Older Utahns say health care debate grows more confusing
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Wayne Hardy says the health care reform debate gives him a headache. Dorothy Marzolf admits she doesn't really understand it.

And the morning after President Obama tried to reassure older Americans that his health care reform plan will improve Medicare, Lynn Marsh was still doubtful change is possible, because of partisan bickering.

"I think it is really going to become a problem," said Marsh, 80, of Taylorsville.

These Utahns are not alone.

Senior citizens are the group most likely to report they are confused about the various proposals and how the plans might affect their Medicare health care coverage, according to the Kaiser Family Foundation.

But here is one myth senior citizens can lay to rest: No proposal calls for rationing health care for older Americans.

"It is a lie, plain and simple," Obama said to much applause during Wednesday's health care speech before Congress.

What some bills, sponsored by both Republicans and Democrats, do promote is end-of-life care planning -- that is, discussions between physicians, patients and their families about the kind of care they want to receive when faced with a terminal illness.

"It is such a far cry from what people are implying with death panels, it is a horrible, abuse tactic," said Rob Ence, AARP Utah state director.

Still, many older Americans fear reform will negatively affect Medicare. Obama's message to them: Absolutely not.

"More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years," he said, calling the program a "sacred trust" passed from generation to generation.

"If you are among the hundreds of millions of Americans who already have health insurance through your job, or Medicare, or Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have," Obama said.

That is just fine with Hardy, a 68-year-old retired railroader in Milford.

"I am quite comfortable with the way they have it right now," said Hardy, who has Medicare and a supplemental insurance plan provided by his former employer.

Like Marsh, Hardy said the rancorous debate troubles him.

"You don't know who's right and who's wrong," said Marsh, who was at a volleyball game and did not listen to Obama's speech. "We're all Americans and we should try and work something out that way."

Obama echoed his frustration with the bickering that has taken over the health care reform effort and distorted his plan for Medicare.

What Obama said he is promising are changes to Medicare that eliminate billions spent in waste, fraud and unwarranted subsidies to insurance companies.

Kaiser estimates that provisions in H.R. 3200, the House health care reform proposal, would result in savings of $538.5 billion to Medicare over 10 years.

Among those cost-saving proposals: expanding preventive services, increasing oversight of billing procedures, offering incentives to new primary care providers and reducing payments to hospitals for preventable readmissions.

"AARP is not going to support anything that cuts benefits but we believe, as most people do, that there are things in the Medicare system that can be cut to save costs," Ence said. "Specifically, too many procedures are done that don't add to the quality of outcome for a patient."

AARP wants Congress to provide a plan that gives access to insurance for its members ages 50 to 64 who currently have no health coverage.

And Ence said the amounts paid to providers who see patients under private Medicare Advantage plans needs to be aligned with traditional Medicare, which would result in a huge cost savings -- and is addressed in several proposals.

Some proposals would achieve savings by requiring couples with high incomes ($170,000 a year, for example) to pay more for their Medicare coverage.

Obama's plan also would close the gap in prescription drug coverage that now forces many seniors to spend thousands on medication.

That coverage gap is a concern to both Marsh and Marzolf, who lives in Salt Lake County.

"I volunteer at a food pantry and we see a lot of people who come in with a prescription they can't afford," said Marzolf, 79.

She has experienced problems with her own prescription plan, too. One of her blood pressure medications wasn't covered by her plan, so the insurer gave her a different drug that now costs her $85 a month.

"It is wrong for insurance companies to tell us what medications we can and can't take," Marzolf said. "I think health care shouldn't be a luxury, it is a necessity. It should be available to everybody."

Marsh, who sells supplemental and prescription drug Medicare plans, said the drug coverage gap "is really hurting people. The people who really need the help aren't getting it."

Senior citizens with incomes just above the poverty threshold are "paying out a lot," he said. Among them: A friend who is diabetic.

After getting two prescriptions filled, the friend falls in the gap for the rest of the year and pays out-of-pocket -- $1,053 for a three-month supply of insulin.

"I really believe the help for the seniors needs to be in the prescription plan," Marsh said.

Ence said that, as Obama stressed in his speech Wednesday night, the current health care system is unsustainable.

"We can't continue on the same track," he said. "The things that we are supporting we believe will strengthen and streamline Medicare, allow them to buy drugs in the donut hole. Long-term care will start to be addressed, which it is not right now.

"Medicare will be insolvent in a few years if costs aren't curtailed and processes changed."

brooke@sltrib.com