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A Questionable Way to Change Medicare

With so many significant changes to the Medicare program being discussed right now, I thought it would be a good idea to take a step back and examine the way changes in Medicare policy get made. It would be good to understand, for example, what tools are used to make it possible for any president’s administration to unilaterally change the program.

As you know, there is a defined process that allows our government to spend money and to change programs that have been legislated into law. A tool that presidents are using more frequently to get around these conventional processes involves the Center for Medicare and Medicaid Innovation (CMMI).

CMMI was created within the Affordable Care Act (Obamacare) as a testing ground for new ways to implement and pay for healthcare in our country. It was a great idea, have providers or payers or academia propose new ways to increase the efficiency and lower the cost of healthcare. Let them get a small number of representative healthcare providers signed up and test a new concept outside of current regulations and restrictions. If there is a positive result from the small test, then the changes to the existing laws can be proposed and the normal legislative processes are followed to implement the changes. What a great idea, test ideas to find the best way to administer healthcare before you change the existing laws. Unfortunately, this great idea began to be used instead as a way to circumvent the usual process and change Medicare policy, by both the Obama and the Trump administrations.

This misuse began with the administration proposing ideas directly to the CMMI that were so large in scale they were similar to an actual policy change. These proposed tests were not limited; they were designed to include virtually all the providers in America. And the test mandated participation, no provider could opt out. There is no legislative input and no judicial review. This is not how the CMMI has usually done business, it ignores the checks and balances that historically have been part of the CMMI process. Whether you believe the changes proposed by a president are good or not, this is not the way we should be changing programs that have been voted into law by the legislative process.

Misusing designed testing programs is not limited to the CMMI. The $200 card that the President proposed to send to 33 million Medicare beneficiaries to help pay for prescription drugs uses a program in the Social Security Act that allows Medicare to test out new money saving programs. These tests are usually proposed by state governments, Congress or the private sector and go through a rigorous, methodical approval process. Again, it isn’t for implementing a payment to 33 million Americans within a few weeks. This program is primarily for saving money so it must be at least budget neutral. The proposed source of funds to offset the cost of this $6.6 billion program is the savings from the “most favored nation” Executive Order, a program that hasn’t been implemented and any proposed savings are suspect. This onetime payment does nothing to lower the long-term costs of our healthcare. A yearly cap on the out-of-pocket payments on Medicare Part D would be a much more effective long-term solution to those who really need help with the tens of thousands they pay each year for their prescription drugs.

Somehow, we must put safeguards around these various testing programs. They should be transparent, have continued congressional oversight, have clear goals and published updates, be available to testify at congressional hearings, and have committee hearings before a rule is finalized. Unilaterally changing Medicare is not the way we should be operating. The checks and balances inherent in our government have worked for over 200 years. As you communicate with those who represent you, either directly or through your vote, remember how important it is to make sure that any changes to Medicare go through the same approval process that brought us this great benefit.

Get your flu shot and stay healthy, Thair



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The President Releases a Hurtful and Ill-timed Executive Order

As we all feared the President released an Executive Order (EO) last week that imports foreign drug pricing, an ill-advised and shortsighted method to lower drug costs. This EO is even worse than the proposed order that was released in July in that it also includes Medicare Part D drugs. It expanded from targeting drugs administered at the hospital or doctor’s office to those Part D prescriptions you get at your local pharmacy. This is a dangerous escalation.

This EO uses the term favored nation as a way to identify the foreign nations used for setting American drug prices. What it really does is import the socialistic, government dictated, access-controlled, pricing schemes of these so called “favored nations”, nations we have historically condemned for these very practices. I have said it before and will say it again, price controls don’t work, no matter what foreign country we seek to emulate.

It amazes me that the President has decided to release this innovation-limiting EO at the very time that we need all the innovation we can get to battle the COVID-19 pandemic. Even worse, it will depress innovation long term, meaning the new cures and vaccines we will need for the next pandemic-causing virus may not be available when we need them.

I don’t like the fact that Americans have been footing most of the bill for innovation but there are many other tools that can be used to accomplish this goal. This hurtful and ill-timed EO capitulates to the heavy-handed schemes used by foreign countries rather than using other tools, like proven free market policies and trade agreements, to level the playing field.

I’m asking you to speak out. Use whatever communication method you feel most comfortable with to tell your Senators and your Representative that this Executive Order is ill-timed and hurtful to older Americans. I like the fact that America is the center for new drug discovery, and we are often the first to get access to these lifesaving and life changing treatments. This Executive Order threatens the very foundation of this innovation that has changed our lives. Washington needs to know now how you feel. I urge you to make your voices heard.

Thair



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Upcoming Webinar/Tele Town Hall

Latest Survey Results, Medicare Part D, Prescription Drug Program
This Wednesday, September 16th, at 4:00 p.m. ET, Medicare Today’s Seniors Speak Out will conduct another webinar town hall. This virtual town hall will discuss the results of our yearly survey on Part D, the Medicare prescription drug program. We have always thought it was important, through a survey each year, to take the pulse of seniors concerning their feelings about Part D, a program that continues to have a huge impact on the wellbeing of older Americans.

Those of us that were around in 2002 and 2003, when this new program was hotly debated, remember the doubters who predicted that the new program wouldn’t offer enough choices in rural areas and that the costs would balloon out of control. Today, in one of our most rural of states, Montana, there are 17 different plans to choose from. As for the cost, Part D is the only government program, that I know of, that not only came in under its initial estimate but 30% below that estimate.

There have been, over the years, changes to Part D, some good and some bad, but it remains a success in improving the health and well being of seniors. There continues to be proposed changes . . . we have worked hard to keep you informed about the impact on you of these proposed changes. We also know that we need to continually let you speak out, through seminars, surveys, tele town halls, etc. so we can monitor your feelings about Part D. We don’t want to become complacent in safeguarding this life saving and life changing program.

Our tele town hall this Wednesday, September 16th, will discuss our latest Part D survey. We’ll cover the results, especially as they relate to the current crazy times we are living in. It will also give you a chance to ask questions about the survey and the program itself. It will give you a chance to speak out and tell us how you feel about how Part D is working for you.

I will be one of the presenters at the tele town hall along with Jennifer MacDonald, a Director at Morning Consult, a data intelligence company. It will start at 4:00 p.m. ET on Wednesday, September 16, 2020. We hope you can attend. You can register by clicking the link below:
https://zoom.us/webinar/register/WN_vmMKJHrPQNm7LIjNk4hx4A
After registering, you will receive a confirmation email containing information on joining the webinar.

Don’t miss out on this chance to speak out about this important prescription drug program.

Best, Thair



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This month is Healthy Aging Month

This focus on healthy aging started over 20 years ago as the baby boomers began to turn 50 and it became evident that getting old had a bad reputation. The ornery, bent over, lap blanket, picture of anyone over 50 needed to be changed. Everyone’s attitude toward getting old needed to be updated. I’ve had the patch below hanging in my office for a long time.

I’ve always looked at it as a testament to a great plane, one that I happen to have over 2,000 hours in as an Air Force bombardier, but it’s also an indication of the understood distrust most people had in people over 50. It was this type of attitude that needed to be changed. President Reagan’s age, he was 69, became quite a discussion item during his campaign for President. The average age of the two candidates running for President right now is 75.5. Hopefully, America’s attitude about age is becoming more positive but the most important attitude about getting older is our own. Healthy aging is much more than our physical health, it’s how we look at each day when we rise in the morning and how we evaluate our day as we go to sleep at night.

I always enjoy getting tips about how to play better golf and I found these great 10 tips on the healthy aging website. I liked the straightforward way they presented the 10 ways we can change to live a more positive, healthy life. So, here are 10 tips for reinventing yourself:

1. Do Not Act Your Age

Do not act your age or at least what you think your current age should act like. What was your best year so far? 28? 40? Now? Picture yourself at that age and be it. Some people may say this is denial, but we say it’s positive thinking and goes a long way toward feeling better about yourself. (Tip: Don’t keep looking in the mirror, just FEEL IT!)

2. Be Positive

Be positive in your conversations and your actions every day. When you catch yourself complaining, check yourself right there and change the conversation to something positive. (Tip: Stop watching the police reports on the local news).

3.  Ditch the Negativity

Have negative friends who complain all of the time and constantly talk about how awful everything is? Drop them. As cruel as that may sound, distance yourself from people who do not have a positive outlook on life. They will only depress you and stop you from moving forward. Surround yourself with energetic, happy, positive people of all ages and you will be happier too. (Tip: Smile often. It’s contagious and wards off naysayers.)

4. Walk Tall

Walk like a vibrant, healthy person. Come on. You can probably do it. Analyze your gait. Do you walk slowly because you have just become lazy or, perhaps, have a fear of falling? (Tip: Make a conscious effort to take big strides, walk with your heel first, and wear comfortable shoes.)

5.  Stand Tall

Stand up straight! You can knock off the appearance of a few extra years with this trick your mother kept trying to tell you. Look at yourself in the mirror. Are you holding your stomach in, have your shoulders back, chin up? Check out how much better your neck looks! Fix your stance and practice it every day, all day until it is natural. You will look great and feel better. (Tip: Your waistline will look trimmer if you follow this advice.)

6. How Are Your Pearly Whites?

How’s your smile? Research shows people who smile more often are happier. Your teeth are just as important to your good health as the rest of your body. Not only is it the first thing people notice, but good oral health is a gateway to your overall well-being. (Tip: Go to the dentist regularly and look into teeth whitening. Nothing says old more than yellowing teeth!)

7. Lonely?

Stop brooding and complaining about having no friends or family. Do something about it now. Right this minute. Pick up the phone, landline, or cell and make a call to do one or more of the following: Volunteer your time; take a class; invite someone to meet for lunch, brunch, dinner, or coffee. (Tip: Volunteer at the local public school to stay in touch with younger people and to keep current on trends, take a computer class or a tutorial session at your cell phone store to keep up with technology, choose a new person every week for your dining out.) [You may have to be creative during these times of COVID-19 but there are many safe ways we can volunteer and touch other people’s lives.]

8. Walk 10,000 Steps A Day

Start walking not only for your health but to see the neighbors. Have a dog? You’ll be amazed how the dog can be a conversation starter. (Tip: If you don’t have time for a dog, go to your local animal shelter and volunteer. You will be thrilled by the puppy love!) Make it a goal to walk 10,000 steps a day. Want to lose some weight or belly fat? Make it 15,000. You can do it!

9. Get Those Annual Check-Ups

Make this month the time to set up your annual physical and other health screenings. Go to the appointments and then, hopefully, you can stop worrying about ailments for a while. [Also, make sure you get your needed vaccinations.]

10. Find your inner artist.

Who says taking music lessons is for young school children? You may have an artist lurking inside you just waiting to be tapped. Have you always wanted to play the piano, violin, or tuba? Have you ever wondered if you could paint a portrait or scenic in oil? What about working in wood? (Tip: Sign up now for fall art or music classes and discover your inner artist!)

I think these are great ways to reinvent ourselves. It’s a good time to disprove the negative saying, “you can’t teach an old dog new tricks.” It’s a good time to show everyone that your lifetime of experience is a good reason that they can trust someone over 50, over 60, over 70, etc. Fall is the time that the kids go back to school, it’s a good time for us to get busy and reinvent ourselves.

Best, Thair



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A Birthday Check List

It’s the end of the summer and for me that means another birthday. In fact, my birthday is today. As I was musing about how old I’ve become I thought there had to be something productive I could do other than wish I was younger. And, as you might have guessed, I thought that maybe a birthday was a good time to do some things that will help us stay healthy and happy and might make a for a helpful blog. We all know to change the batteries in our smoke detectors when we change the clock to, or back from, Daylight Saving Time. It’s a great way to keep our houses safe. So why not use our birthday as a reminder to do some other things that not only keeps us safe and healthy but also maybe a little bit richer. You might have some more things to add to the list, I’m always open to comments with suggestions. Here’s my list . . .

Get your yearly physical – This reminder is almost as common as the smoke detector batteries, but I think it might be the most important item on the list. Many of us have been self-quarantining, which has kept us away from the doctor’s office. I just got my physical and our care givers are really good at keeping us safe. They take everyone’s temperature, we go through a check list to see if we might be a COVID-19 risk, and everyone wears a mask and makes sure we are wearing ours. They clean everything between patients. I felt safe wherever I went. Getting a yearly physical exam is the best thing we can do for our long-term health.

Review your immunization needs – Part of our yearly physical should include gathering and reviewing our immunization records and finding out what immunizations we might still need. Click here to go to my recent blog about immunizations. It has links to some great sites to help you determine what vaccines you need. If you don’t have your immunization records, request them when you visit the doctor. Many doctors’ offices have online portals that give you access to your health records. One way or another, get a copy and keep it in a safe place.

Review your Medicare Part D drug coverage – While your birthday may not coincide with the Part D annual enrollment period (October 15 to December 7), your birthday is not a bad time to get your prescription drug information together. It’s a good time to update your information with any changes you’ve had to your medications.

Actions required on important birthdays – As we get older there are some important birthdays that needs special scrutiny and possible important action. The important date for Medicare is 65, that’s when we need to sign up and register for Medicare and decide whether we want to use Medicare fee-for-service or Medicare Advantage. Even if we are still working and have private insurance there are still actions that we must take.  Go to CMS.gov to find out about your Medicare benefits. There are other important birthdates, 62, 66 and 8 months to 67 (depending on your birth year), and 70. These are birthdays when you can elect to begin receiving Social Security (SS). There are a lot of variables that go into when you should begin taking Social Security. Before your 62nd birthday make an appointment to talk with a SS representative. In these times of the COVID-19 virus, it might be difficult to meet in person but don’t put off finding out all about this important benefit.

Inventory your medicine cabinet – Your birthday is a great time to inventory your medicine cabinet. It’s a good time to get rid of old medicine, both prescriptions and over the counter medicines. Many pharmacies will help you dispose of old medicine. Don’t flush it down the toilet or throw it in the garbage. We want to safely remove it from the environment. Now, I need to talk about a touchy but important topic. Many people suffer from drug addictions. We have all heard of the alarming increase in opioid addiction in our country. Unfortunately, a common way these drugs are obtained are by friends and relatives stealing prescription drugs from someone’s medicine cabinet. Having a medicine cabinet lock helps prevent this problem while also keeping these medicines from unsuspecting children. At the very least, monitor who has access to your prescription medicines.

Review your financial health – Being financially secure helps both our physical and mental health. You should review your finances with a trusted advisor. It’s up to you who you deem trustworthy, but it is a place to be very careful. Unfortunately, there are people out there who prey on older people and find ways to rob them of their savings. It’s always a good idea to have a third party, unconnected with your trusted advisor, independently review any actions with your savings. Due to the COVID-19 impact on the economy and investments it is especially important to review your finances. It’s also a good time to go over your non liquid assets, like property, jewelry, etc. A balance sheet to identify your net worth helps you understand your financial standing.

Inventory your passwords – This might seem like a trivial item but many people’s identity and ultimately their money are stolen because a person used common passwords or made access to their passwords easy. Find a smart computer person to help you set up a secure password vault and, after it is set up, change all of your passwords. There are vaults that only require you to remember one password to get into the vault, and they have all of your other passwords.

I’m sure you can think of other things that should be done at least once a year. I suggest creating a check list. Unlike my keys or my cell phone, my birthday is one thing I don’t forget. Use that fact to help you remember some things that may be even more important than your birthday.

Be safe and register to vote, Thair



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Our Legislative Focus

As summer wanes and fall begins to come into focus, it’s time to look ahead to the healthcare legislative issues that could come into play. With campaigns heating up and the debates beginning, you can guarantee that promises will be made and accusations leveled concerning your healthcare. Some of the issues that will be brought up might have a small chance of actually being implemented, but this doesn’t mean that we shouldn’t pay attention. In the past, seemingly long shot proposals have become late night trading fodder when politicians make deals on far reaching legislation. Many of the issues I’ll talk about today were thought to be not-starters a few years ago and now they are political realities. What I will do is offer a simple explanation of each issue, give you an idea on how it could affect you and how likely I think it will be to be implemented. I’ve written an earlier blog about many of these issues. You can look through recent posts to get a more detailed explanation of some of the issues.

International Pricing Index/Favored Nation Pricing

Background – In an effort to lower drug costs some in Washington (most recently the President) have proposed that we fix the cost of a drug to the lowest price a “favored nation” paid. As I’ve explained before, price fixing has never been a long-term solution to any cost problem. There are better ways to have other nations share in the costly research and development that goes into discovering and manufacturing prescription drugs.

Impact – If this approach is implemented the supply line safety that we have enjoyed over the years will be jeopardized with no guarantee that any savings will make its way to you.

Chance of Implementation – While this idea has been around for at least a couple of years, its chances of becoming a reality have gone up. It would be difficult to implement and the chance of unintended consequences high. This makes its implementation politically unpopular but a great thing to talk about during debates.

Importation

Background – This issue has some of the same characteristics as the international pricing index. The goal is again to lower drug prices by allowing importation of these drugs from Canada. I talked about this proposal in my earlier blog explaining how it bypasses the safety net we now enjoy without any proof that the patient will see any savings while counting on Canada to implement a program that they have already said they can’t support.

Impact – While you or someone you know has gone across either our southern or northern boarders to purchase medicine at a lower price, this is not what this proposal is about. This importation proposal is at a much higher-level involving suppliers and transporters and large volumes. Some states have passed laws allowing importation but none of them have been implemented.

Chance of Implementation – This approach has been around for many years and no one yet has found a way to safely implement it. A pilot program of some sort may be started but it will take some real political will to make it happen.  Canadian officials have indicated they will not support it. However, the chances of it happening are much more likely than they were just a few years ago. This is one of those solutions that may gain some traction.

Changes to Medicare Part B

Background – The price of drugs administered and paid for under Medicare Part B have increased substantially. These are drugs that are often injected at a doctor’s office for serious diseases like cancer and many types of autoimmune diseases. A proposal to fix the cost of these medicines has been put forth. This approach would go against the market-based approach that is now in place. It would impact many of the doctors who perform these services and upend and regulate this vitally important portion of our healthcare. Again, fixing prices has never been and efficient, long range solution.

Impact – If implemented, this approach would change the economics of this vital service. Any savings to the patient has been hard to quantify but it would most certainly put pressure on already pressured neighborhood practices. Losing these close, more accessible, services would have serious consequences.

Chance of Implementation – Part B drug prices have become a focal point for people seeking solutions to increased costs. We need to correct the underlying parts of the system rather than using a sledgehammer to bludgeon one part of the business.

Part D Cap

Background – Almost all of us, either in private insurance or Medicare or Medicare supplemental insurance, have experienced caps on our healthcare out-of-pocket costs. It helped us budget our money, we even decided what type of insurance to buy based on the yearly cost caps. Medicare Part D has no such caps. Depending on what prescription drugs, we need we may have out-of-pocket costs that balloon to the tens of thousands a year.

Impact – While we have been against the other proposed changes, a Medicare Part D cap would have a huge impact on those of us who are already retired and everyone younger as they plan for their retirement. I’ve known people, maybe you have also, who were living comfortably until an illness struck and their drug costs forced them to tap into their retirement. The peace of mind that a cap on our drug costs would give all of us, whether planning for or already retired, would be immense. This a change that is worth fighting for.

Chance of Implementation – This change is gaining some traction. While it probably won’t be something that is done on its own, it is a change that could be incorporated in some larger legislation as a balance or concession to reach final approval on the bigger legislation. It would be a most welcome change.

It is guaranteed that there will be other changes to our healthcare put forth as we near election day. We will keep you up to date on each one, explaining in simple terms what the change is and its impact on you. There is one over all criteria that I would like you to consider. Making short term, knee jerk, politically popular, changes is not the answer. Trying to band aid or quick fix a broken process never ends well. We need to fix the underlying problem, simplify the process, and let the free market drive us to the most effective, cost efficient solution. I believe the reduction of administrative overhead and regulations is a big step toward this goal. Measure each change to see if it offers simplicity and transparency in its solution.

Let’s stay informed as we approach this critical election. Get involved, tell those in Washington how you feel. Also, get registered to vote and then vote! It’s one of the most powerful things we can do.

Thair



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News Break!

NEWS Break!

A new bill has been introduced that focuses on the very thing yesterday’s blog talked about, the importance of getting your immunizations this fall. It is heartening to know that some in Washington understand the importance of getting immunized for flu, pneumonia, etc. during the pandemic. This bill is H.R. 8061, the Community Immunity During COVID-19 Act. We ask you to encourage your Senators and Representative to support this initiative.



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National Immunization Awareness Month

This month is National immunization Awareness Month. For over twenty years, in one capacity or another I’ve been encouraging mature Americans during this month to get their shots, especially their flu and pneumonia shots. It has always been difficult to get people interested in getting vaccinated for sicknesses that become prevalent in the fall, so it’s pretty strange that this year all we’ve been talking about is vaccines and when one will be available for COVID-19. While this is good, I’m worried that we might forget that there are already vaccines available for other illnesses and we need those even more this year.

We’ve been sequestered and socially distanced for almost 6 months. We’ve delayed or cancelled non-emergency doctor visits and it looks like we’ll continue on this path into the fall. What we can’t lose sight of is the increased importance of getting your needed vaccinations this year. The worst outcome I can think of is catching the flu or pneumonia and then catching COVID-19. The CDC (Centers for Disease Control and Prevention) makes the following statement about your flu shots and COVID-19.

“There is no evidence that getting a flu vaccine increases the risk of getting COVID-19. There are many benefits from flu vaccination and preventing flu is always important, but in the context of the COVID-19 pandemic, it’s even more important to do everything possible to reduce illnesses and preserve scarce health care resources.”

For you who get your required shots every year, good job, continue on. For those of you who just couldn’t seem to find the time each year to get your shots . . . change your ways. This is the year that you need to get protected. Call your doctor and talk with him/her about what immunizations you need and then discuss the best social distanced way for you to get immunized.

As always, I have links to information to help you. These links are all on the CDC web site. The first link, click here, is to a page that tells you all about vaccines that adults need. One of the important links on this web page is to the adult vaccine self-assessment tool that can help you find out what vaccines you may need.

If you want even more detailed information about vaccines, you can click here. This link should satisfy even the most detailed oriented amongst us.

We’ve done a lot of things to stay healthy during these interesting times. Now is not the time to let our guard down. While we hope that a vaccine for COVID-19 will soon be available, we shouldn’t pass up the chance to get inoculated with vaccines that are already available and are critical to keeping us healthy in these unhealthy times.

Call your doctor, get scheduled for your shots in September or October at the latest. It’s important and can save your life or the life of a loved one.

Thair  



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Medicare Today – Tele Town Hall Overview

On July 29 we had another Medicare Today town hall. Our guest was Shalla RossPresident of the Ross Group, LLC.  We shared our perspectives on likely legislative and regulatory action for the remainder of the year related to Medicare and provided an overview of the electoral atmosphere concerning healthcare and how it might impact Medicare after the election.

Shalla went through a few slides as she discussed what we might expect from Washington both before and after the election. She offered some great insights on what changes were and were not in play. I won’t recap that portion of the town hall. You can click here to see the entire town meeting; it’s a little over 30 minutes long. I will spend some time talking about the questions that were asked and expanding on the answers when appropriate. We had some excellent questions, and is evident that the preservation and efficacy of our healthcare is on everybody’s mind.

The first question asked if the President’s executive order directing the use of the International Pricing Index (where the price of a drug is fixed at the lowest price that a foreign country pays) will have an adverse effect on small pharmaceutical companies. We answered that it would have a chilling effect on all research and development and pointed out that price fixing never has worked. On reflecting more on this question, I would like to note that the world’s reaction to the COVID-19 pandemic is an indication of how important the private, free market is to the development of new drugs. To date 661 unique drug programs have been launched to combat COVID-19. Over half of these programs originated within the United States and 70% of these were started by small biopharmaceutical companies. If, through price fixing, our government imposes itself into the private, free market drug development system, this type of responsive innovation will be lost, and the first to be impacted will be the small companies.

The second question asked about the importation portion of the President’s executive orders. I answered by saying that importation is now and always was a bad idea. Importation has always been an option if the secretary of Health and Human Services would certify to guarantee its safety. No HHS Secretary, under any administration, has done that. This approach would bypass that safe, established supply line. Canada, the country from which we would import these drugs, has said that they couldn’t guarantee the safety of the drugs and they couldn’t logistically support this type of importation. Finally, our own accountants, the Congressional Budget Office could not find there to be any substantial savings through importation. There just seems to be a bunch of reasons not to attempt this dangerous approach.

A question was asked about changes to Medicare. The person said they had heard that there were changes coming to Medicare. We answered that there were many proposed changes but no substantial changes so far. We did acknowledge that more flexibility has been given to Medicare Advantage programs as Medicare tries to transition from a fee for service approach to a value-based approach. I do want to add that as we get closer to the November elections you will hear more and more rhetoric about our healthcare. Candidates will make promises and accuse their opponents of cutting Medicare. We will stay up to date on the rhetoric here at Seniors Speak Out and sift the wheat from the chaff and help you identify what is important and what is election year hot air.

A question was asked about any positive changes to Medicare Part D, Medicare’s prescription drug program. I answered that the biggest improvement that I could see was to put a cap on the yearly out-of-pocket costs for drugs. It makes so much sense. It would give people the peace of mind they deserve as they plan for, or are already in the midst of, retirement. We’ll talk more about Medicare Part D in our next town hall on September 16 now at 4:00 PM ET. You can register here.

The final question asked if the cost of getting a drug approved by the FDA was a reason that drug prices were high. We pointed out that the FDA was the gold standard for drug safety. We feel safe in taking new drugs because of their reputation. Getting a drug approved in this country is a billion-dollar undertaking but the safety and efficacy of these new and ever more complicated drugs is worth it. Investors wouldn’t invest money if there was something more than a very small chance of problems after approval. The FDA is recognized and respected worldwide. Having said that, there is administrative red tape that is costly and could be improved. An increase in transparency could speed up approvals. There are unique pipelines that could be developed that would speed up approvals and lower costs. These types of improvements should be explored. Reducing costs anywhere in the research and development cycle could have a positive impact on drug costs.

I appreciate your interest and great questions at these tele town halls. I wish I could get out to talk to you in person and listen to your opinions and questions face to face. The sooner we can beat this pandemic the quicker that can happen. Thanks for your interest, I hope your summer is going great.

Thair



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Happy Birthday Medicare

A few days ago, July 30 to be exact, we celebrated the 55th anniversary of Medicare and Medicaid. Most of us were pretty young to remember this important even,t but it has had a tremendous impact on our lives.

Before Medicare, about half of those 65 and older did not have any health insurance; they were one illness away from bankruptcy. Today, over 99% of seniors have health insurance. The signing of the amendments to the Social Security Act, on July 30 1965, gave birth to Medicare, and was the culmination of almost a decade of effort to give older Americans the safety of health insurance. It was signed into law by President Lyndon Johnson in the Harry S. Truman library. President Truman and his wife, Bess, were present at the signing and were the first to sign up for the new program. One important and often overlooked fact about the Medicare program was its role in spurring integration. Medicare would not pay providers, hospitals, physicians, etc. unless they were desegregated. This had quite an impact on our society in 1965. Medicare has been changed and expanded over the years. One of the biggest changes was the addition of prescription drug coverage, Medicare Part D, in 2003, by President George W. Bush.

Medicare consists of four main areas:

  • Part A, Hospital/Hospice Insurance – This covers most inpatient hospital services when the patient is admitted to the hospital.
  • Part B, Medical Insurance – Covers outpatient costs including doctors, medical equipment, tests and medicine administered by the doctor.
  • Part C, Medicare Advantage – This addition to Medicare was passed in 1997 and gave beneficiaries a choice to move from fee-for-service insurance to a coordinated care approach that now incorporates health and prescription drug insurance.
  • Part D, Prescription Drug Insurance – Covers most self-administered prescription drugs.

You can find out more about Medicare by clicking here to go to our short Medicare 101 video on the basics of Medicare.

Over the years, Medicare has made a huge impact on our quality of life. It has allowed us peace of mind as we neared retirement, helped us stay active and sometimes even saved our life. By having this insurance, we can get the care we need before our health problems become serious. One example of this improvement is the reduction of trips to the hospital that occurred when Part D was passed and people had increased access to prescription drugs. It is important that we encourage our government to continue to support this critical program. As we continue to live longer, the demand on the program has increased. Medicare is not sustainable unless we make the necessary financial arrangements to ensure it is there for our children and grandchildren.

At the risk of telling you how old I am, I’ll tell you that I turned 17 a month after Medicare was born. I don’t think I paid any attention to its birth, but I did notice pretty quickly, as I started working, that there was this sizable deduction in my pay check, part of which went into the trust fund to finance Medicare. As I found out more about the program, I came to think this money I was giving the government was like a contract. If I gave them part of my hard-earned money every month, they promised that when I turned 65 they would provide me with basic high quality healthcare that was reliable and accessible. We should expect our government to remember this promise 55 years later.

As health costs increase, politicians, especially as they run for office in the next 100 days, will offer many changes and so-called improvements to Medicare. It will be difficult, but important, to wade through their rhetoric and ascertain the true nature of their proposals. We should expect everyone that runs for office to remember the promise they made 55 years ago. We count on Medicare and expect it to be there when we need it.

I think we all can say happy 55th birthday to this life improving and life saving program. It made an immediate impact to my grandparents’ lives in 1965, to my parents’ lives 15 years later and to my life 48 years later. We all need to tell those who represent us in Washington that we need them to maintain this critical program. We also need to tell those who are running for office that we expect them to preserve the reliability, accessibility, and quality of Medicare.

I hope you’re staying safe and finding joy in these unique times.

Thair



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Executive Orders on Drug Prices

Last Friday President Trump signed four executive orders aimed at lowering drug prices. These executive orders are not small tweaks, they are big changes, changes that could have a long-term effect on both the safety and future innovation of your prescription drugs.

Many have already questioned both the timing and rhetoric surrounding the signing of these four executive orders. I will let others delve into those issues. I will go over the executive orders with an emphasis on their likely impact on you.

These changes were not a sudden brainstorm of the White House, they have proposed some form of three of the four approaches to lowering drug prices for over two years. It is worth noting that the President altered some of the earlier approaches in these latest executive orders. If you’d like some background information on who the players are in our healthcare system you can click here to access one of my earlier blogs.

Now, let’s dive into these four executive orders –

Importation – This proposal would give states, pharmacies, and drug wholesalers the right to import drugs from Canada. The administration thinks this would offer lower prices to the states, pharmacies, and drug wholesalers. Our own Congressional Budget Office (the bi-partisan government agency that calculates the economic impact of proposed government legislation, regulations, and executive orders) found, when this approach was first proposed, that there were no savings resulting from this type of importation. Furthermore, the Canadian government said that they would not and could not support this type of importation and would not guarantee the validity of the drugs obtained this way. It is also unsettling to know that this approach would bypass the United States’ established and proven safe supply lines. We know how many scammers have sprung up during the coronavirus pandemic, can you imagine what would happen if these same criminals could infiltrate our prescription drug supply lines through this type of importation? It seems that this approach threatens our safety without offering any savings. This doesn’t sound like a good idea to me.

Rebates – This executive order would resurrect an approach that would move rebates paid by drug companies closer to the patient. While there are perverse incentives in our drug supply line that have produced higher list prices without necessarily lowering the cost to patients, this may not be the best way to solve this problem. The drug supply line is complicated, and this approach would be extremely difficult to implement and there is no guarantee that any of the savings would reach you, the patient. President Trump introduced this approach last year and then rescinded it. It is interesting that it suddenly has reappeared.

International Pricing Index – This is another approach that has been around for years and this latest approach, called “the most favored nation” in the executive order, is even worse than the original proposal. It fixes the price of a drug at the lowest price of one or more of the “favored” nations. This is price fixing at its worst. We are setting a price based on countries with single payer systems, where the government dictates who gets what medicine. The patients in these countries wait years for new medicines. Of the 74 cancer drugs launched between 2011-2018, 95% are available in the United States, compared with 74% in the UK, 49% in Japan, and 8% in Greece. While it is wrong for these countries not to help pay for the research and development of drugs, there are other ways to approach this problem rather than disrupting an industry that has year over year produced lifesaving and life altering drugs and is right now in an all-out effort to find medicines and vaccines to treat the COVID-19 virus. Fixing prices is short sighted and has never worked as a viable economic solution. The industry disruption and the projected reduction in innovation will affect us all. This lack of new drugs might have a direct effect on you or your loved ones. The one thing we shouldn’t limit is our hope for future cures.

Insulin Discounts – This program requires drug manufacturers to give huge discounts to hospitals and community centers who serve the poor. Insulin prices have skyrocketed and has jeopardized the access to this life saving drug. One proposed solution is the Part D Senior Savings Model (see my recent blog here). A program to limit the cost of insulin to the poor and indigent could be added and tested in this model rather than relying on the 340b program to administer this approach. The 340b program, is a government entity that grants huge discounts for providers who serve the poor and indigent. There are solutions to providing diabetics with affordable insulin. An executive order dictating this implementation may not be the best solution, especially at this time.

As you can see, these proposed solutions are not what we need to improve our healthcare. There are workable solutions that could be developed in the arena of bi-partisan cooperation, one of the few areas where this might be the case. An approach that includes more than just the executive branch of our government might produce the workable solutions we are looking for. We need to tell those that represent us in Washington that the four executive orders are not the solutions we need to improve our healthcare.



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The Medicare Part D Senior Savings Model

Lowering drug prices has been a lot like Charles Warner’s quote, “Everybody complains about the weather, but nobody does anything about it”. Doing anything about drug prices has been as difficult as changing the weather, primarily because it is complicated. I have always been a champion of the free market, it was this market competition that has kept Medicare’s drug insurance costs low. But, as always is the case in healthcare matters, there must be regulations and guard rails established that will ensure safety and access. Part D, Medicare’s drug insurance program, is a government program and the government, through legislation, regulation and rulemaking, is responsible for maintaining the safeguards and guard rails in Part D. Access, as it pertains to prescription drugs, has often been impacted by the out-of-pocket costs paid by the consumer. It was this out-of-pocket cost that caused the consumer to walk away from the drug store counter without their prescription drugs.

Often the drug price rhetoric focuses on a drug’s list price, or the rebates paid by different entities in the supply line, or what percentage of the cost that manufacturers and insurance companies pay during the different phases of Medicare Part D . . . but my focus, as it always will be on Seniors Speak Out, is on you, the patient. What will any proposed change do to the amount of money you spend on your healthcare. There is such a change that has been proposed that will address the out-of-pocket costs paid by consumers for insulin, it is the Medicare Part D Senior Savings Model.

This Savings Model addresses a problem with the rapidly escalating consumer cost of insulin. These rising costs have forced patients to make difficult decisions on what to eliminate from their life to pay for their insulin or, in some cases, forced them to ration or curtail their insulin use. Controlling diabetes is essential for the overall health of those with this disease. Uncontrolled diabetes threatens every other aspect of a patient’s health. Ensuring a diabetic had access to his/her required insulin will have a huge effect on their overall health and save money in the long run. It made sense to attack these suddenly skyrocketing costs quickly.

CMS, the Centers for Medicare and Medicaid Services, proposed the Savings Model as a test of a change to the pricing of insulin that would lower the cost to the patient. It would cap the out-of-pocket costs for insulin to $35 per month, regardless of which phase of Part D coverage the patient is in and is predicted to save $446 dollars a year. This is significant and especially important given the fluctuations in cost that patients have seen depending on which phase of coverage they are in. The chart below shows that a patient may see big out-of-pocket costs early in their year of coverage. This front loading in cost would be the logical point where insulin use would be rationed or stopped. This interruption could have long range effects on health that might not be alleviated later in the year when the costs would come down and usage would return to normal. The long-term damage to the patient’s health would have already occurred. The proposed model would smooth the costs into a predictable, affordable, monthly outlay that could be budgeted.

There has been widespread acceptance of this model. As of now, an estimated 58% of people currently enrolled in Medicare Part D are covered by plans that will institute the Senior Savings Model. The model is scheduled to be implemented starting January 1,  2021, which means it will be important for those who use insulin to review their coverage during this year’s open enrollment or sign-up period (October 15 to December 7, 2020) and ensure they enroll in a Part D plan that is participating in the Senior Savings Model.

While this model will test that the desired outcomes are realized, it is important that significant information is gathered so that changes can be made and opportunities for increased efficiencies recognized when the final policy is implemented.

I hope that those of you who use insulin will see your costs reduced, smoothed out and predictable as this model is implemented next year.

Thair



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Reopening – Staying Safe and Healthy

The pandemic is still with us . . . I’m not sure any of us thought that statement would be in our vocabulary in January, but it is and it will be true for a while more. Now is a good time to review where we are with COVID-19, what should we be doing to stay safe and how do we continue to stay healthy.

Shutting down our economy seemed to work initially but the often talked about resurgence, as we reopened, has come true. Many states are breaking records for new cases and the resulting deaths, while lagging somewhat, have begun to rise. Our Government, both at the Federal and State level, have been trying to balance the reopening of our economy with the risk of citizens catching the COVID-19 virus. They realized that keeping our economy shut down ran the risk of pushing many to poverty and the ensuing health risks that always followed. The stimulus checks and other programs cannot be sustained, and if the shutdown were continued it wouldn’t be long before the economy was irreparably damaged. These are unknown waters that our country has been thrown in; there are no operator’s manual on pandemics, at least not yet. So . . . what should we be doing as we continue down this long road back to normalcy.

We all should know by heart the pandemic safety mantra, wear a mask, social distance, wash your hands often. This still applies and is even more important as things begin to open up and some of those around us have let their guard down and aren’t practicing these safety measures. As things open up we might be asking ourselves, “what is safe to do? are some things safer than others?” The Texas Medical Association ranked nearly every activity—from opening your mail to going to a bar—by their risk level. In their calculations they assumed that everyone was following the three safety measures listed above. Click here to see the chart. As you can see, gathering indoors in large groups is the most unsafe activity, and anything outdoors is much safer. You might consider small outdoor gatherings for you and your family, still following the safety rules, as a way to finally see loved ones. One of the first activities to reopen was golfing. I know personally that being able to go out and golf saved my sanity. Hopefully, the low risk things on the chart will offer us some small sense of normalcy.

 Finally, I want to remind everyone that keeping yourself healthy should be priority one. That means taking your medicine as instructed and seeing your doctor. The chart showed the risk level of going to the doctor as a level four, relatively safe. Seeing your doctor, when necessary, should not be postponed. Having said that, there are alternatives available that might accomplish the same thing as a doctor visit without leaving your home. Next time you need to talk to your doctor, ask about the possibility of a telehealth appointment. Many health processes can be done over the phone or through video conferencing. A few months ago, Zoom was what the grandkids did when they came to visit. Now, many of us found out it was a way we could see and talk to them while we are quarantining. Whatever you do, don’t miss seeing your doctor, either in person or on the phone or through video conferencing.

A lot is happening in our country. As you try to make sense of it all, don’t forget that your health is priority one. Keep healthy and stay safe.

Thair



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Alzheimer’s and Brain Awareness Month

Last month, June, was Alzheimer’s and Brain Awareness Month – you may have seen some information about it on social media. I wanted to add to those voices before everyone moved on.

Alzheimer’s is the most common form of dementia, accounting for 60 to 80% of dementia cases, it affects over 5.5 million Americans. Alzheimer’s is one of those diseases that is all to common, most of us either have someone close to us with the disease or know someone whose loved one has Alzheimer’s. It has a huge affect on our nation because it requires caregivers with enormous patience, it lasts a long time, has no cure and is one of the nation’s costliest diseases. It is estimated that it will cost our nation over 300 billion dollars this year and the cost is going up. This cost doesn’t even figure in the cost to society of unpaid caregivers. While the death rate of other diseases has fallen . . . the death rate of heart disease, the most common cause of death, has fallen 11% . . . the death rate from Alzheimer’s has risen 123% between 2000 and 2015. Alzheimer’s impacts us all, personally and financially.

So, you might ask, “why haven’t we found a cure? It is obvious that we should be working day and night on a cure for this disease.” Well, we have, but it has been rough going. Alzheimer’s is a complicated and multifaceted disease. There have been many promising medicines that have been tested and failed, some of the failures coming at the very end of the clinical trials. It has been heartbreaking to those impacted by Alzheimer’s to have hope and then be disappointed.

Scientists have identified that plaque buildup in the brain seems to be common in those with Alzheimer’s. They have also discovered that a vital brain cell transport system collapses when a certain protein twists into microscopic fibers called tangles. These discoveries have given hints to the cause, but a solution has been elusive. While there have been medicines created that treat some of the symptoms, there is still no cure. But there is hope. Scientists have joined forces by forming the Coalition Against Major Diseases (CAMD), an alliance of pharmaceutical companies, nonprofit foundations and government advisers, that have forged a first-of-its-kind partnership to share data from Alzheimer’s clinical trials. It will take a combined effort like this to tackle this terrible disease.

As a country we need to ensure that our government allows coalitions like this the freedom to pursue a cure for Alzheimer’s. My math says an Alzheimer’s cure could save our nation 3 trillion dollars over 10 years, to say nothing of the impact on the millions of patients and caregivers whose lives are devastated by this disease.

In these times of isolation my sincere thanks goes to those in the Alzheimer’s units throughout the country who have stayed on the front lines, often at the risk of their own health, to care for the millions of Alzheimer’s patients. Find out more about Alzheimer’s and Brain Awareness Month by going to this website. You might also try wearing a nice-looking purple outfit in hopes that someone will ask you about it and you can tell them about Alzheimer’s and the importance of finding a cure.

In the meantime, stay safe and be joyful.

Thair



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Our Government and the Pandemic

We’ve talked a lot about how the pandemic has affected us, mentally, physically and financially. In our recent Medicare Today/ Seniors Speak Out poll we saw that our healthcare providers had a favorable rating (54% said the healthcare providers performed better than expected) as opposed to the government where only 16% thought they performed betterthan expected. As many states are beginning to open up, I thought it would be beneficial to look at what our government has done so far and the affect it has had on us so far.

There’s been a lot of discussion as to whether the President handled the pandemic correctly or not. It continues to be difficult to separate the truth from the political rhetoric. Did he take the pandemic seriously at the beginning? Did we shut down too early or too late?  Did he take power away from the states or gave them too much power to decide how their state was going to react? It may take years to analyze what actually happened and which actions were right and which were wrong. What we can talk about is what affects the Federal and State policies concerning the COVID-19 pandemic had on older Americans.

Most of us got a stimulus and/or an unemployment check from the government. We hope that the small business loans and Paycheck Protection Program money will help those who were furloughed or laid off. It seemed that every discussion I had with other seniors at some point turned to how our kids’ and grandkids’ employment was affected. It seemed that the government was trying to keep our economy going until it could be opened up again. Finances remain at the top of every discussion concerning the pandemic, but it has also affected us in other ways.

As you might remember the shutdown caught many by surprise. Some seniors were caught on cruise ships and in foreign countries and in many instances had a very difficult time getting back home. Some states even had travel restrictions that hindered travel between certain states. Each state has responded differently as to when and for how long to institute the shutdown of commercial businesses. What this meant for many seniors was the separation from their loved ones and the disruption of their routines. I did notice something else, the further splintering of America. It seemed that rather than pulling together, we spent a great deal of time and effort pointing fingers. At a time when we should have been uniting against a common foe, the pandemic, we talked about who to blame for its spread and who to listen to. It seemed hard to know who to believe. It was very unsettling.

While each of our lives was affected in different ways I want to focus on two aspects of the pandemic that I think will have long term consequences if we don’t address them; the situation at long term care facilities and the ways our government entities communicate with us.

It was quickly ascertained that the people who were most vulnerable to dying from the virus were people over 65. This was due to the fact that this population had more of the other conditions that made them vulnerable, like lung problems, diabetes and other medical conditions that inhibited their bodies from fighting the virus. It should have been very evident that people over 65 and in close quarters at long term care facilities had more of a chance of catching the virus and having poor outcomes.

I think this was the time and place for the government to step in and get masks and other healthcare support to these people as quick as possible. The final statistics will reveal how many seniors died in long term care facilities. There were certainly some facilities that didn’t have a plan in place or didn’t react as they should. Since then state and federal governments have stepped in to assure better protections. When the pandemic is contained and we can reflect on what changes need to be made, the regulations and avenues of support available for long term care facilities in times of crisis need to be reviewed and strengthened.

Our access to information has exploded over the last few years. More seniors found out how to use Zoom in the last few months than anyone could have ever predicted. We had access 24 hours a day to the 15-minute news cycle which, you’d think, would have kept us informed and reassured. Instead we began to distrust institutions that we used to have confidence in. There was misinformation disseminated by the CDC (Centers for Disease Control and Prevention) and the WHO (World Health Organization) has become suspect due to the influence of China in its pandemic recommendations. Dr. Fauci, an expert at the NIH (National Institutes of Health) since 1984, garnered some trust in the daily briefings that were aired on TV, but he was often contradicted by the administration. The result is we had all this information and didn’t have any trust that it was accurate. One of the basic duties of government is to offer reassurance in times of crisis. In my estimation, we didn’t have this reassurance at a time when we needed it most. For seniors, trapped in their homes without close personal contact with their loved ones, this was unsettling. Why is it that more Americans trust the Joe Rogan podcast more than the CDC, the government agency that is supposedly the most informed about pandemics? The pandemic has exposed a vacuum in trust that supersedes this health emergency and may prove to be the biggest problem our nation will face once the pandemic is over.

Our government shouldn’t be responsible for rescuing us from every problem. Our government should be the rallying voice and our most trusted supporter that helps us rescue ourselves. Whether it’s ensuring that long term care facilities are able to effectively take care of those that are the most frail or being a trusted source of accurate information to help us make informed decisions about our lives, the government of the United States of America must somehow regain our trust. This pandemic will have profound impacts on our lives for years to come. I wish I had all the answers to the problems that this pandemic exposed. What I do know is that we will get through this. We are a great country and we have the ability to fix our problems. In the meantime, stay safe and have joy.



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June 13th, National Family Health and Fitness Day

Today is Family Health and Fitness Day and it’s a great time to refocus on the things that keeps us healthy. Since early March we have done nothing but try to keep from getting the coronavirus. We’ve stayed sequestered, we’ve worn masks, we’ve avoided some of the things that give us the most joy, like hugging and visiting with our grand kids. We’ve been extra careful because we know that we are in the most vulnerable age group, those of us that are over 65. This focus on avoiding the coronavirus may have caused us to quit doing the things that have helped us stay physically and mentally healthy, like going to a health club to exercise, going swimming, or walking without friends. The virus made doing these things unsafe and, even though many places in America are opening up, we should stay vigilant. We remain at risk and should remain careful.  There are, however, some things we can do that are safe but will improve our health and fitness.

 In past Family Health and Fitness Days, seniors were encouraged to walk with friends, attend a fitness class, go dancing, have a health screening with your doctor or volunteer. These were all great ways to get healthy and fit but what do we do now when we are trying to stay safe?

Here are some things that we can do that will keep us safe but will increase our health and keep us fit.

  • Going outside and walking is still safe, as long as you stay 6 feet away from everyone. The virus has a much less chance of reaching you when you’re outside. Keep a mask with you in case you meet someone that you want to stop and talk with.
  • Find a yoga or exercise class on-line and make it a part of your daily routine. There are even some exercise classes on the tv that you can tune into.
  • Team up with one of your friends and act as each other’s enforcer to ensure that you stay with your daily exercise routine. It helps you stay on your plan when you know you have to “report” to your friend on your progress.
  • You can still volunteer by calling someone who needs to hear your voice. Encourage someone who is down. Order a gift for someone online and have it delivered to their house as a surprise. Doing something for someone else helps us forget our own troubles.
  • Don’t forget to keep seeing the doctor as required. While this might not be the time for a wellness visit or for some elective procedures, it is important to see your doctor for new or long-term health problems. Your doctor has done everything possible to maintain a germ-free environment and will advise you if keeping an appointment is not necessary. Don’t hesitate to use the telephone or have virtual meetings with your healthcare provider. Medicare and other insurance companies have stated that they will cover telehealth appointments.

These are just a few ways to return our focus to our long-term health and fitness. It’s so uplifting to see things begin to open up. While we still need to be careful, we can be happy that there is a light at the end of the tunnel. The scientists are working hard to find medicines that can lesson or stop the effects of the drug and develop a vaccine that will protect us in the future. In the meantime, stay safe, keep yourself healthy and fit and stay joyful.



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Your Answers to Our COVID-19 Poll

We did a poll concerning the COVID-19 pandemic to give you an opportunity to tell us how this worldwide virus has impacted you. Your answers revealed some interesting information on how older Americans are weathering this unprecedented health emergency.

The first question was:

Concerning the impact of COVID-19 on your physical health – check all that apply.

Below are the choices and the percentage each choice was selected:

  • Has it been more difficult to get your medicine? 27.1%
  • Is it harder to see a doctor? 39.6%
  • Have you had trouble receiving home health? 8.3%
  • Other 25%

As you can see the response selected more often was the difficulty in seeing your doctor. You can understand that the fear of going out to a doctor’s appointment, especially for non-emergency issues, kept many people from venturing out to the doctor’s office. I wonder how many cancer screenings, colonoscopies, blood tests, physicals, etc. were missed and what price seniors will pay for this inability to get both preventative care as well as needed periodic care for existing conditions. I’m afraid that the effects of the pandemic on the health of seniors will be long term and costly.

The second most selected choice was difficulty in getting medicine. One of the fears providers had, with the strict quarantining recommendations, especially for older people, was – it would hinder seniors from getting their prescription medications. It was also worrisome that the supply chain for medications would be interrupted causing shortages. The quick response to expand the number of pills per prescription, the reduction or elimination of out-of-pocket costs and the ingenuity in maintaining adequate supplies all helped to ensure we were able to continue to get our needed prescriptions.

The third most selected choice was “other”. This pandemic affected each of us in a very personal way. We all are different and it affected us in different ways but there is no doubt it is affecting us all significantly.

Only 8.3% said it was difficult getting home health care. I hope this continues to be the case.

The second question was:

Concerning the impact of COVID-19 on your emotional health – What worries you the most?

Below are the choices and the percentage each choice was selected:

Becoming sick with COVID-19 21.6%

Your family members becoming ill with COVID-19 27%

Loss of retirement 5.4%

Loneliness 5.4%

Family members losing employment 18.9%

Access to healthcare 13.5%

Other 8.1%

The top two choices were fear of you or your family getting sick with the virus. As it seems is always the case we had more fear that one of our family members would get the virus rather than ourselves. That was also the case with worrying about our retirement or our family’s employment. We were much more worried about our family losing employment than we were about losing our retirement. It is interesting that only 5.4% chose loneliness as a problem. I think we might be seeing the reduction in restrictions as a light at the end of the tunnel and seeing hope that we can visit our families. It might also be that technology has helped. There our substantially more older Americans that know how to use Zoom than before the pandemic.

The third question was:

Who do you turn to for reliable COVID-19 information?

Below are the choices and the percentage each choice was selected:

TV news 24.3%

The daily Coronavirus Task Force briefings 27%

Internet 21.6%

Radio 2.7%

Newspaper 2.7%

Other 21.6%

The daily Coronavirus Task Force briefings was the top choice. I know I appreciated hearing Dr. Fauci’s insights and developed a trust for his opinions. We still go to the TV for our news and the daily briefing, the TV is our window on the world. The internet is moving up the ranks and the distinction between the “TV” and the “internet” is blurring. We are nearing the world where our internet is the conduit to news, radio, newspaper and any other information we seek. I do wonder where the 21.6% who selected other got their information? I suspect it is friends or family who visit with us and talk about the pandemic.

The fourth question asked:

In their response to COVID-19, do you think healthcare industries (hospitals, drug and device manufacturers, insurers) have:

The choices and the percentage selected are:

Performed better than expected 54.1%

Performed as expected 27%

Performed worse than expected 18.9%

It might have been a little difficult to evaluate the healthcare industries’ performance given none of us had ever experienced a pandemic like this. Given that, over half of us said they did better than expected and only 19% said they did worse than expected. I think three things impressed us:

  • the bravery of the healthcare workers as they exposed themselves to danger as they cared for us
  • the quick reaction of our insurance providers to cut our out-of-pocket expenses so that cost did not hinder our access to care and medicines (I just a received a card from my Medicare Advantage insurer that waived all out-of-pocket costs for primary care visits, outpatient behavioral health visits and telehealth visits)
  • The willingness of pharmaceutical manufacturers to band together and spend millions of dollars to look for medicines that will reduce the severity of the COVID-19 and to produce an effective vaccine.

Sometimes adversity brings out the best in us.

The final question asked:

In their response to COVID-19, do you think the federal government (Congress and the Administration) has:

The choices and the percentage selected are:

Performed better than expected 18.9%

Performed as expected 18.9%

Performed worse than expected 62.2%

It seems we don’t think our government responded very well to this pandemic.  We did have other countries’ response that we could use as we compared the effectiveness of our country’s response. There is still a lot we don’t know about what actually happened. Some countries that started out with lower infections were later inundated. State governors responded very differently and the resulting number of COVID-19 infections varied widely. As time goes on we’ll know more about what methods worked and what didn’t. We’ll also know what information our government had and when they had it and how they responded to it. But right now, there is no doubt that we aren’t happy with the government’s response.

We’re glad you chose to speak up and participate in our poll. We will continue to do surveys and polls to give you a chance to speak out. In the meantime, stay safe and have joy.

Thair



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What Healthcare Issues Do You Care About Most During COVID-19?

I hope this communication finds you safe and finding ways to have joy in these trying times. I have faith that we will emerge stronger and smarter from this experience.

First of all, I want to thank everyone who has participated in our survey and encourage anyone who hasn’t to click here and give us your input. The survey asks about your experiences with the COVID-19 pandemic, your health, your healthcare, how the government and drug manufacturers have performed so far and how you get your information about the pandemic. It is important for you to speak out about these important health issues. Those in Washington, that have such an impact on our lives in these stressful times, need to know how you feel about these issues. Please participate.

Second, I want to talk about importation. This is an issue that I’ve talked about before. It has been trumpeted by Washington at different times over the years as a way to lower costs. The importation of prescription drugs has some basic flaws:

  • It lacks the basic safeguards to guarantee the safety of the medicine
  • The approach is resisted, or is outright rejected, by the very countries who would be counted on to support this approach
  • The Congressional Budget Office (CBO) has calculated that importation would result in minimal savings, if any at all


I can’t help but think that the COVID-19 pandemic has highlighted another flaw, our reliance on other countries for our medicine. I’m not talking about the raw materials or manufacturing that are supplied or accomplished by foreign countries and certified by the FDA. I’m talking about legislation that circumnavigates these established, inspected and approved supply lines and opens up pathways for counterfeit drugs. We see today countries arguing about who would get COVID-19 vaccines or medicine first, deals being made between countries that might ignore the priority of getting medicines or vaccines to those who need it most. It highlights another reason that importation legislation is not the solution. When push comes to shove a foreign country’s priorities will come before ours and any agreement that is not based on economics and competition will be driven by political priorities that will not be to the safety and benefit of the patient.

As I have said before, as the elections get closer, the politicians will begin to focus on schemes to get elected. Importation may again be presented as a solution to drug prices. We all need to understand the real dangers of this flawed solution.

Stay safe and be joyful, Thair.



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Tele town hall

I want to thank everyone who joined our Seniors Speak Out tele town hall yesterday. We discussed the impact on senior’s healthcare that the COVID-19 pandemic has had, and could have, in the future. We also discussed what might happen with healthcare issues and legislation in this election year. I appreciated the questions, both written and expressed during the tele town hall. In response to one of the questions I am including the link to the IRS’ Get My Payment web site where you can check on the status of your stimulus check. Just click here to get to the site.

We also announced the broadening outreach of the new Seniors Speak Out. The use of polls and surveys, of webinars and tele town halls, and, when appropriate, visits to expos, seminars and anywhere mature Americans gather. Our goal is to find out how seniors truly feel about their healthcare and what their stance is on the issues that affect their lives. We are looking forward to this journey as we face this trying but important year.

Our first poll is ready on our web site – just click here to take the poll and participate in this process of speaking out.

I look forward to working with you as we seek to speak out and be heard.

Thair



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The COVID-19 Virus – Our Government’s Response

Here we are, hunkered down and wondering when, or if, we’ll be back to normal. It is a strange juxtaposition we are involved in . . . a national disaster that, in the past, has brought us together now forces us apart. I hate that we can’t gather our families together to weather this storm, but it is best, especially for us older folk, to stay isolated and wait for the “all clear” message. I’ve included some links below that will give you access to health and financial information concerning the COVID-19 pandemic. Here are a few updates on how our government is working to help out and guide us.

The 2 trillion-dollar stimulus legislation has been signed by the President. It contains a multitude of economic fixes. I will highlight a few of what is in the bill and a few things that were left out:

  • The bill allows us to have the medicine we need while we are quarantined (see my last blog) by allowing doctors to prescribe up to 90-day prescriptions without any restrictions by pharmacies or insurance providers.
  • The bill also includes provisions to expand telehealth, a great idea to get help from a health care provider without leaving the safety of your house.
  • Any costs related to getting tested for COVID-19 will be done with no costs to the patient.
  • We will be getting as much as $1,200 in a one-time check. It will be based on our 2018 Adjusted Gross Income. If you made too much money in 2018 your check could be reduced or eliminated.
  • Some changes affect your retirement funds. Talk to your financial advisor to see if any of the changes will help you.

One thing that wasn’t included in the bill was the ability to have some Medicare Part B drugs, primarily those that were injectable or infused, be provided in the home if the patient and physician think that’s the best option. It would have allowed much safer access to these life altering and life saving drugs. Many organizations fought for this change, but it wasn’t included. We hope that some later legislation will recognize the importance of this provision.

Another change that might help is the IRS has delayed when you need to file your 2019 taxes. Both the filing date and, more importantly, when any taxes you might owe are due has been extended to July 15th. Click on the IRS link below to get more information.

While the just passed legislation dealt with the immediate financial problems of those that were suddenly laid off and small and large businesses that were impacted by the pandemic, I want to remind our government that many seniors will also be affected financially. As we saw in the great recession, many older Americans found that they were the ones that rescued their children by letting them move back in with them or offering free childcare as their kids weathered the recession. We all know that we will do anything for our kids, but we’re older now and our retirement funds have been decimated. I’ll work to keep Washington apprised as this pandemic and its effects on the economy plays out, making sure they know how it affects the seniors in our country.

In the meantime, stay safe and stay involved, our country needs your steady spirit as we work to weather this storm.

Thair

HELPFUL LINKS

SENIORS

The CDC has guidance for older Americans on COVID-19 which can be found here.

For questions about receiving Social Security benefits during the COVID-19 national emergency, visit the SSA’s updates and frequently asked questions page here. If you need to get in touch with your local Social Security Office, use the office locator here to find their phone number.

Mental Health and Other Wellness Resources

The National Alliance on Mental Illness (NAMI) has a resource guide on dealing with anxiety related to COVID-19 and some frequently asked questions, which can be found here.

The National Suicide Prevention Lifeline is free, confidential, and available 24/7 at 800-273-8255.

The National Domestic Violence Hotline has resources and recommendations for staying safe during COVID-19, which can be found here. If you or a friend needs help, call the hotline at 1-800-799-SAFE(7233).

VETERANS

Updated information on COVID-19 from the Department of Veterans Affairs can be found here.

What should veterans do if they think they have COVID-19?

Before visiting local VA medical facilities, community providers, urgent care centers, or emergency departments in their communities, veterans experiencing COVID-19 symptoms—such as fever, cough, and shortness of breath—are encouraged to call their VA medical facility or call MyVA311 (844-698-2311, press #3 to be connected). Veterans can also send secure messages to their health care providers via MyhealtheVet, VA’s online patient portal. VA clinicians will evaluate veterans’ symptoms and direct them to the most appropriate providers for further evaluation and treatment. This may include referral to state or local health departments for COVID-19 testing.

What about routine appointments and previously scheduled procedures?

VA is encouraging all veterans to call their VA facility before seeking any care—even previously scheduled medical visits, mental health appointments, or surgical procedures. Veterans can also send secure messages to their health care providers via MyhealtheVet and find out whether they should still come in for their scheduled appointments. VA providers may arrange to convert appointments to video visits, where possible.

Can visitors still access VA medical facilities?

Many VA medical facilities have cancelled public events for the time being, and VA is urging all visitors who do not feel well to postpone their visits to local VA medical facilities. Facilities have also been directed to limit the number of entrances through which visitors can enter. Upon arrival, all patients, visitors, and employees will be screened for COVID-19 symptoms and possible exposure.

IRS

The IRS has established an updated resource section on steps to help taxpayers, businesses, and others affected by the coronavirus, which can be found here.



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Something You Might Have Missed Concerning the Coronavirus

A few days ago, I received information from Healthcare.gov, a website created by the part of our government that oversees Medicare, concerning the Coronavirus.  It offered the following guidelines to help us as we combat this serious health risk:

To prevent the spread of this illness or other illnesses, including the flu:

  • Wash your hands often with soap and water,
  • Cover your mouth and nose when you cough or sneeze,
  • Stay home when you’re sick, and
  • See your doctor if you think you’re ill.

Good information but I think they missed something that is key in this battle . . . ensuring each of us have ample medication or required medical supplies to last through a 14-day quarantine period or weeks longer if required.

Many of us take daily medicine or require medical supplies that enable us to live normal lives and, in some cases, keeps us alive.  If we are quarantined because we contract the virus or to keep us from coming in contact with someone who has, we quite possibly won’t have the chance to renew our prescription or obtain enough medical supplies to last through the quarantine period or weeks longer if required.  Now is the time to think about this possibility and take the needed steps to be prepared.

Determine what medicine and medical supplies you may need and contact your doctor or pharmacist as well your medical supplies company to obtain the medicine and supplies you need to make it through at least a quarantine period and even a few weeks longer.  If you are a caregiver take the needed steps to protect those you care for.

These are strange times and we need to take care of ourselves and our loved ones by being prepared.



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A Chance to be Heard

As you might notice the name of this blog is, “Seniors Speak Out”. That means that somehow, I need to tap into what older Americans find important. I can’t do that unless I find a way to get out and actually talk with those of us who can be classified as seniors . . . and that’s exactly what I’m going to do.


The idea of a listening tour is not new, I did one a few years ago when I ran a senior advocacy organization. I found it was a great way to really understand how seniors felt. I was somewhat limited in how much of the nation I could get to on that listening tour, but I’m not limited this time. I am committed to getting to all corners of our nation. I know that there are state and regional differences in healthcare, and it will be important to listen to, and convey, those differences. I will focus on getting in front of small groups at assisted living and senior centers, to get on radio programs to invite comments, to go to senior fairs and expos and to go to important senior conferences. My goal will be to find out what is important to you, what keeps you up at night, how you feel about the proposed changes to health care and what solutions you might have. I then will assemble your comments, views and solutions into simple and common-sense statements that I can deliver to Capitol hill. Something that will convey to them how seniors really feel.


Just recently, I had a chance to speak to a group in Virginia. We spent about an hour and a half discussing healthcare. One of the things they brought up was the difference in the price of their prescription drugs when they go to the pharmacist and use their insurance as compared to when they use a discount card and finally when they go someplace else, like Costco, and pay cash. The question was asked, “why does the cost to the patient differ”. We had quite a discussion and I won’t go into it here, but it is the type of discussion that America needs and one that the people in Washington need to hear about.


I would like your help. If you would like to have a chance to tell me and your members of Congress how you feel about your healthcare please click here and tell me when and where. I might not be able to accommodate all the requests, but I’ll do my best.


This blog is about you, the patient, and I’m looking forward to getting to know exactly how you feel.