Categorized | Technology

Letters: Medicare change would hurt seniors

For decades, local affiliates of the National Urban League have worked to empower Hoosiers of all backgrounds by removing any barriers that could keep them from leading successful, healthy lives. One of those barriers continues to be access to affordable, quality health care.

Knowing the complexity of our country’s health-care system, I appreciate any attempt to lower costs, but unfortunately a new proposal in Congress could put one of our most vulnerable populations at risk: seniors.

Groundbreaking work to develop new medicines to fight diseases like dementia is happening here in Indiana. Researchers at Indiana University just identified 24 compounds that could create drugs to protect against the disease. But this proposal could restrict seniors’ access to those innovative medications.

The plan would change the structure of Part D, Medicare’s prescription drug benefit program. More than 600,000 Indiana patients are enrolled in Part D, which covers prescription drugs for seniors and those with disabilities.

The program took effect more than a decade ago and has been hugely successful, coming in way under budget. Thus far, Part D has cost about 45 percent less than the Congressional Budget Office initially anticipated.

Seniors have shared in these savings. Their average monthly premium is about half of the original predicted $60. In Indiana, beneficiaries can choose a plan with a monthly premium of just $15.

This increased access to affordable medications improves seniors’ health. One recent study found that Part D reduces senior mortality rates by more than 2 percent annually.

With benefits like these, it’s no wonder that nearly nine out of 10 Part D enrollees report satisfaction with their coverage.

So what’s the key to Part D’s success? Its unique structure.

Part D fosters competition among private insurers. These payers negotiate discounts and rebates directly with pharmaceutical companies. They’re tough negotiators. They’ve secured discounts that are an average of 35 percent off the list price of medicines, according to a QuintilesIMS Institute Study.

After securing these discounts, insurers come up with plans that pass the savings to beneficiaries through lower premiums, co-pays, and deductibles. Seniors can then choose whichever Part D plan works best for their budget and needs.

There’s good incentive to keep costs low — if a plan isn’t offering seniors a sweet deal, they can just enroll in another one. Indeed, Indiana seniors have 23 plans from which to choose. And thanks to continued competition among plans, 81 percent of Hoosiers have access to a plan with a lower premium than what they paid in 2016.

Despite the program’s success, policymakers are bent on changing its structure. They want to repeal the noninterference clause, which would allow the government to interfere with current private negotiations. Proponents of the proposal think that the Health and Human Services Secretary would be able to secure bigger discounts on drugs.

The nonpartisan Congressional Budget Office repeatedly has said that the government can’t secure bigger discounts than private payers. The only way to achieve significant savings would be to restrict access to certain medicines and establish a single formulary of approved ones.

That would have devastating implications for patients. If the government creates a single formulary, it would no doubt leave off the newest and most advanced medicines. Seniors using Part D would no longer have access to these drugs, including ones that treat dementia.

This isn’t hypothetical. The government-negotiated Veterans Affairs health system covers far fewer innovative drugs than Part D. A recent study looked at these plans’ coverage of 25 newly-approved drugs. On average, Part D plans covered 81 percent of them. The VA covered only 12 percent.

Restricting seniors’ access to innovative medicines will irreparably harm them. Congress ought to remember that before it votes to radically change a popular, successful program.

Tony Mason

President and CEO, Indianapolis Urban League

U.S. withdrawal on Paris climate deal not catastrophic

As news of the Trump Administration withdrawal from the Paris Climate Agreement hit, I was left pondering the question “What next, planet Earth?” As a climate scientist and a former senior science adviser for the Sate Department working on climate issues, I have a pretty good understanding of what uncurbed climate change will do to the planet, and to people on it.

But I am not sure that our withdrawal matters in terms of the actual trajectory of energy choices and climate change on the planet. We should take a deep calming breath and examine what this globally unpopular move will really mean for climate.

The Paris Climate Agreement is largely symbolic anyway. It was a good faith effort of nearly every nation on the planet to develop its own national benchmarks for net carbon emissions over the next several decades. The targets were nationally based, and compliance to those targets was similarly nationally policed.

Most of the national climate plans are things that are or will likely happen anyway. For example, because renewable energy sources have become so cheap, electrification of large swaths of currently light-less continents is best done by small-scale, renewable-based power grids. Renewables will continue to dominate new power development around the world, as reflected in nearly every economic projection and futures market.

Additionally, natural gas has continued to replace coal as an energy feedstock, resulting in most nations abandoning plans to build new coal-fired power plants (sorry again, Trump). This replacement has its own issues, as natural gas is a fossil fuel and still contributions to carbon emissions, but it is at least cleaner than coal and does emit less carbon per BTU than coal.

Paris has a lot of national-scale action occurring by 2025 or 2030. It really has to start in 2017, or indeed to have started in 1980, to have the potential to stop short of 2 degrees of warming, which is the global climate target built into the Paris Agreement. Last I looked at the global carbon dioxide curve, climbing upward every year, I see little reason for optimism on this front.

I am not suggesting that we stop trying, but that most of Paris will probably happen anyway, and we have to be a bit more realistic and start living with the reality of a warming planet. We need to seriously consider what 2050 will look like, and determine how best to manage resources so that more money is not thrown down the drain protecting areas that are doomed (hello, Miami Beach) and protecting people who do not have the capacity to “weather the storm.”

Another in a series of internationally-embarrassing moments for the U.S.? Yes. Portending the imminent destruction of our planet? Not exactly.

Gabriel Filippelli, PhD

Indianapolis

Pence ignores servant-leadership principles

In Maureen Groppe’s report on Vice President Mike Pence’s recent Naval Academy graduation speeches she quoted his support of servant leadership. I could not help but notice that Pence either failed to mention or contradicted some key Greenleaf writings. While Pence preached that one should follow the chain of command “without exception,” Greenleaf suggested that servant-leaders should choose to not follow non-servants. A servant-leader uses persuasion rather than coercion or manipulation as the preferred mode of power. Servant-leaders are known by their outcomes, not just their motives. The test is whether those being served are “healthier, wiser, freer, more autonomous, and more likely themselves to become servants,” and whether the least privileged are “helped, or at least not further harmed.” None of this happens without trust that is granted by followers, not proclaimed by leaders.

Don Frick

Noblesville

 

Article source: http://www.indystar.com/story/opinion/readers/2017/06/02/letters-medicare-change-would-hurt-seniors/365175001/

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