Medicare premium hike
could hurt isle poor
Paying almost $8 more a month for health care doesn't sound like a lot.
But for a number of Hawaii's elderly -- some of whom already have to choose between food and prescription drugs -- an increase in Medicare premiums taking effect in January could mean they'll have to make possibly health-detrimental decisions.
"I can categorically say that it will be a lot for a lot of people," said Laura Manis, a member of the Coalition for Affordable Longterm Care. "These are retirees. A lot of them were plantation workers who didn't have any pensions. Hotel workers, too."
Medicare premiums will rise next year by 13.5 percent to $66.60 a month; this year's premiums rose 8.7 percent, to $58.70.
Already, Manis said, a number of Hawaii's senior citizens do without proper medical care because they can't afford expensive prescription drugs and other health care coupled with the state's high cost of living.
Nearly 20 percent of the state's population is over 60 years old. About 12,000 Hawaii residents over 65 have incomes at or below the federal poverty level, according to 2000 U.S. Census figures.
Meanwhile, recent statistics from the Health Care Association of Hawaii show that about 82 percent of Hawaii's senior citizens who require long-term care have annual incomes of less than $20,000.
About 43 percent have incomes of less than $10,000.
"If they are sick, if they have to buy medicine, they don't," Manis said. "They will cut pills in half or not fill the prescription."
Low-income seniors also end up paying more later, both monetarily and in terms of their health, when they need more extensive medical care for a sickness that could have been treated with prescription drugs, said Ruth Dias, former chairwoman of the legislative committee for the American Association of Retired Persons.
Dias, who is also on Assisted Living Hawaii's board of directors, said she has felt the pinch of higher medical costs because her husband's deteriorating health has required more doctors visits and medications over the past year.
The Medicare increase comes as the costs of patient care and prescriptions are also rising. Medicare premiums are adjusted annually so that participants continue to cover one-fourth of the overall cost of the program.
"All the health care costs nationwide are in the double digits," Dias said. "It's a chain. When you raise something, something else goes up."
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Medicare premium to rise
The 13.5% increase to $66.60 a month
is the third-largest in the program's history
WASHINGTON >> Medicare premiums will rise next year by 13.5 percent to $66.60 a month for about 40 million Americans in the program, the third-largest increase in its history, the government said yesterday.
Reflecting rapidly escalating health care costs, the $7.90-per-month increase in premiums is for the portion of Medicare that pays doctor visits and other expenses outside of hospital care.
This year's increase was 8.7 percent, to $58.70 a month.
The annual increases are mandated by Congress, which requires that participants' premiums cover a fourth of the overall cost of the health care program for seniors.
When Medicare began in 1967, premiums were set at $3 a month.
The largest premium increase was in 1988, at 38.5 percent, followed by 1993, when the jump was 15.1 percent.
The Bush administration said next year's large increase intensifies the need to reform the system.
"We need a Medicare system that provides more choices for beneficiaries and more incentives for efficient, high-quality care," Health and Human Services Secretary Tommy Thompson said yesterday. "Choice and efficient care can help keep Medicare spending and Medicare premiums affordable, as well as help us down the road to preserving Medicare for future generations."
The Medicare premium increase is likely to erode much of the modest cost-of-living adjustment that Social Security recipients will receive next year. Economists anticipate that the adjustment, based on inflation, will be around 2 percent. The government will announce the increase today.
AARP, formerly the American Association of Retired Persons, said Congress should not approve additional payments to medical providers until it passes a prescription-drug benefit. When the cost of the program rises, participants end up footing more of the bill.
The large rise in premiums "emphasizes even more why action on a drug benefit is critical this year," said Kirsten Sloan, AARP national coordinator for health issues.
In Congress, lawmakers are working on compromise legislation to add a prescription-drug benefit to Medicare as well as overhaul the basic health care program.
Republicans in particular want to inject competition into Medicare by inviting private insurers to compete for seniors' health care dollars, arguing that it would modernize the 38-year-old government program as well as hold down future government spending.
With next year's election looming, both parties are eager to send a bill to President Bush, who also is urging action on the issue.
Meanwhile, senior lawmakers working behind closed doors reported a growing consensus yesterday behind a requirement for higher-income seniors to pay more for their health coverage under Medicare than other beneficiaries.
The development marked an important step toward agreement on an overall Medicare prescription drug bill, and -- if enacted into law -- would also signal a historic shift in a program that has always provided a standard benefit at a fixed price.
Emerging from their daily bargaining session in the Capitol, the lawmakers stressed that no details had been settled on the issue. And participants said there appeared to be some differences over how far down the income scale seniors should be asked to pay higher amounts for health care coverage.
Congressional sources, speaking on condition of anonymity, said some lawmakers advocate requiring seniors to begin paying more when their income reaches $100,000, while others favored a lower threshold, in the range of $75,000 to $80,000.
Whatever the differences on details, Sen. John Breaux, D-La., said there was a "developing consensus on means-testing Part B" of Medicare, the portion that provides non-hospital coverage, including doctor care.
