The American Association of Retired Persons, characteristically, has firm opinions on what should be included in any health-care-reform package Congress puts together. Typically, those opinions make great sense. But before this newspaper embraces AARP's suggestions, the matter of cost will have to be spelled out, which to date it hasn't.
AARP has six features it wants included in any legislation to be considered: Extending Medicaid coverage to people between 50 and 64. Currently, a person must be 65 to qualify for coverage. This is the provision that causes most concern, since it seems to represent an enormous increase in cost.
However, Bill Ferris, legislative representative in AARP's New York State Legislative Office, explained the organization's justification in a meeting last week with the Press-Republican's Editorial Board this way: On a strictly humanitarian level, the coverage is essential so that all — or, at least, more — of the needy are taken care of. It is unacceptable that our humane, empathetic nation would leave so much of its population without access to medicine and health care. On a financial level, getting treatment for the now-uncovered needy leads to deep and expensive health problems by the time they reach their 65th birthday. Getting them treated early would relieve a lot of that cost.
He admits that the specific figures haven't been calculated yet, but that final reckoning has to figure prominently into any argument over extending Medicare coverage. Closing a Medicaid coverage gap that now exists between annual drug costs of between $2,700 and $6,154. Below $2,700 and above $6,154, patients can receive subsidies. Between them, there is nothing. AARP wants the government close what is known as this non-coverage "doughnut hole."
Lowering drug costs through generic biologics. Biologic drugs, used against our most serious diseases, are also our most expensive. According to Ferris, the Food and Drug Administration now has no authority to grant approval for less-expensive generics.
Offering a follow-up care benefit to prevent costly hospital readmissions.
Developing a system of long-term care wherein patients are encouraged and enabled to live at home rather than in nursing homes.
Increasing availability of low-cost care, not just for the elderly but for low-income patients, as well — extending medical benefits to Medicaid recipients, of whom there are 28,000 in Clinton, Essex and Franklin counties now, according to Erin K. Mitchell, AARP associate state director.
AARP says some of the huge outlay of money could become available by curtailing the estimated $300 million annually in waste and fraud. Also, as mentioned before, prompt care can forestall serious, more expensive illness.
While these proposals sound attractive, financial numbers are going to have to be applied before we'd want to decide whether they are sound or unsound ideas. We want comprehensive coverage, but we must also have manageable costs.
Opinion
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In My Opinion: A new focus for mental well-being


