Powerful groups seeking changes from president


November 25, 1993|By John Fairhall | John Fairhall,Staff Writer

At the upscale Edenwald retirement center in Towson, Douglas Dorman views the Clinton health care plan with open suspicion.

"It may be better than sliced bread, I don't know," says the robust 79-year-old, sitting at a reading table in Edenwald's library. "It's a brand-spanking-new plan and it's bound to have bugs."

Polls show that many of the elderly share Mr. Dorman's skepticism, presenting the Clinton administration with a potentially serious problem. Its sweeping reform plan has little chance of passing Congress without the support of the politically powerful seniors.

Although the president included subsidized prescription drugs and long-term-care benefits to win their support, senior citizens are not enthusiastic about the plan. Many are largely unaware of the new benefits it would offer them. Others are worried that the proposal to cut future Medicare spending by $124 billion and to reduce doctors' fees would prompt doctors to turn elderly patients away.

"There's a great deal of fear in the senior population that they're going to lose, that they're not going to gain anything," says Dr. Philip H. Pushkin, director of the Department of Aging in Baltimore County, which has the highest concentration of elderly people in Maryland. Some 19 percent of county residents are at least 60 years old.

Major senior citizen groups, including the 33-million-member American Association of Retired Persons and the National Council of Senior Citizens, are generally supportive of President Clinton's plan but want changes and have not endorsed it.

Congress is also approaching the plan's provisions for the elderly with caution. Lawmakers still haven't forgotten the debacle five years ago when they passed catastrophic-health insurance -- a benefit they thought the elderly would eagerly embrace -- and found themselves forced to repeal it because of outrage over higher fees.

Many older people already have at least some of the benefits the president is offering. Fifty-four percent of the elderly have prescription-drug coverage, which they pay for through private insurance plans that supplement Medicare.

A much smaller group, including Mr. Dorman, also has long-term-care benefits -- either through supplemental insurance or a life-care community like Edenwald. Prosperous residents of the high-rise complex next to Goucher College make a hefty down payment and then pay a large monthly fee guaranteeing them nursing home care and other services.

But the doubts about the Clinton health reform plan are not confined to the well-off or well-insured. At the Liberty senior citizen center in Randallstown, a daytime mecca for people of all economic backgrounds, the same range of questions about the plan can be heard.

"I don't know if it will hurt me or not," says Lucille Seymour, a retiree who volunteers at the center's front desk. "I'm sure we will have to pay more for this new plan -- hopefully it won't be too much. But I'm more concerned about the doctors, that we can go to the doctors we presently have."

Across the room from Ms. Seymour, Amy Taylor is playing pinochle with three friends around a card table. The former Social Security Administration employee admits she has had a hard time grasping details of the plan.

"I'm confused. You hear so much, the pros and cons, as to how the coverage will affect families," she says. "I guess maybe cost is the biggest thing I'm concerned about."

Most elderly people -- and most Americans of all ages -- don't understand the plan, according to polls. Older people's chief concerns revolve around issues of cost, freedom to pick physicians and, above all, the impact on Medicare.

Whatever complaints they have about Medicare, the elderly appreciate that it gives their age group something none other has: universal health insurance coverage for hospitalization and doctor's visits. Recognizing this, the Clinton administration made political decision to keep Medicare intact, while offering the elderly new benefits, such as prescription drugs.

But many senior citizens still worry that Medicare would suffer.

"I would hate to see that disturbed," says Edenwald resident Mary White Johnson, 83, who worked at Johns Hopkins Hospital. "I have depended a great deal on Medicare because I have had some high expenses."

Administration officials are confident of eventually winning senior citizens' backing. Given its "important new benefits," says White House spokeswoman Marla Romash, "we certainly believe that the more seniors know about the plan, the more they support it."

The prime benefit in the plan for many older Americans is long-term care. A new program of home-based services would serve seriously disabled people of all ages.

For the 44 percent of senior citizens who don't have prescription drug coverage, this benefit could be a life saver. "My sister-in-law only [buys] half of a prescription because she can't afford a whole one," says Liberty senior center visitor Leah Tattar, 70.

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