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Town Hall Recap – 2021 Medicare Part D Satisfaction Survey

On Wednesday, September 15 we held a virtual town hall to review our yearly Part D Satisfaction Survey. We have been doing this survey for 14 years to give seniors across our nation the opportunity to tell us how they feel about Medicare’s prescription drug program. This year, with all the discussion about changing Part D by those who say the program isn’t working, it is especially important to skip over all of the rhetoric and let you, the beneficiary, tell us how you feel about Part D.

You can click here to see the 30-minute video of the virtual town hall. My goal in this blog is to give you the Reader’s Digest version of the Town Hall.

I started off the town hall by giving a short history of the birth of Part D and its subsequent performance. Part D passed Congress by a narrow margin in 2003 after much debate. The debate ranged from creating a single payer government run program, similar to the VA program, to setting up a voucher driven system where patients would use a voucher to buy a prescription drug plan in the commercial marketplace. A public/private partnership was the final program design. When the bill was being debated, the naysayers conjectured that:

  • There wouldn’t be enough competition and choices, especially in the rural areas.
  • Overall plan premiums would increase dramatically.
  • Seniors wouldn’t be able to wade through the complicated sign-up process or the yearly open enrollment.

Part D has proven these predictions to be wrong, today:

  • Montana, a very rural state, has 23 Part D plans to choose from.
  • Premiums have grown slower than the consumer price index; Part D costs are 40% less than predicted.
  • State and local “navigators” helped with initial sign-up and a continually improved website helps with the yearly enrollment.

Not many government programs have been this successful. 1 in 3 Medicare eligible veterans, who have their own prescription drug program, have chosen to sign-up for Part D. The Medicare Prescription Drug program has proven, over the last 15 years, to be very successful.

After my walk down memory lane I turned the time over to Caroline Bye, an Associate Vice President for Morning Consult, to go over the survey offering insights into the survey itself. Caroline leads survey research, advocacy and messaging strategy for multinational nonprofits, advocacy groups, and higher education institutions at Morning Consult.

Caroline began by explaining that the survey was limited to people 65 and over and had prescription coverage through Medicare Part D. The slide below details the three key findings from the survey. You can see Caroline’s entire slide deck here.

The first survey question was how seniors felt about their overall Medicare healthcare coverage. The satisfaction level again this year stayed above 90%. The next question asked the important question of how they felt about Medicare’s prescription drug program. As you can see in the graph below, the satisfaction level stayed strong at 87%. Caroline pointed out that this level of satisfaction was consistent across demographics, race, sex, party affiliation, etc. It is also interesting to note that those who are taking one or more prescription drugs had a higher satisfaction level than those who were not taking any prescriptions.

The survey revealed that over 90% of the seniors feel very fortunate to have a prescription drug program. The next questions were more detailed asking if they felt the program was convenient to use, the copays and/or coinsurance amounts on generic medicines were affordable, the monthly premium was affordable, and whether the plan works well and without hassle. The results were 91%, 86%, 84%, and 86% respectively.

Seniors, to the tune of 83%, thought it was important to have a variety of prescription plans to choose from, while 2/3 of the respondents strongly agree that their out-of-pocket costs would be higher without Medicare Part D. It is also important to note that 62% of seniors said their drug costs had not changed or had gone down over the last year. It’s not surprising that 90% of seniors would recommend Part D to their friends.

The survey asked some questions concerning policy proposals that have been put forth. Respondents were asked to rate their satisfaction with these proposed changes from 0 to 10 with 0 being not at all supportive. The graph below shows the percentage of people that gave the proposal the very low score of 0 or 1. In other words, the number shown is the percentage of respondents who did not want that proposed change implemented.

Remember, these are the percentage of people who gave these proposed changes a 0 to 1 score. There could have been many scores of 5 or lower. It is evident that when the proposed changes included increasing the federal government’s involvement or the possible result of these proposed changes were identified, the proposed changes weren’t as popular as some would have you believe.

The survey then asked the respondents to choose which of the following statements is closer to their own opinion, even if neither is exactly right?

  1. We should keep the current Medicare law so that the government is prohibited from deciding which drugs are available to seniors and people with disabilities, even if that means the cost of some medicines might not go down.
  2. We need to reform the current Medicare law so that the government can negotiate costs with drug companies, even if that means the government will decide which drugs are available to seniors and people with disabilities.

50% chose number 1, keep the current law, while 30% chose number 2, change the current law with 19% having no opinion. That’s a pretty positive vote for keeping the current law.

It is interesting to show the above results broken out in different demographics, as shown in the chart below. As you might guess, Republicans are more likely to want to keep the current law 65% to 19% against keeping the law than Democrats. But, even among the Democrats, 40% still want to keep the current law as opposed to the 39% that want to change.  

The final question presented a list of proposed changes and asked seniors how concerned they were with each change. Out of the 8 proposed changes, over 80% of the people were concerned with 6 of the changes with last two showing 76% and 61% of the people were concerned. Again, a vast majority of seniors are concerned with changing Part D.

Caroline turned the town hall over to Mary R. Grealy, president of the Healthcare Leadership Council, for her comments. Mary put the survey results into context of the present political environment. She pointed out that some in Congress want to move away from the fundamental design of Part D. She wondered if any of the members of Congress, who are proposing these changes, ever stopped to ask America’s seniors what they wanted? The survey showed that there is really no clamor for change among America’s seniors. Mary pointed out that the average Part D premium has stayed between $30 and $35 dollars for several years. Mary summarized her comments with the question, “if Part D is affordable and seniors are satisfied with it, what is the compelling reason for radical change”?

The town hall was then opened up for questions. The first question for Mary asked if she thought there were improvements in Part D that should be considered. Mary replied that there certainly were changes that would improve the program. She said that the proposal to limit out-of-pocket costs was a needed improvement. She also said that value-based negotiations between drug manufacturers and providers would be an ideal direction to take.

The next question was to Caroline asking how the satisfaction numbers compared year over year. She said that year-over-year the general satisfaction has remained very high.

The next question asked why we were seeing these calls for extreme changes in Part D?  Mary thought that the changes were based on a few medicines and anecdotal instances, rather than relying on a broad fact-based experience. The current method of negotiations has resulted in stable, affordable prices.

The next question asked what aspect of this survey jumped out as notable? Caroline indicated that in her work with big companies she has seen surveys that had high satisfaction ratings, like this one, but the willingness of seniors to promote and recommend Part D was unique. Mary indicated that she was impressed with the number of self-identified Democrats who didn’t want to change Part D. I interjected that the slightly lower numbers from last year reflect the white noise and rhetoric that is coming out of Washington, which seeks to confuse seniors. The survey shows that when seniors sit back and ask how Part D performs for them, they are really satisfied. While there are changes that can and should be made, seniors don’t want to make radical changes.

We encourage you to look at the slides that were presented. They are available here or you can watch the entire town hall here.

Best, Thair



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COVID Update – It Is a Life-or-Death Choice

As I looked forward to September, I thought this would be a good time to give an update on where we are in the quest to finally defeat this terrible pandemic. In the last few weeks, it has become abundantly clear that using the word defeat, at least in the short term, is not appropriate. The Delta variant has pushed many communities back into those critical times we experienced in the past when hospitals and caregivers were overwhelmed. There are, however, some big differences with this wave of COVID-19 infections.

The vast majority of new COVID infections are among the unvaccinated. According to MIT Medical you have a .0008 percent of dying from COVID-19 if you are vaccinated. The New York Times stated that vaccinated people take about the same risk with COVID-19 as they do when they venture out in their car. Getting vaccinated can certainly save your life. Also, there is a difference in the age of those getting sick. The age of those getting seriously ill from getting infected has dropped considerably, with children being much more vulnerable than they were early on in the pandemic. These differences have raised some important considerations.

According to most doctors and scientists, if the vast majority (over 80%) of the citizens of the U.S. would have rushed out and been vaccinated, the impact of the Delta variant would have been a fraction of its present infections. The increased infection rate has also raised the fear that the number of unvaccinated people getting infected will increase the chance of another mutation and possibly an even more dangerous variant. The obvious answer to these problems is for everyone to relent and go get vaccinated.

Some institutions, both private and public, have mandated that participants must be vaccinated. Many companies have declared that employees be vaccinated or have weekly COVID-19 tests. Many colleges have said that students must be vaccinated to attend class. Even some concert venues have required proof of vaccination to attend. President Biden, last week, announced some broad vaccination mandates in his effort to raise the percentage of vaccinated citizens. These mandates have triggered a considerable amount of push back from people who say that these mandates threaten their freedom of choice, and some say they go against the guaranteed freedoms in the U.S. Constitution. These mandates may have even threatened the progress they hoped to bolster. The chart below shows that after the final approval of the Pfizer-BioNTech the number of weekly vaccinations rose but in the last few weeks the number has dropped considerably.

These new developments have again served to divide us. Some say we should let the unvaccinated reap the results of their choice. This might be an easy out except for the fact that their choice is loading our healthcare system to the point that important surgeries and treatments for those who are vaccinated and uninfected are being delayed. Their choice also raises the possibility of the birth of a new variant that may threaten even those who are vaccinated. It is a complicated problem.

The real solution is clearly that we all need to get vaccinated. Almost 90% of those over 65 have been vaccinated and their infection rate is low. We have a fully approved vaccine and other emergency approved vaccines that have proven they can save lives. State governments have mandated that children must have certain vaccines to enter school for decades. These mandates have virtually eliminated some diseases and saved countless lives. Mandates are not a new thing. Now is not the time to suddenly push back against mandates and recommendations that can save lives. We need to appeal to those we know who haven’t been vaccinated that they should get vaccinated, if only to help their loved ones and friends. It is a choice that we all can live with.

Best, Thair

p.s. Don’t miss the chance to find out the results of the Medicare Part D survey by joining out virtual town hall. Register Here See details below.

Medicare Today Town Hall
Wednesday, September 15, 2021
2:00 p.m. ET
Guest Speakers
Thair Phillips
former President and CEO of RetireSafe
And
Caroline Bye
AVP of Advocacy and Government at Morning Consult
Register Here

After registering, you will receive a confirmation email containing
information on joining the Town Hall.

You can join on your computer without your camera or you can dial-in as
well – whatever works for you!



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Healthy Aging Month – Are We Supposed to Act Our Age?

It’s September which means it’s Healthy Aging Month. Last year at this time I wrote a great blog about this important month, it was witty and informative (at least I thought it was) and you can read it by clicking here. The same ten helpful points in last year’s blog are still relevant and I hope they give you some food for thought. This year I will offer some new ideas and thoughts on aging that may give you a new perspective on how you see yourself as you get older.

Full disclosure, I turned 73 a week ago and I still wonder how that happened. If I’ve heard it once, I’ve heard it a hundred times, “I woke up one morning and I was old.” While we didn’t get old overnight, our realization of being old probably came when we were surprised by someone’s comment or on a particular birthday. Maybe it was when you were stopped by a police officer who looked as old as one of your kids, or you were surprised in the exam room by a Doogie Houser look alike who claimed to be a doctor? Any of these events may have caused you to reflect on your age. Rather than letting these events get you depressed, think of this – the fact that you were surprised at how old you suddenly became is a very positive thing. You should celebrate that you were surprised at your age, that in your mind you weren’t that old. We can’t let someone else tell us how old we are. We can’t let some event establish our age. It’s our mind and our own picture of ourselves that should guide our perception of our age.

Now I’m not trying to convince you that you should be doing the things you did when you were 30. There is no denying the aches and pains that come when you get older. What I am saying is . . . don’t let the aches and pains keep you from trying new things or finding ways to keep moving and pushing the envelope of your present physical abilities. For instance, I remember when I had to give up playing tennis. My knees and hips just didn’t allow the movement necessary to be competitive and have fun. Then along comes someone’s great idea of pickleball. Maybe you’ve heard of it; it’s a cross between ping pong, tennis, and badminton. It allows someone to be active and be competitive at a sport without requiring the running and movement required in tennis. My friend who’s a year older than I am plays it every day. It keeps him in great shape. He’s going to teach me how to play.

Find something that gets you out and moving; golf has done that for me. Golf often occupies my mind when I’m not actually playing it. I’m thinking of things I can try to improve my game. It’s my happy place where I go when things around me are trying to depress me. Find the activity that motivates you to do better and becomes your happy place.

My point here echoes the first point of my 10-point list from last year – don’t act your age. Much to many people’s amazement, older Americans were not the age group that suffered the most mental problems during the pandemic. Our age group bore the brunt of the deaths, yet, somehow, we held up and soldiered on. We are a strong group; we’ve done hard things during our lives, and we are still strong enough to do more hard things. Don’t let anyone or anything dictate how old you should act.

Best, Thair

p.s. Don’t miss the chance to find out the results of the Medicare Part D survey by joining out virtual town hall. See details below.

Medicare Today Town Hall
Wednesday, September 15, 2021
2:00 p.m. ET
Guest Speakers
Thair Phillips
former President and CEO of RetireSafe
And
Caroline Bye
AVP of Advocacy and Government at Morning Consult

They will discuss: The results of the annual Part D Satisfaction Survey
Register Here

After registering, you will receive a confirmation email containing
information on joining the Town Hall.

You can join on your computer without your camera or you can dial-in as
well – whatever works for you!



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You Spoke! The 2021 Senior Satisfaction Survey

Once again, we gave seniors the opportunity to tell us how they feel about Medicare Part D, Medicare’s prescription drug program. This survey was the 15th year that we’ve asked seniors how the feel about Part D. We do this because it is important to break through all of the rhetoric and posturing that is taking place concerning this vital program. Many politicians think we need to change the program, dictate drug prices, set prices based on those in foreign countries, import drugs from other countries, etc. They are focused on “fixing” Medicare Part D when I’m not sure they have any idea whether those who use the program think it needs to be fixed. We do this survey each year because we want you to have a voice.

I may be revealing how old I am, but I was involved with senior organizations and public policy before Part D was passed in 2003 and implemented in 2006. I know that before Part D, when seniors were responsible for the full cost of their prescription drugs, the financial uncertainty of these costs was deeply troubling and was a constant worry. Most people don’t know that many in Washington were against the program as it was being debated. They thought that there wouldn’t be enough plans competing in each state, especially in rural states. They thought it would be too complicated for seniors to understand. They though that premiums would spiral out-of-control. They thought that seniors would be unhappy. It was a close vote, but it passed.

So, what has happened over the last 15 years? There are many Part D plans to choose from in each state. In Montana, one of our most rural states, there are 23 different plans. With the help of state aids, pharmacists, automation, information from HHS, and the resourcefulness and self-reliance of seniors, they continue to choose the plans that fit them best. The premiums have been 30% lower than were estimated during the debate 15 years ago. These are the indicators of a successful program and seniors have agreed since the program’s inception.

For instance, in 2007, 86% of the respondents said they were very positive or somewhat positive about Part D. In our 2021 survey 87% said they were satisfied with their Part D coverage. We asked a variety of questions in our survey, covering senior’s feelings about things like out-of-pocket costs and their opinions about the changes that are being proposed. There are a lot of interesting facts that have come out of this year’s survey, too many to go into here. Luckily, we have scheduled a virtual town hall on September 15th to discuss the survey in more detail. We hope you can join us. You can click here to register for the town hall. Detailed information about the town hall is below.

I always want you to be the voice I listen to. How well Medicare is serving you is what’s important. I think that sometimes those in Washington forget who eventually pays the bills and who the real customers are. Our yearly survey is one way we try to let you speak out. Join us on the 15th.

Thanks, Thair

Medicare Today Town Hall
Wednesday, September 15, 2021, 2:00 p.m. ET

Guest Speakers
Thair Phillips, former President and CEO of RetireSafe
And
Caroline Bye, AVP of Advocacy and Government at Morning Consult

They will discuss:
The results of the annual Part D Satisfaction Survey
Register Here

After registering, you will receive a confirmation email containing
information on joining the Town Hall. You can join on your computer without your camera and you can dial-in as well – whatever works for you!



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Turbulent Times Ahead

As the summer draws to a close, the citizens of this great nation face a dangerous time, the return of the politicians to Washington after the August recess. All of those who represent us think that they must take action, fix something, change things. It never crosses their mind that leaving things that are working alone might be a valid approach. Medicare, especially Part D, the prescription drug benefit, is something that has been working better than expected. Over the years, it has enjoyed a continued vote of confidence from seniors (we’ll talk about the latest Part D satisfaction poll next month). Washington needs to consider the old adage, “if it aint broke, don’t fix it.” Nevertheless, there is a strong possibility that Congress and/or the President will be predisposed to making changes in Medicare and Part D.

There are two bills that will be at the top of the priority list when Congress returns, the bipartisan infrastructure bill and the 3.5 trillion dollar social policy bill that the Democrats can pass with a simple majority using budget rules. The infrastructure bill, as drafted, does not include substantive changes to Medicare. The bipartisan nature of the bill kept it focused on infrastructure issues. The other bill, often called the reconciliation bill, will most likely contain many proposed changes to Part D. The President has already given the Department of Health and Human Services and Congress some strong guidance on what he wants in the reconciliation bill. He said that he wanted three changes: the first two would allow the Government to set prices on prescription drugs – the so-called negotiation option and the ability to charge penalties if drug prices are raised higher than inflation. The third change would set a cap on the yearly out-of-pocket prescription drug charges for Medicare beneficiaries.

When anyone proposes changes to Part D I always look at how it affects the beneficiaries. . . how does it affect what I pay and my access to medications? There is no guarantee that having the government controlling drug prices will result in any savings for you and me. Drug manufacturers may make less and Medicare may pay less but the convoluted pricing and supply structure may limit any savings from getting down to the patient. The third proposed change, the out-of-pocket cap, is the only change that will benefit the patient. I’ve discussed how important this change would be for those who are saddled with unrestrained out-of-pocket costs. It would correct the problem of requiring the sickest amongst us to bear the burden of huge costs.

I expect there will be a huge amount of pressure to include changes to Medicare in the social policy bill. As you might expect, I have some thoughts that I hope Congress and the President would consider.

First, President Biden has already threatened to use Executive Orders (EO) to accomplish some of the proposed changes. It was wrong when President Trump did it and it’s wrong if President Biden does it. Presidential fiat is not the way we deserve to be governed. There are constitutional checks and balances that are the basis of how changes are made. Circumnavigating these checks and balances is not the way to make changes. These EOs are almost always subject to legal challenges. They are also subject to being rescinded by the next President, as President Biden has already done to some of President Trump’s EOs.

Second, it just doesn’t seem right to use money supposedly “saved” from Medicare costs to fund other initiatives. Medicare is not an ATM to be used to fund other parts of the government.

Third, the pandemic has caused a great deal of chaos in the supply chain for prescription drugs, coupled with President Trump’s Executive Orders and then President Biden’s withdrawal of some of those Orders, the drug manufacturers have found it difficult to keep the research and development and the manufacturing processes efficient. Throwing more change into this system is a prescription for shortages.

Fourth, is now the time we want to insert the government deeper into our healthcare? American’s trust in our government’s ability to advise us on healthcare is at an all-time low. It seems that there is more and more distrust in the accuracy and motivation of the guidance coming from Federal institutions. Somehow, our leaders need to work to regain this trust. Changing a part of our healthcare that produced a life saving vaccine in record time is not the way to accomplish this difficult task.

Fifth, the drug manufacturers and the insurance companies have already indicated their willingness to sit down and talk about improvements that can be made. There are bad players and bad rules and regulations that need to be dealt with. This seems to be a logical way forward.

As you can see there is a lot to consider in the months ahead. We’re at a critical crossroads. I ask that you pay attention as those in Washington consider these important changes to our healthcare. Don’t hesitate to tell them how you feel about these changes. The one thing that everyone in Washington cares about is your vote. Know where your Senators and Representative stand on these changes and don’t hesitate to tell them how you feel.

Best, Thair



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A pop quiz with a reward

I know, you think the lead-in to this blog is a cheap trick to get you to take a stupid quiz with the promise of a reward, that turns out to be a free 30-day trial for something you don’t need. Well, you’re wrong, this quiz concerns your knowledge of Medicare and some of the rules that may well affect your pocketbook. The reward is . . . I’ll give you the answers to the quiz at the end and you’ll be rewarded with some information that hopefully will help you stay healthy and may even save you some money. Some of the questions are multiple choice; others will force you to come up with the right answer without having a choice. So, here we go, good luck!

  1. What is the difference between Medicare and Medicare Advantage plans?
  2. What is the difference between Medicare and Medicaid?
  3. What Part of Medicare covers prescription drugs?
    a. Part D
    b. Part C
    c. Part B
    d. Part A
  4. When is Medicare Part D open enrollment?
  5. Is there a yearly out-of-pocket spending cap on Part D?
  6. This is the very important and more difficult bonus question –

 What is the difference between a co-pay and co-insurance?

The answers are below.

Answer to 1 – Medicare and Medicare Advantage are two different ways that the Medicare benefit is administered. Medicare (also known as Medicare Fee For Service (FFS)) provides beneficiaries 65 and over with healthcare and is paid directly by the government. Medicare Advantage, often called Medicare Part C, is administered and controlled by a private health insurance company which is paid a fixed amount per beneficiary. Most seniors in America have the option to choose between standard Medicare and Medicare Advantage. Most seniors now choose to participate in Medicare Advantage instead of Medicare FFS as they become eligible because it offers additional benefits and predictability in costs. Many seniors who opt for standard Medicare also choose Medicare supplemental insurance that offers lower out-of-pocket costs and expanded benefits but costs extra money. It is worth taking the time, and seeking help when needed, to make the correct choice for your particular health requirements and the different plans offered in your area.

Answer to 2 – As explained in question 1, Medicare is the benefit offered to those turning 65. Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.

Answer to 3 – Part D is Medicare’s prescription drug program. It was not part of the original Medicare benefit that was signed into law in 1965. Part D was signed into law in 2003 and began offering coverage in 2006.

Answer to 4 – You can change your Part D prescription drug insurance plan every year during the open enrollment period from October 15 to December 7 for the following year. When you turn 65 you need to apply for Medicare Part D sometime between the three months before the month in which you turn 65 until three months after if you aren’t covered by private prescription drug insurance. If you delay signing up for Part D, you will be charged a 1% higher premium for each year you delay. This is a lifetime penalty, so it is important to understand and follow the Part D enrollment rules.

Answer to 5 – Some Medicare Advantage plans have a yearly out-of-pocket cap on prescription drug costs. Regular Medicare does not have a yearly cap on out-of-pocket costs for prescription drugs. One of the changes to Medicare that has been discussed lately is putting a yearly cap on these Part D out-of-pocket costs. As I’ve discussed in earlier blogs, this is a great idea and one I feel seniors throughout America should be urging their representatives in Washington to implement.

Answer to 6 – This bonus question deals with a nuance in healthcare insurance that most people don’t understand but can have a big impact on your out-of-pocket costs.

A co-pay is the amount you may have to pay every time you go to a doctor or the amount you may have to pay when you have some sort of test performed or when you have a prescription filled. It is a fixed amount and is detailed in the Medicare benefit explanations, Medicare supplemental insurance guides or Medicare Advantage plan explanations. These co-pays should be part of your consideration as you choose which plan works best for you. The good part of co-pays is that they remain the same and are not impacted by the amount of the procedure or prescription drug cost. The cost may be more for a visit to a specialist or if the prescription is a generic or a brand name drug, but they will be fixed and will be documented in the plans guidelines.

Co-insurance is an out-of-pocket cost that may be charged every time you use a healthcare service. The difference between co-insurance and a co-pay is that the out-of-pocket cost for co-insurance is calculated as a percentage of the cost of the healthcare goods or service provided. If your co-insurance is 15% then you must pay 15% of the cost of the procedure, test, office visit or prescription drug. This cost is not fixed and could run into large out-of-pocket costs depending on the cost of the goods or service provided. The differences between co-insurance and co-pays need to be understood as you consider different options under Medicare.

I hope you did well on this little pop quiz. More importantly I hope you learned some things that might help you choose the best healthcare for your situation and maybe even save you some money.

Best, Thair



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Summertime and the Living is Easy – – – Maybe

We’re in the dog days of summer and I’m sure we all were thinking this summer we could get back to living easy. Well, because of the COVID-19 Delta variant we are still most definitely feeling uneasy. Well, let’s erase all those worries for a moment and think about ways we can enjoy summer by eating right, keeping ourselves in good health and taking advantage of activities that keep us moving.

First, a little factoid you can use to impress your friends. The dog days of summer have nothing to do with dogs; it recognizes the rising of the star Sirius, often called the dog star, which ancient people linked with heat, drought, lethargy, fever and bad luck.

Now, let’s talk about some activities you may not have taken advantage of but are great ways to combat the dog days, especially that lethargy part.

Many seniors have found that swimming is a great way to exercise without the pounding that running or other exercises give to your lower body. I started a couple of years ago and had to stop due to COVID-19. Maybe that has also happened to you. I found out that when I transferred to Medicare Advantage, I got free membership at a local pool, and I’ve signed up. Check your insurance to see if they offer some free benefits like this. I do know that when I first signed up two years ago the price was really reasonable.

Another fun thing I’ve discovered is electric bikes. My wife and I bought regular bikes a few years ago and we discovered that riding was difficult because our riding speeds were much different. Many of our friends have bought electric bikes (the price continues to drop as more and more people buy them) and they have told me how great they were. They evened out the speed differences and it lets you exercise at whatever level fits you best. The electric bikes also allow you to get out for some long rides. Many electric bikes have a 50 mile or more range. We just bought some and they are proving to be a great way to get out and get moving.

Eating right takes some effort. My son is introducing us to “clean eating” and the keto diet. My wife is following it much more closely than I am, but I can really taste the difference in clean foods. Good and healthy summer recipes may be just the cure for that same food rut we may have gotten into during the pandemic.

The Taste of Home website has a whole bunch of great summer recipes. One that caught my eye was Rosemary Salmon and Veggies.  Go to Recipe.

Another great place for good recipes is the WebMD website. The lemon dill chicken caught the attention of my tastebuds. Go to Recipe.

I always have to give you a link to a CDC website that gives us hints on how to have a healthy and safe summer. You’ve probably heard most of them at a bunch of different places but here they all are in one place.

Now that you are exercising and eating healthy, let me break the dog day spell and return us to the reality of the times. We need to respond to the pleas of everyone around us and get vaccinated for COVID-19. I assume almost all of you have been vaccinated (around 80% of Americans over 65 have been vaccinated so far) so I’m asking you to talk with those friends and relatives you know that haven’t been vaccinated. Listen to them, really listen to them. Listen and empathize with their feelings and fears. Find some things you can agree upon, i.e., we all want people around us to be safe. Spouting a bunch of facts often is counterproductive; they’ve heard all of those before. It’s the fear and distrust that we need to recognize. We’ve all had illogical fears that scared us no matter what others have said. Telling the unvaccinated about your experience and how you felt when you got vaccinated is a good way to help them understand your feelings. COVID-19 has ruined a lot of things over the last year and a half, don’t let it ruin a friendship over getting vaccinated. Just let them know that you’re their friend and you just want them to be healthy and safe.

Stay cool, healthy, and safe and continue to have a great summer.

Thair



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Vaccines – A Different Focus

Over the last year and a half, we all spent a huge amount of time hearing, reading, and watching TV or media about vaccines. We became experts on viruses and how they spread. Most of us complied with the guidance when COVID-19 first hit, we hunkered down, wore masks and, while seniors initially bore the brunt of COVID deaths, a lot of us made it through. We got vaccinated and we were told that finally we didn’t have to wear masks, we could see our kids and grandkids, and even sit down and eat inside a restaurant . . . and then the Delta variant threw us a curve. Once again, we find ourselves wading through voluminous amounts of information, talking to those we trust and deciding how to respond to this new threat. Now, you might think I’m going to begin a long and drawn-out discussion about how to react to this new challenge but you’re wrong, at least mostly. As the title suggests, I’ve decided to focus on a different aspect of vaccinations.

Over the last year and a half, we have been laser focused on COVID-19. This focus, along with the fear of venturing out, even to see our doctor, has caused another health problem that we desperately need to recognize and react to. I’m talking about all the other periodic vaccinations that we may have canceled or postponed, vaccinations that we really need to keep us healthy.

While the flu was virtually nonexistent for the 2020/2021 season, due to our mask wearing and our social distancing, pneumonia was not so lucky. According to CDC statistics from 2017 through 2020 the average number of weekly deaths due to pneumonia was 4,434. I used the first week of January of each year since that seemed to be the height of the flu and pneumonia season. What surprised me was the number of deaths for the first week of January in 2021 (the depth of the pandemic), 16,852 died of pneumonia. I was taken back by this huge increase in pneumonia deaths. Now I don’t know all the reasons for this sudden increase, but I do know that many older people I’ve talked with have put off going to the doctor to get their periodic vaccinations.

Most of the medicine we take is to treat a disease or health issue are for illnesses we already have. The magic of many vaccines is they keep us from getting sick. There are a precious few medicines that can cure a disease. What a gift it is to have access to disease preventing vaccines. We need to refocus on taking advantage of these marvelous discoveries.

I was lucky enough a few weeks ago to be selected to give oral comments to the Advisory Committee on Immunization Practices (ACIP). These are a group of experts that advise our government healthcare leaders on what immunization guidelines should be followed by our healthcare providers. I focused on encouraging them to include recently approved vaccines for pneumonia in their recommendations. My goal then, and my goal now, is to ensure you have access to all the preventative vaccines available and to encourage you to get your required vaccines.

I would be remiss if I didn’t plead with you to get vaccinated immediately for COVID-19 if you haven’t already. According to Axios.com, if you’ve been vaccinated for COVID-19, you have less than a 0.1% of testing positive for COVID-19 and all of its variants. If you know someone who hasn’t been vaccinated, listen to them, listen to why they haven’t chosen to be vaccinated. Tell them how liberated you felt when you got vaccinated.

This month is National Immunization Month. It is an ideal time to make an appointment with your doctor to discuss what vaccinations you need going into the fall flu and pneumonia season. Tell your friends how important it is to get vaccinated. The best defense against all of the viruses out there and the other health problems you may have is to protect yourself from those ailments that are preventable.

Best, Thair



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I Can See Clearly Now

This month is Healthy Vision Month. . . now maybe the blog title makes sense. I’ve talked in earlier blogs about different special days, weeks and months that emphasize different diseases or ways to stay healthy. Each of these may or may not have struck a chord with you but I think having healthy vision is important to virtually all older Americans. One study indicated that 92% of those over 65 wear glasses or contacts and, an astounding 1 in 3 have some sort of vision impairing eye disease. Our eyes and their health should be important to all of us.

Before I jump into information and sources we can use to keep our eyes healthy I’d like to talk about something I’ve observed. My mother had macular degeneration in both eyes and her eyesight deteriorated as she became older. Things became very blurry except for some of her peripheral vision. I noticed this poor eyesight made her somewhat disconnected in large gatherings. She found it difficult to connect with people she couldn’t see. She seemed to withdraw and not participate. She loved to read and when she lost that ability she tried listening to audio books but her mind wandered such that it made it difficult for her to stay focused. Her quality of life declined. Seeing this happen to my mother has motivated me to pay special attention to my eyes. I hope it also motivates you.

There are a lot of resources you can access to maintain your healthy vision. Getting older increases your risk of some eye diseases. You might also have a higher risk of some eye diseases if you:

  • Are overweight or obese.
  • Have a family history of eye disease.
  • Are African American, Hispanic, or Native American.

Other health conditions, like diabetes or high blood pressure, can also increase your risk of some eye diseases. For example, people with diabetes are at risk for diabetic retinopathy — an eye condition that can cause vision loss and blindness.

If you’re worried you might be at risk for some eye diseases, talk to your doctor. You may be able to take steps to lower your risk.

Know your family’s health history. Talk with your family members to find out if they’ve had any eye problems. Some eye diseases and conditions run in families, like age-related macular degeneration or glaucoma. Be sure to tell your eye doctor if any eye diseases run in your family.

It is important to get a dilated eye exam every one to two years. It is the single best way and often the only way to discover many eye diseases. Go here to learn more about a dilated eye exam.

Here are 8 things you can do to maintain your healthy vision.

1. Find an eye doctor you trust.

2. Ask how often you need a dilated eye exam.

3. Add more movement to your day.

4. Get your family talking… about eye health history!

5. Step up your healthy eating game.

6. Make a habit of wearing your sunglasses — even on cloudy days. 

7. Stay on top of long-term health conditions — like diabetes and high blood pressure.

8. If you smoke, make a quit plan.

Go here to find out more about these 8 steps to healthy vision.

We all know that Medicare doesn’t cover most aspects of eye care. There are some efforts to add vision coverage to the Medicare benefits but until then it comes out of our own pockets. If you are having trouble affording eye care, there are programs available to help you pay for it. One program is EyeCare America. They have helped millions get the eye care they need. You can go here to find out about this beneficial program.

As we begin to return to normal this summer let’s strive to take care of our eyes so that we can see every detail of our grandchild’s smile.

Best,
Thair



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Lowering Drug Prices – Two Different Approaches

Last week Senator Wyden, the Democratic Chairman of the Senate Finance Committee, and Senator Crapo, the Republican Ranking Member of the same Committee each released their solutions to lowering drug prices.

Senator Wyden’s letter proposed the following five basic principles (the three page paper can be found here).

  1. Medicare must have the authority to negotiate with pharmaceutical companies, especially when competition and market practices are not keeping prices in check.
  2. American consumers must pay less at the pharmacy counter.
  3. Prices of drugs that increase faster than inflation will not be subsidized by patients and taxpayers.
  4. Drug pricing reforms that keep prices and patient costs in check should extend beyond Medicare to all Americans, including those covered by employer and commercial health plans.
  5. Drug pricing reforms should reward scientific innovation, not patent games.

The letter’s singular author was Senator Wyden and was a stark departure from Senator Wyden’s and Senator Grassley’s bipartisan plan they proposed last year. Senator Grassley disagreed with the principles released last week and dismissed the approach as an effort to placate the progressive side of his party.

The short three-page document consisted of a series of broad statements that could morph into a menagerie of different regulations and controls. It uses the word fair without defining who would define “fair.” Who would decide when prices were not in check? How would a patient’s out-of-pocket costs be lowered? How would you extend these regulations and controls into employer and commercial health plans without changing the basic ways these markets function today? The letter generated many questions with answers that could have a huge negative impact on, not only the healthcare of older Americans, but the healthcare of all Americans.

Senator Crapo also put forth his solution to drug prices last week, the “Lower Costs, More Cures Act” (LCMCA) (you can find a section by section break down of the legislation here). This legislation was introduced last year with nine cosponsors. It is a detailed, free market solution that encourages innovation. The Lower Costs, More Cures Act, among other things, would:

  • Modernize payments for drugs delivered in the doctor’s office under Medicare Part B.
  • Incentivize lower-cost alternatives, or biosimilars.
  • Establish an annual out-of-pocket cap of $3,100 for Medicare Part D enrollees and allow certain patients to pay in monthly installments.
  • Decrease beneficiary cost sharing from 25 percent to 15 percent of costs before the out-of-pocket cap is reached.
  • Allow prescription drug plan sponsors to offer, at minimum, up to four Part D plans per region, spurring competition and innovation.
  • Make permanent the Center for Medicare and Medicaid Innovation model that enables Part D enrollees taking insulin to limit out-of-pocket costs to $35.
  • Allow state Medicaid programs to enter into outcomes-based agreements to pay for life-saving gene therapy treatments.
  • Provide the HHS Secretary with the authority to require drug manufacturers to provide pricing information on all direct-to-consumer advertising.
  • Codify a Trump Administration regulatory action that classifies insulin and other treatments for chronic conditions as preventative care so that high deductible health plans can cover costs before the patient reaches the deductible.
  • Create a trade negotiator solely dedicated to putting American patients first in government trade negotiations related to medicines in order to prevent foreign “free-loading” off America’s investment.

As you have probably figured out, I prefer the second solution. It has the detail required for real solutions. It details ways that this legislation will lower a patient’s out-of-pocket costs while encouraging the continuance of our country’s, best in world, innovation. It focuses on the patient. The Lower Costs, More Cures Act is not perfect, but it offers the basis for real-world solutions.

It is interesting to contrast these two plans offered by the Democratic and Republican leaders of the Senate Finance Committee. I’m convinced that as we move forward this year there will be many more drug pricing proposals. I will work to keep you informed and alert you to any needed action required to either promote those solutions that help the patient or defeat those proposals that hurt our access to healthcare or stifle innovation.

Best, Thair