Author Archives for Herb Weiss

Kennedy Must Lead Fight Against Medicare HMO Rate Hikes

Published in The Pawtucket Times on November 19, 2001

Across the nation, seniors who have enrolled in Medicare HMOs are getting hit hard in the pocketbook.  Premiums and copays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County.  Now Blue Cross Blue Shield of Rhode Island (BCBS) informs its seniors that higher premiums and copays come next year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services, and more. The added out-of-pocket costs impacts about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying BlueCHiP’s request for a rate increases.

In a strongly worded letter Tom Scully, the administrator of the Centers for Medicare and Medicaid Services, the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBS are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBS spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospital and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds. “These co-pays have been the same for the last three years.”

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increase was given a thumbs up by the Feds.

Are BCBS’s rate increase actually sound thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be paid for in fee-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group. Believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable?”

“Consumers just don’t have access to that type of information, Zesk said.

With Medicare reform now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and Subcommittee on Labor, Health and Human Services and Education, to address the rising out-of-pocket healthcare costs for Medicare HMO enrollees. As the Congressional elections approach, seniors will want to see concrete congressional action leading to meaningful Medicare reforms.

Kennedy Must Lead Fight Against Medicare HMO rate Hikes

Published in the Pawtucket Times on November 19, 2001

Across the nation, seniors who enrolled in Medicare HMOs are getting hit hard in the pocket book. Premiums and co-pays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about the inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County. Now Blue Cross and Blue Shield of Rhode Island BCBSRI) informs its seniors that higher premiums and copays come net year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services and more.  The added out-of-project costs impact about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying  BlueCHiPs request for rate increases.

In a strongly worded letter to Tom Scully, the administrator of the Centers for Medicare and Medicaid Services (CMS), the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBSRI are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBSRI spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospitals and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds.  “These co-pays have been the same for the last three years,” he says.

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increases were given a thumbs up by the feds.

Are BCBSRI’s rate increases actually sound, thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be  paid for in fee-for-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group, believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable.”

“Consumers just don’t have access to that type of information,” Zesk said.

With Medicare reforms now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and the Subcommittee on Labor, Health and Human Services and Education to address the rising out-of-pocket health care costs for Medicare HMO enrollees.  As the Congressional elections approach, seniors will want to see concrete congressional action, leading to meaningful Medicare reform.

The Best of…Program Shows It’s Never Too Late to Become Artistic

            Published November 12, 2001, Pawtucket Times

 

           The painting of large colorful murals not only brightened up the lobby area, the main hall, and the lunchroom’s blank white walls but sparked the interest for art among seniors at Providence’s Westminster Senior Center.    

            Last week, the budding artists along with their admirers gathered in the Center’s 1,000 square foot basement to show off their artistic works (created with charcoal, pastels, colored pencils and acrylic paints), all produced during 20 art classes held over a 10 month period..  

           Providence  resident Natalie Austin, 69, a former legal secretary who now works part-time at the Westminister Senior Center as a receptionist, had little exposure to the arts.  Courses taken in elementary and high school, an art history course at Brown University, along with some attempts to paint her summer home in Maine,  summed up Natalie’s life experience in the arts in one sentence.

           Austin, a graduate of Brown University who rallied the seniors at the Center to support the offering of art lessons, knew that it would become a popular program.  While not wishing to replace the late Grandma Moses, an American painter who in her late 70s began to paint, Austin paints for her own pleasure and that of others, she says.

         One of Austin’s class assignments was to draw a picture with charcoal using the elements of Van Gogh’s  famous painting, “The Starry Night.”  The drawing of a bag and straw hat were done fairly fast,Austin admits, noting that the swirling lines and distinct outlines of the Van Gogh masterpiece are incorporated into her work.   

         Another class assignment, using a landscape painting drawn by Pierre Bonnard-Ford, taught Austin the proper way to mix and use colors.  Her colorful drawing, using blues and oranges, followed her instructors assignment of copying the French artist’s palette while painting another subject.   

         While pleased with the quality of the art work she has produced in the art classes,Austin quips, “There’s always room for improvement.  I am always competing with myself, trying to improve.”

         Meanwhile, other lessons are learned besides the technical skills of mixing paint or sharpening charcoal pencils.  “Art gives you  insight into what people are like,”Austin says, noting that it also reveals their values too.

         Professional artists Pierre Lamuniere-Ford, his wife Jenny Booth and Jen Iwasyk were able to develop this unique art program for seniors which included  the purchase art supplies, courtesy of a $5,000 grant from the state’s Department of Elderly Affairs.

         Much thought was put into creating the curriculum for each class, Lamuniere-Ford told All About Seniors.                  

        The instructors, all in their 30s, taught basic drawing techniques, from gesture to realistic drawing, along with color mixing to their older students.    

         “When classes began it was hard to get people to get past their self doubts that they could become artists,” Lamuniere-Ford said.  “We worked very hard to dislodge the myth that you are [born] immediately talented, he added..

         According to Lamuniere-Ford, his students learned that art should not always be viewed as a pretty picture. “Art can be disturbing  and not pretty to see,” he says, noting that it can reflect one’s soul or a person’s state of mind.     

         Additionally, the students were able to use art to help them learn more about each other.  More important, he says, “they became less critical of self and of others.”

         Executive Director Marianela Dougal, of the Westminster Senior Center, acknowledges that she is not an artist, but views herself as an art lover.  She believes that art classes at her Center provide seniors with an avenue to express themselves and to be creative, giving them an opportunity to gain a sense of well being.

         Adds Rachel Filinson, Ph.D., Coordinator of Gerontology Program at Rhode Island College,  research findings indicate that creativity extends into the later years.  “People who are artists their whole life continue to be very prolific in producing quality work as they did in their earlier years,” she says. 

         “Anything that is stimulating will promote both your mental and physical health,” adds Filinson.  

          Herb Weiss is a Pawtucket, Rhode Island-based writer covering aging, health care and medical issues. This article appeared in the November 12, 2001 issue of the Pawtucket Times. He can be reached at hweissri@aol.com.