Older Americans are under attack in Washington D.C. The strategy of the current leadership in the U.S. Congress and Bush Administration is to pit the middle class against the poor. This strategy provides a smoke screen behind which to suck money from middle class Americans up the economic pyramid to the wealthiest group living in luxury at the very top of the pyramid.

Medicare is a major target of this strategy directed to ease the tax burdens of the rich at the expense of middle class and poorer elderly citizens. Citizens, young and old, must come to understand that the attack on the health care programs in place for older Americans has nothing to do with reducing health care costs, or reducing taxes for the overwhelming majority of families.
All of these objectives of cost and tax reduction can be achieved by:
The balance of this page is devoted to addressing some basic questions about Medicare, Medicaid, entitlements and human welfare.

Medicare, Medicaid, Entitlements, & Human Welfare

(Click on Highlighted Question to Access the Answer Below)

What Does Medicare Cost Enrollees?

What Could Medicare "Reform" Mean to an Oregonian?

How Could Out-Of-Pocket Costs Increase?

What About Lower-Income Medicare Beneficiaries?

What does entitlements mean?

What's the difference bween Medicare and Medicaid?

What's the difference between entitlements and welfare?

Costs to Medicare Beneficiaries

For Medicare beneficiaries, new costs would come on top of the high health care costs they already pay. Currently, the average beneficiary in Oregon will spend several thousand dollars out-of-pocket to cover Medicare premiums, deductibles, coinsurance and the cost of services not covered by Medicare (like prescription drugs and preventive care). This does not include the enormous cost of nursing home care which averages over $40,000 a year. Median household income for older Americans is roughly $17,000 per year, half that of the non-elderly. Yet over 30 percent of the average older American's income is spent on health care.

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Medicare "Reform" Impact

Medicare needs to be improved. But, "reform" sponsors are proposing major and rapid changes in Medicare that could force beneficiaries into managed care plans like HMOs or give them a voucher to buy private insurance. Currently, there are only about 30%, of Medicare beneficiaries in Oregon enrolled in Medicare managed care. Many Members of Congress who support cutting almost $300 billion out of Medicare also say that it will be a person's choice whether he/she wants to keep her/his own doctor, but to keep that choice she/he will have to pay a lot more.

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Increased Out-of-Pocket Costs

To achieve the proposed billions in Medicare spending reductions, beneficiaries in Oregon could be faced with: Return to List of Questions Above

Low-Income Beneficiaries

Low-income older Americans would be hardest hit by the increased out-of-pocket costs, particularly if the Medicaid program becomes a block grant to states. According to the most recent year of data available, there were approximately 38,000 seniors in Oregon below the poverty level. Lower-income older Americans spend more than 25% of their income on health care. Currently Medicaid pays for the premiums, deductibles and copays of Medicare beneficiaries who fall below the poverty line through the Qualified Medicare Beneficiary (QMB) program. Now Congress is considering eliminating the QMB program. This would increase low income Medicare beneficiaries' out -of-pocket health costs even more and jeopardize their access to even the most basic Medicare services.

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Meaning of Entitlements

The official definition is this: By meeting certain criteria, such as age, years of contributions, or income level, you are eligible, or entitled, to receive certain benefits. Social Security and Medicare are the two largest entitlement programs. But all entitlements are not the same; they vary in eligibility requirements, size, funding source, rate of growth, and financial health. Politicians and pundits tend to lump all entitlement programs together and talk about them as if they are one program. That's confusing and misleading. Because when people talk about cutting or capping entitlements, it's Social Security and Medicare that will be cut the most, since that's where the money is.

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Difference Between Medicare and Medicaid

Medicare, like Social Security, is an earned benefit based on the recipient's past contributions. If you paid into Medicare during your working life, you are entitled to collect benefits when you turn 65. Medicaid is based on current need and benefits are given to people whose income is below a specified level.

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Difference Between Entitlements and Welfare

Basicallly the difference is in what makes you eligible to collect benefits. You're automatically eligible to collect Social Security and Medicare benefits when you retire or turn 65, for example, because you earned the benefits by contributing during your work life. They're not welfare. Other entitlement programs are based on need, like food stamps and Medicaid. Eligibility is based on a person's income and assets, not on what has been paid into the system.
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Estimates on this Web page are based on data from Citizen's Fund, The Urban Institute, a private insurer, the Health Care Financing Administration (HCFA), the Center for the Study of Responsive Law, the Congressional Budget Office (CBO), and the Philadelphia Inquirer.

Questions or comments about Medicare, Medicaid, Entitlements, and Welfare can be directed to: