Where the AARP went wrong

The AARP has long been known as an advocacy service for older people in this country. I remember when my mother first received her AARP membership card in the mail; she was so excited about getting discounts. The AARP was the voice for the older generation, advocating for social change. Working in the health care advocacy field has since taught me a greater lesson. AARP should not be trusted.

When I coordinated older volunteers who counseled Medicare beneficiaries, I once had to reprimand (in a loving way) a volunteer who told someone “AARP are a bunch of con artists”. Obviously, this was unprofessional and not the best way to handle the call as a representative of the organization. But, she wasn’t wrong.

I had the amazing opportunity of working for a Medicare rights organization while simultaneously studying health care policy and law. I got to see how policies affecting Medicare were developed and implemented, and then how they affected people on the personal level. It was a great way to see the larger picture of the Medicare program and of health care in general.

What stuck out most in my mind about AARP was that they were quick to support a Medicare Prescription Drug Benefit administered solely through private insurance companies. I guess this should not have been a surprise. AARP had already partnered with United Health Insurance to provide supplemental insurance plans for Medicare beneficiaries. Of course when the drug benefit was then implemented, AARP/United Health offered a drug plan as well. Hmm, advocating for a controversial drug benefit not supported by many of your members while selling health care insurance all in the same breath. Can you say conflict of interest?

And as far as drug plans went, the AARP plan was fairly decent. AARP stood out above many other companies because they offered a physical list of drugs they covered and for how much. This was particularly hard to get from most plans so people jumped on it. But mostly, I heard from people that they didn’t want to look at all 60 drug plans available to them so they would just enroll in the AARP plan because it was a name they recognized. Apparently it didn’t matter if the plan actually covered their drugs or if they could get their drugs cheaper through another plan. Nope, they knew of and respected AARP and that was enough. Then of course, there were the individuals who kept up with Medicare policy and resented AARP for the role they played in the drug benefit, my volunteer for example.

Well, it turns out that AARP is now under some severe scrutiny for “royalties and fees” built into insurance premiums (not just with Medicare or even health insurance, but their insurance plans in general). Apparently these royalties and fees have added up to 43% of the organization’s revenue last year. AARP defends this by saying that higher premiums come with better coverage. However, as the article illustrates, this can be debated by looking at their Medicare supplemental plans. Medicare supplemental plans (Medigaps) are standardized and so all plans must offer the same coverage. There is no way that the AARP Medigap can offer better coverage, yet they are still not the cheapest plan. So that theory goes out the window.

AARP’s enormous clout comes from the threat they could defeat people in Congress who don’t do what they want. They are the most powerful interest group in Washington.
-James Thurber, director of the Center for Congressional and Presidential Studies at American University in Washington

The AARP can be a positive force for seniors in the U.S. For example, they fought and derailed Bush’s proposal for the privatization of social security. But when an organization uses its positive reputation to make money and take advantage of the individuals it’s claiming to help, that’s misuse of power. If AARP is to advocate for the health of older people, they need to be in a position where they do not benefit from charging people more money for benefits. Isn’t this what they’re trying to protect people from?

Guest Blogger on The Only Baggage You Can Bring

I got the opportunity to be a guest blogger on Samantha Grace's The Only Baggage You Can Bring blog. Check out my post on Medicare and the Election.

Thanks Sam Grace!

Medicare "Advantage" Plans

(A brief introduction for those not familiar with how Medicare is administered. There are two ways to receive Medicare benefits when you are eligible; one is through the government administered traditional Medicare and the second option is to get your benefits through a private insurer. The benefits under the traditional system are pretty standard across the country, while private plans have different costs and benefits by region and plan.)

This is exactly why private insurers should not be involved in Medicare. If you need more convincing, read this. A few things to note:

-People who have Medicare tend to be the least likely (able) to research and understand what the differences between 50 drug plans are. We're talking about people who tend to be less mentally acute (whether because of age or a disability) and who may never have used a computer before (something our generation takes for granted). Much of the information about the plans is online.

-Both CMS (the federal adminstrator of Medicare) and private insurers have been called out on inappropriate actions. The insurers are not following through on marketing promises and CMS fails to regulate them.

-Keep in mind that the increase in premiums is typically not met with an increase in income. Most Medicare beneficiaries lived on a fixed income.

So, to sum up. If you're able to know what questions to ask of whom, you're likely to get incorrect information and pay an increasingly high percentage of your limited income on a plan that doesn't give you coverage.

Additionally, if you think that private plans are saving the government money, think again. The government pays the insurers to provide Medicare plans, more than what it pays for a beneficiary under the federal program.

Medicare’s payments for beneficiaries enrolled in Medicare Advantage plans are higher, on average, than what the program would spend if those beneficiaries were in the FFS [fee for service] sector—so shifts in enrollment out of the FFS program and into private plans increase net Medicare spending.

Health Care in the news today

BBC -
If you thought there was a shortages of nurses and other medical staff in the U.S., you'll be utterly disheartened by the shortages internationally. On the one hand, it's great that doctors and nurses are able to immigrate to more prosperous countries. But, it creates an even greater hardship on their home country's resources. In the U.S. they pay tuition or give subsidies to med students who practice in rural, resource-depleted areas. I cannot imagine this idea not being expanded internationally.

NY Times -
The need for presidential candidates to ponder the futures of Medicare and Medicaid. My suggestion: Can't we just find an independently wealthy do-gooder to be our benefactor?

Very interesting article about Cochlear Implants. It shows support for implanting not only adults, but preferrably young children (as young as 1 month old). I don't know, I'm still a bit skeptical. If someone wants to get the implants themself, great. But, implanting such young children still raises some concerns for me, although I realize the greater ability to learn english at a young age. Have any studies been done to see how these things affect brain functioning and physiology in the long run? On another note, Swiller's book sounds really interesting.