Dear Rep. Moran

I wanted to get your feedback on several issues regarding elder health care and pensions, as was covered in chilling fashion in the Oct. 31, 2005 issue of Time magazine.

What can be done to bring stability back to the pension system, where right now well-managed companies must pick up the slack for companies that default?

What can be done about those individuals between “forced retirement” and their eligibility for Medicare (at age 65) when their former employers find it increasingly difficult to fund retiree health insurance, and where individuals in that age range seem to be poor actuarial risks for individual insurance?

Of particular concern is the fact that hospitals often charge a “list price” for a procedure or stay that is several times for an uninsured self-pay that it is under a group insurance contract. For example, I would have been charged $1750 for an oral cat scan last January until my retiree insurer agreed to cover it (as medical rather than dental), whereupon the contract list price came down all the way to $370. Several years ago, in Minneapolis, I would have been charged $4400 for a week in rehab after a winter accident resulting in an acetabular hip fracture; after the insurer accepted a formal referral, the list came down to just $950.

I think it is time that we have an objective discussion of the opportunities for stability offered by a single payer system of universal coverage such as in Canada. This is an emotional issue for people, as President and Mrs. Clinton found out in 1993. We would want to know, in some objective sense, how well Canada, Britain, and similar modern countries deal with questions like rationing, waiting lists, age maximums for certain procedures, filial support (in a world of smaller and scattered families), and custodial care. It seems that an objective understanding is hard to come by, but we need to start the debate again. For example, in 1998 I received a state-of-the-art new surgical procedure with a new implanted device for restore the hip, partly underwritten by the medical equipment company, at the University of Minnesota, where I had full employer-provided insurance. I don’t know if the same kind of care would have been available in a single payer system. But we need to find out.

(Oct. 26, 2005)

(Jan 20, 2006)

Rep. Moran replies:

Thank you for contacting me with your concern over two of the greatest budgetary challenges facing the nation – retirement security and health care costs. I appreciate having the benefit of your views on these issues and regret the delay in my response.

I share your concern form rising health costs as well as increased access to health care. Universal health care systems have both advantages and drawbacks. While universal service plans create better access to health care, they have proven to be very costly and have numerous inefficiencies that can lead to a decline in the quality of care. Nonetheless, there is much that our current system could learn from universal systems of coverage. Indeed, the U.S. programs that most closely resemble universal service plans. Indeed. The U.S. programs that most closely resemble universal service plans – Medicare and Veterans Administration – are solid models upon which certain national reforms could be based.

As an affordable alternative to fee for service plans, managed care reform may be a partial answer to providing greater access to quality care. I have supported past efforts that afford consumer protections and rights under managed care systems and believe that this may be a potential avenue for future health care reform.

Medicaid is another important way to cut down on the number of people without access to affordable health care. Studies show that only a fraction of Medicaid-eligible families apply to their own states for benefits. Greater outreach to these eligible families would also help encourage economically disadvantaged families to gain access to health care.

I have enclosed excerpts from a recent Congressional Research Service report that touches upon many of the important issues involved in safeguarding American retirement. I invite you to visit my website at http://www.moran.house.gov that contains information on many topics of interest and allows you to sign up for Moran e-News.

Thank you again for contacting me.

The report is “Pension Sponsorship and Participation: Summary of Recent Trends,” Sept. 8, 2005, by Patrick Purcell, Specialist in Social Legislation, Domestic Social Policy Legislation.

http://digitalcommons.ilr.cornell.edu/key_workplace/261/

http://www.loc.gov/crsinfo/CRS04_AnnRpt.pdf

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