In Health Debate, Both Sides Vie For Seniors' Support
Nearly all seniors already have health insurance through the Medicare program, but they are among the most sought-after groups in the political struggle to pass or kill a health overhaul bill.
Democrats have stuffed their bills with sweeteners intended to woo the over-65 crowd. "The House health insurance reform bill will strengthen and improve Medicare and its benefits for older Americans, and help eliminate waste, fraud and inefficiency from Medicare," said Rep. James Clyburn of South Carolina, the House's No. 3 Democrat.
Among those sweeteners is a gradual closing of the "doughnut hole," the quirk in the Medicare drug benefit that requires patients to continue to pay premiums even while paying the full cost of their medicines. The bills would also eliminate copayments on preventive care. And the Senate Finance bill would pay for annual "wellness" checkups for every Medicare patient. Currently, the program only pays for a single physical when a senior first enrolls in the program.
Republicans, however, have been hammering for months the fact that much of the bill would be financed by cutting future Medicare spending.
"It will slash Medicare for seniors by about a half a trillion dollars over the next 10 years," Senate Minority Leader Mitch McConnell (R-KY) said last week on the Senate floor. "These are major cuts with serious consequences."
Targeting The Senior Vote
It's no secret why both sides are so actively aiming their messages at seniors, says Robert Blendon, a public opinion and health expert at the Harvard School of Public Health. "Seniors are incredibly important politically," he says.
In fact, in off-year elections, like the one coming up next year, says Blendon, seniors "tend to turn out at much higher proportions than other age groups, and when it comes to voting, it turns out that health care is incredibly important to their vote, much more so than younger voters."
So far, says Blendon, seniors are more negative toward the health overhaul effort than most other age groups. He says that's in part because of Republican efforts to paint the Medicare cuts as potentially damaging to benefits, even though Democrats say the reductions will only target waste and inefficient spending.
"I think what has been going on is that seniors have read about large-scale cuts, and that's the way you've seen it in the newspapers or on talk radio shows. And they perceive that their care could deteriorate as a result of this," he says.
Selling The Bill
But Blendon also says Democrats simply haven't done a very good job letting seniors know that there are benefits aimed at them in the bills: "They're not at all seeing the potential benefits that the Congress has tried to provide in this legislation for them."
That helps explain why in recent weeks Democrats have held a series of events to publicize the new benefits — and even improved some of them. For example, the drug benefit doughnut hole will now be closed faster — over 10 years, rather than the original 15.
"The first bill was good. This is much better," said House Speaker Nancy Pelosi about the change.
But whether it will be good enough to change seniors' so-far negative view of the bills remains an open question.
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RENEE MONTAGNE, host:
This is MORNING EDITION from NPR News. Good morning. I'm Renee Montagne.
STEVE INSKEEP, host:
And I'm Steve Inskeep. Even though the health care debate is partly about getting insurance to people who don't have it, much of the discussion focuses on people who by and large are already covered - America's senior citizens. Seniors have power and they're being courted as lawmakers move toward key votes on bills that would extend health insurance to millions of the uninsured. NPR's Julie Rovner reports.
JULIE ROVNER: While most seniors love their government-run Medicare coverage, there are some things they'd like to see improved. One of those things is the so-called doughnut hole. It's a quirk in Medicare's prescription drug benefit where drug coverage stops but seniors still have to pay their monthly premiums.
At a Capitol Hill news conference last week, AARP's Nancy LeaMond said it's a fairly widespread problem.
Ms. NANCY LEAMOND (AARP): In 17 states, over 30 percent of all Medicare recipients are in the doughnut hole. This is a big issue for us.
ROVNER: So buried in the health care overhaul bills are provisions to address that problem. And unlike many of the other benefits in the bill, said Florida Democrat Congressman Ron Klein, seniors won't have to wait.
Representative RON KLEIN (Democrat, Florida): We're making this happen right away, as early as January 1 of next year. And from day one seniors will see real relief. The doughnut hole will start to shrink and seniors who fall into it will immediately pay less for their medicine.
ROVNER: 50 percent less for brand-name medicines, to be specific. And over the next 10 years the doughnut hole will be closed completely. House Speaker Nancy Pelosi noted that's faster than was envisioned when the bills were first considered by House committees last summer.
Speaker NANCY PELOSI (Democrat, California): This is one of the improvements from the original bill to now. The bill was - the first bill was good. This is much better.
ROVNER: Filling in the Medicare drug benefits doughnut hole is just one of the sweeteners aimed at seniors. There's also free preventive services and the Senate Finance Committee bill includes the cost of annual physical for every Medicare patient. Currently the program only covers a single physical for first time enrollees.
Bob Blendon of the Harvard School of Public Health says it's no secret why Democrats are so anxious to court senior support for their health effort.
Mr. BOB BLENDON (Harvard School of Public Health): Seniors as a group are a swing vote between the parties. And in elections where the president is not running - off-year elections - they tend to turn out at much higher proportions than other age groups. And when it comes to voting, it turns out that health care is incredibly important to their vote, much more so than younger voters.
ROVNER: But at the moment, says Blendon, who specialize in public opinion on health care, most seniors have a more negative view of the health overhaul effort than other age groups. He says that's due in part to an all-out effort by Republicans to play up the fact that a significant portion of the bill would be financed by cutting payments to Medicare.
Democrats say those cuts are aimed at waste and unnecessary spending and won't affect benefits. But Republicans like David Dreier of California say that's not how their constituents see it.
Representative DAVID DREIER (Republican, California): They know and understand that a massive government takeover of health care is not the answer to our problem. In fact, it could exacerbate the problem, especially with the proposed Medicare cuts that will hurt our seniors.
ROVNER: But Blendon says at least part of the problem Democrats have with seniors is that they've simply done a bad sales job.
Mr. BLENDON: And all they hear about is that their care currently could deteriorate by very large cuts. And they're not at all seeing the potential benefits that the Congress has tried to provide in this legislation for them.
ROVNER: Which helps explain the stepped-up efforts by Democrats in recent weeks to try to publicize the new benefits for seniors. The question remains, though, whether it's too little, too late.
Julie Rovner, NPR News, Washington.
INSKEEP: We're glad you're following our health care coverage this morning on this public radio station, and as you check news headlines through the day at NPR.org you can also offer your own opinions on health care.
MONTAGNE: And in the other big health story we're following, government health officials say people should start having an easier time getting the vaccine for the H1N1 virus. More than 22 million doses are available now. There were just 14 million doses on hand last week. The shortage has upset millions of people across the country who were standing in lines to get the vaccine for hours. Transcript provided by NPR, Copyright National Public Radio.
