By James Reed
MnSF member

More than 100 registered attendees and several other brave souls slogged through a winter storm to air grievances and hear from congressional representatives on upcoming upheavals in Medicare. The Minnesota Senior Federation, Minnesota AARP and Minnesota Alliance of Retired Americans hosted this Congressional Forum on Medicare at Minnetonka Community Center Dec. 1.

The forum brought together several factions to address concerns of increasing costs of Medicare premiums, planned physician reimbursement cuts for Jan. 1 and pending changes to Medicare funding.

Senior Federation Board chair, Barbara Kaufman, opened the forum welcoming attendees and setting the framework for guest presentations and panel discussion. On hand to present were G. Richard Geier, Jr., MD, past president of the Minnesota Medical Association; Janet E. Witt, MS, RD, a representative from the National Committee to Preserve Social Security and Medicare; Gregg Redfield, vice president of finance, Minnesota Hospital Association, St. Paul; and Skip Humphrey, president of AARP, Minnesota.

Additional presentations came from Vicki Tigwell, state director for Sen. Norm Coleman; Rose Bauman, outreach director for Sen. Amy Klobuchar; Mike Siebenaler, coordinator of constituent services for Rep. Keith Ellison; and Karin Hope, legislative director for Rep. Jim Ramstad. All joined the panel discussion to field questions from the audience.

Geier began with the difficult topic of Medicare reimbursement to physicians. He congratulated the overall success of the Medicare program, but warned that a proposed ten percent cut in Medicare reimbursement would force some physicians to leave practice and others to stop accepting Medicare patients altogether. The successes of the past could well be lost if Congress does not act to compensate physicians enough to cover rising practice costs. Rural practices will be especially hurt as rural physicians have a disproportionately large portion of Medicare patients. Lawmakers crafted a six-month reprieve from the 10 percent cut for Medicare physicians Dec. 18.  Instead they will receive a 0.5 percent raise when treating Medicare patients. Some communities might lose their only physician. And Minnesota will suffer more because of Medicare’s built-in disparities in reimbursement.

Janet Witt proposed replacement of the current Medicare Part D private-public prescription plan with a direct Medicare reimbursement plan. She listed deficiencies in the current plan: the confusing complement of private plans, rapidly rising plan premiums, surprising reassignments of low-income recipients, and the growing “donut hole” in plan reimbursement. She protested the generally rising premiums for Medicare.

Gregg Redfield explained that Medicare reimbursement to hospitals, particularly rural hospitals, is not keeping up with costs. Rural hospitals may close simply because their major income source, Medicare, is insufficient. Meanwhile Medicare patients are confused by the array of hospital coverage rules in the Medicare Advantage plans. With 15 million new Medicare enrollees coming soon, Congress must do something, something fast.

Skip Humphrey supported concerns of the previous speakers, particularly the rapid rise in Medicare premiums to recipients. He focused attention to the doubling of Medicare part A/B premiums in just seven years, a history that may end Medicare availability for coming retirees. Criteria for premium subsidy are nearly impossible to meet for most low-income seniors. Seniors must demand of Congress a solution that controls Medicare premiums.

The Senate and Congressional office staff spoke briefly. Vicki Tigwell introduced the Health Information Act sponsored by Sen. Coleman, an act to make medical service information accessible; Rose Baumann stated that Sen. Klobuchar is looking at funding options for Medicare and drug re-importation; Mike Siebenaler related Rep. Ellison’s support for drug negotiation and HR6123, an act to restructure Medicare costs for individuals; Karin Hope listed Ramstad’s support for drug re-importation, drug negotiation, solving physician reimbursement and addressing reimbursement inequalities.

During the following question/answer session, the audience submitted 17 questions to panelists ranging from the high cost for health care, to the prospects for a single payer health care system, to complications in Medicare, and to inconsistencies in health care contracts. To meet time constraints, panelists gave brief answers to questions; but those answers displayed a breadth of opinion on how Medicare and health service should evolve. Dr. Geier explained that high medical costs are attributable to long term care for chronic illness, care that has extended a higher quality life. Mike Siebenaler stated Rep. Ellison’s support for a single payer health care system, but others expressed their reservations, particularly about patient choice.

Janet Witt spoke of NCPSSM efforts to have Congress simplify Medicare Part D. Karin Hope thought Congress could reduce or remove penalties and other limitations in Medicare enrollment and usage. Vicki Tigwell mentioned expanding tax credits for health care.

The Senior Federation also provided free Medicare Part D consulting throughout the morning which attracted several attendees and the participating health plan and other service vendors were pleased with exhibit traffic.