Preserving the Dignity of Health Care for All
Written by Barbara T. Baylor, MPH, Minister for Health Care Justice
October 24, 2012
On June 28, 2012, the United States Supreme Court declared the Affordable Care Act (federal health care law) constitutional. The decision was lauded as a victory for American families because the law targets health care benefits to the most vulnerable and those most in need.
I had the occasion to talk with two seniors (one female and one male) both of whom had recent and very serious health events. One had had a stroke and the other had taken a serious fall and had broken several bones. Both had to be hospitalized for a while. While they both had good health care coverage, they both shared how their lives were very different now. Their quality of life has been minimized because of their health conditions. However, they both realized the importance of having accessible health care and how having it had helped their physical healing. They both indicated how important it is to have both quality of life and meaning in their lives. One of them indicated how she could no longer get groceries for herself. She has to write out a list and have an aide go shopping for her. That used to be a source of independence and social interaction for her. I have watched my own mother who is 91 years old go through a serious health challenge and recall her saying to me how “we don’t have much use for old people these days.” My mother was also referring to quality and meaning of life.
As I listened to their stories and thought about my own mother, I couldn’t help but think about the thousands of seniors who must feel the same way. I thought about what seniors, who are confused and frightened by the current debates around Medicare, must be thinking. I thought about what possible changes to this valuable safety net could mean for their quality of life.
One of the important accomplishments of our society was the enactment of the Medicare program signed by President Lyndon Baines Johnson in 1965. Prior to 1965, nearly half of the elderly had no health insurance and many others had inadequate coverage. Medicare was enacted to help assure that virtually all citizens age 65 or older would have health care coverage. The idea for Medicare was placed on the national agenda by former President Harry S. Truman. When the law was passed, he and his wife received the first two Medicare cards in the country. At the signing of the Medicare law, President Johnson said this: “No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings they have so carefully put away over a lifetime so they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and to their aunts . . . No longer will this nation refuse the hand of justice to those who have given a lifetime of service and wisdom and labor to the progress of this progressive country.” (Source: 35 Years of Celebrating Medicare. Center for Medicare Services)
Medicare has altered the lives of seniors and Americans living with disabilities. Nearly 50 million Americans and Americans with disabilities rely on Medicare each year (Source: Affordable Care Act Helps Seniors. www.whitehouse.gov). It has made a difference in the quality of life for seniors by improving their health and well-being. Let us look at some of the benefits of Medicare under the new Affordable Care Act that help seniors increase their quality of life:
- For the first time in the history of this country, prevention is being placed at the forefront of our health care agenda. Under the Affordable Care Act, more than 150,000 seniors and people with disabilities have already benefited from the new annual wellness visits in 2011. The new law makes important preventive services more accessible to Medicare beneficiaries. As of January 2011, Medicare beneficiaries no longer have to pay a deductible, co-insurance, or copayment for many preventive services covered by Medicare as well as recommended services newly covered by the program.
- The Affordable Care Acts helps to close the “Donut Hole”. The Donut Hole” refers to the coverage gap in prescription drugs. The coverage gap starts when your total drug costs—including what you and your plan have paid for drugs—reaches a certain amount since the start of the calendar year. In 2012, this amount is generally $2,930. (This may vary based on your plan’s limit for prescription drug. (Source: www.healthcare.gov). When you have reached this limit, your coverage stops and you are responsible for up to 100% of the costs. The Affordable Care Act includes benefits to make your Medicare prescription drug coverage (Part D) more affordable. It does this by gradually closing the gap in drug coverage. As of January 1, 2011, if you reach the coverage gap in your Medicare Part D coverage, you will automatically get a 50% discount on covered brand-name drugs. Starting in 2013, you will pay less and less for your brand-name Part D prescription drugs in the donut hole. (Source: www.healthcare.gov)
- The Affordable Care Act strengthens Medicare. You have been hearing about the $716 billon dollars that have allegedly been taken away from the Medicare program. Facts show that the reductions were aimed at insurance companies and hospitals, not beneficiaries. The law made significant reductions to Medicare Advantage, a subset of Medicare plans run by private insurers. The Medicare Advantage was started under President George W. Bush, and the idea was that competition among the private insurers would reduce costs. But the plans have actually cost more than traditional Medicare. So the health care law scales back the payments to private insurers. Hospitals, too, will be paid less if they have too many re-admissions, or if they fail to meet other new benchmarks for patient care. Those $716 billion reductions in Medicare spending over 10 years primarily paid to insurers and hospitals. The law does not take money already allocated to Medicare away from current recipients. (Sources: Politico Facts and Healthcare.gov)
What might happen if there are changes to this important safety net for seniors?
One of the most frequently discussed proposals would transform Medicare from a defined benefit program, one in which beneficiaries are “guaranteed” a set of benefits as Medicare has traditionally provided to a defined contribution or “premium support” program, one in which beneficiaries are guaranteed a fixed federal payment (subsidy or voucher) to purchase health insurance in a competitive market. (Source: Kaiser Medicare Policy Study, Kaiser Family Foundation). The study by Kaiser indicates that if the “premium support” plan had been in place in 2010, six in 10 Medicare beneficiaries—about 25 million people both in traditional Medicare and in private Medicare Advantage plans —would have faced higher premiums if they didn’t switch to a cheaper plan.
Prevention, savings on prescription drugs, the extended life of Medicare and the guaranteed benefit. All of these issues harken me back to my earlier recall of the conversations I had with the two seniors. One I talked with face to face and the other by phone. It was easy to see frustration on his face but painful to hear the sadness in her voice. I’m pretty clear on where I stand on the Medicare issue. We need it! We must fight for it! It assures our seniors access to high quality medical care and helps to off-set the high costs of care, especially the costs of unforeseen devastating illnesses. Having Medicare does help to restore a measure of quality of life. I realize that having a quality of life and a meaningful life mean more than health care access, although it is a big part of it. I listened to the gentleman as he said, “What are we doing in our churches today for the elderly to help them keep busy? We need to focus on senior ministries not just as objects of mission but as doers of ministry.” As I continued to listen to his story, I couldn’t help but wonder what we as a society and as a church ARE doing to restore dignity, honor, health and meaning to the seniors in our lives.
The United Church of Christ has a resolution titled “Reclaiming the Church’s Ministry of Health and Healing.” This Resolution reminds us that “good health is a part of God’s intention for all people and that health involves the whole person – body, mind and spirit. Healing and health care are valid ways of proclaiming the Gospel and ministering in the name of Jesus Christ (Source: General Synod Resolution 1997). As we think about “wholistic” health ministry, we should not only ask ourselves, “What makes people sick and how can we provide a whole-person healing ministry to heal or save them, but we should also be asking, “What keeps people well and how can we provide a whole-person health ministry that will keep them that way.” (The Lafiya Guide).
The Supreme Court’s decision should serve as a reminder that because of our country’s moral base, Congress passed landmark bills on Social Security, Medicaid (nation’s health program for the poor and disabled), and Medicare (the nation’s health program for seniors). These programs have made health accessible to people who lacked privilege and they have allowed people to be treated, and as well, treated with dignity.
What is dignity? And what is the role of the faith community is promoting dignity? Bishop Yvette Flunder, Senior Pastor, City of Refuge Church in San Francisco says: “it means that we return all to the image of God. All people should be welcomed at the table.” She further said, “It is not the role of the church to take away chairs from the table, but to add as many chairs to the table that we can.”
Dignity is entitled to everyone and our seniors deserve to be treated with dignity and respected for the wisdom that they bring. Robbing the elderly of their dignity and honor by treating them as “less than” or “writing them off the books” has no place in a caring society. Giving physical, emotional, mental and spiritual support to the elderly as well as to children, those who are vulnerable, marginalized and/or disabled, as well as to those who have low-incomes and are without means to provide basic life needs: - housing, food, employment and health care is the measure of caring society. A caring society does not condemn those to a life of chronic illness, lack of health care, abuse, neglect, loneliness, alienation and possibly death. When one member of our family is not well either physically, emotionally, mentally, socially or spiritually, then we all are not well. Preserving the dignity of health care for all includes the elderly! Preserving Medicare honors our seniors. When we speak up about preserving Medicare that is an intentional action on our part to say, “We love you and we need you!”
When one is ill then all of us are not well! During a health care rally in 2004 Rev. James Forbes, Senior Minister Emeritus of the Riverside Church in New York City elegantly illustrated the following story about caring for each other.
“I received an emergency call during a Sunday morning service to go see about an elderly sister of the church, a long time active member of the church, who reportedly had a profuse nosebleed. Several deacons and members accompanied me to the sister’s house. When we arrived, we were not sure what we should do, but we set out to work together. First, the Deacon got a medicine bottle and corked 3 drops of the sister’s blood and sat it on it on the cupboard. When asked why he was doing this, he said, “That’s what grandma did.” Second, another member of the church asked for a brown paper sack, tore off a piece, rolled it up and stuck it under the sister’s lip. Third, another member asked for a towel and ice and applied an icepack to the Sister’s upper bridge of her nose. And finally, I as the preacher placed hands on her shoulders and prayed that the Lord would please heal our sister and help her recover from this condition. After several minutes her nose bleeding stopped. We all rejoiced and shouted. The only problem was that we didn’t know which method had worked!”
As the elections approach we will be inundated with much information regarding the Affordable Care Act, Medicare and Medicaid. Perhaps we could stand back and take a minute to reflect on the dignity and honor of each other and how God’s wish is that all of us have good health and prosper. That includes our seniors. Rev. Forbes closes his poignant story by asking people of faith to reflect on this… “If we as the Body of Christ could love one another, work together, pool our resources and wisdom together, we just might find ways to help our nation recover our spiritual health that will make our physical, mental, emotional and social health a possibility for all.”
Let us preserve the dignity of health care for all! Let us preserve Medicare!