent by reducing spending by $110 billion over seven years.

“That’s not necessarily a reduction from current levels, just reducing the expected growth by 2002 by $110 billion,” said Decker.

Three practical options are available, he added: charging seniors more for the premiums (thus cutting government contributions), paying hospitals and doctors less for services, or increasing the co-payments and deductibles seniors have to pay for health care.

Decker said he expects Congress to look at combining those three options and to avoid the messy and politically sensitive voucher choice.

“The people we’ve talked to look at vouchers and say, ‘Hey, this isn’t at all like the program we’re used to.’ They’re right,” Decker said, “since it changes Medicare from a defined benefit to a defined fixed-dollar payment plan.”

The increased-premium plan might be the most logical choice, but past experience has made members of Congress cautious, he added.

Medicare participants pay about $46.10 per month for physician, outpatient care and other medical services. Under a modified plan, those with incomes over a certain amount would pay more.

“Congress learned increasing premiums on high-income seniors can be dangerous,” Decker said.

The best example was the decision in 1988 to impose higher catastrophic health care costs on the 6 percent of Medicare participants who earned more than $70,000 per year.

“That was what led to people on the streets (in Chicago) rocking and pounding on the car of Congressman (Dan) Rostenkowski,” said Decker. Congress rescinded that increase a year later.

, DataTimes ILLUSTRATION: Photo