Medicare

Thomas M. Tierney, a highly decorated World War II fighter pilot who went on to head the Medicare system under four presidents, died Friday of cancer in the Hospice of Baltimore. A resident of Winthrop House apartments in Charles Village, he was 82. Mr. Tierney was born in Colorado Springs, Colo., and reared in Denver, his home for many years, before moving to Towson in 1967 to take over Medicare, which was then based at the Social Security Administration. After graduating from the University of Notre Dame, he entered the Army Air Forces in 1942, flying combat missions over Europe for the next three years with the celebrated 9th Air Force.

The state's hospitals would absorb all of the 2 percent Medicare cuts required by federal sequestration under a proposal released Thursday by the state panel that sets hospital rates. The recommendation by the staff of the Health Services Cost Review Commission would mean that state hospitals would not get rate increases for the last three months of fiscal year 2013, a decision that prompted intense criticism from medical institutions that say they already operate on slim margins.

After reading the GOP is returning once again to their outrageous voucher system for senior medical care plan ("Medicare next target of GOP," March 3), and reading Steven Brill's article about exploitive hospital charges published in Time magazine and listening while it was further discussed on the Diane Rehm Show last week, I feel certain of the answer to outrageous medical cost and poor health care outcomes. We should, as Mr. Brill suggests, open Medicare coverage to those under 65 willing to pay for the coverage at a cost somewhat below equivalent insurance costs.

The talk in Washington and among opinion leaders around the country's budget issues today centers on "balance" and "responsibility. " Many conservatives declare that these terms mean that there should be no new revenue, only spending cuts to programs such as Social Security and Medicare. They also propose to reduc cost of living adjustments for all Social Security recipients, a group of Americans who have seen traditional pensions eliminated and savings devastated by the Great Recession - and who rely more and more on our Social Security system, into which they paid during their entire working lives.

With all the political drama going on concerning Medicare from both parties, it baffles me that President Barack Obama has ignored his legal responsibilities regarding the "Medicare trigger. " That trigger (covered under Section 1105 of Title 31 of the U.S. Code) is a forecast from the Medicare trustees that general revenues will be required for 45 percent or more of the program's outlays within a seven-year period, which signals that Medicare is financially unsustainable. The president is required to respond to Congress, but though the Medicare trustees issued a warning in 2009, 2010, 2011, and again this spring, President Obama has ignored the law each year and failed to submit the required budgetary legislation to Congress.

In response to Garrison Keillor's Jan. 27 commentary ("Don't knock elitism; it could save your life"): What a childish pout we have here, in explaining the Republican plan for health care as "let them die." I sincerely believe that the Democrats' proposed health care plan will cut nearly $500 billion from Medicare because that has been promised. That will most assuredly let someone die. I recently saw my first "comparative effectiveness" study. I was shocked to see the conclusion that Zocor would be preferred over Lipitor because the additional heart attacks with Zocor didn't cause so much lost work time as to cover the cost of the Lipitor!

Each time I write about reforming Medicare, the budget-busting health program for seniors, emails and blog comments follow. "I paid for my Medicare benefits," is the basic message. "It's not an entitlement. It's insurance. I'm just getting out of the system what I put in. " Retirees and boomers close to retirement are alarmed that substantial changes loom for the program they or their spouses contributed to for decades. Many see the potential cuts or greater required contributions as betrayal.

There is no better news than having Scott Brown elected to Congress, and seniors are rejoicing. The Congressional Democrats just don't get it. It is difficult to understand why our Maryland Democrats would sacrifice and betray the trust of elderly citizens of Maryland and the USA. They have voted to take away $500 billion from our Medicare to fund Obamacare, which will only speed up Medicare's bankruptcy. Elderly people like me depend on Medicare and are at the end of our lives when we may need more care.

With the passage of the Affordable Health Care for America Act (HR 3962) by the House of Representatives ("House OKs historic health bill," Nov. 8), we are one step closer to a stronger Medicare for seniors and future generations, as well as stable, affordable health care options for all Americans. AARP thanks Reps. C.A. Dutch Ruppersberger, John Sarbanes, Donna Edwards, Elijah Cummings, Steny Hoyer and Chris Van Hollen for their votes in favor of better health care for every Marylander.

Among the points discussed in this "fiscal cliff" conversation is the impending insolvency of Medicare. That "entitlement " program must be reformed. There is a solution for this part of the equation. The present age of eligibility for Medicare is 65. Lowering the age of eligibility for Medicare to 55 will add about 20 million new premium paying subscribers to the Medicare rolls. These 20 million are relatively healthier than the current cohort above the age of 65. Thus there will be more money into the system via 20 million people paying the present rate of about $1,200 a year in premiums, and due to their statistically healthier status requiring much less outflow of dollars for services.

University of Maryland St. Joseph Medical Center will be able to recoup some of the tens of millions of dollars it lost while operating without a Medicare certification under a compromise reached with federal officials. The Towson hospital will be able to bill Medicare for treatment given to patients in the federal program since Jan. 7, about six weeks before it regained what is known as a Medicare provider agreement. St. Joseph had operated without one since the University of Maryland Medical System bought the hospital and chose not to renew its existing Medicare certification.

The president and a few other prominent Democrats are openly suggesting that Social Security payments be reduced by applying a lower adjustment for inflation, and that Medicare be means-tested. This is even before Democrats have begun formal budget negotiations with Republicans -- who still refuse to raise taxes on the rich, close tax loopholes the rich depend on (such as hedge-fund and private-equity managers' "carried interest"), increase capital gains taxes on the wealthy, and cap tax deductions or tax financial transactions.

A state plan to tie medical spending to the growth of the economy is making hospital executives uneasy. Executives support the spirit of the plan proposed by the state Department of Health and Mental Hygiene, which seeks to reduce health spending by shifting patient care away from their facilities and toward more outpatient and preventive care. But they worry that its spending goals are too aggressive, and that they can't be attained in the time period the state has laid out. And they say it lacks necessary details on key elements, including how hospitals can be expected to limit spending increases to state economic growth.

Robert Reich's op-ed ("Obama should not compromise on Social Security and Medicare" April 3) prompts me to write. Mr. Reich's prescription for these programs isn't completely off the mark. But there is a much more comprehensive solution to each. Social Security: eliminate the cap on income subject to Social Security taxes. Then lower the rate dramatically. There is no rationale for having any cap on earned income subject to taxes in the first place. This change would dramatically increase revenue into the system without changing benefit formulas.

The statistic was so attention-grabbing that Mayor Stephanie Rawlings-Blake stopped and repeated it: Nearly half of Baltimore's municipal employees and retirees have a "critical or chronic" illness Rawlings-Blake emphasized the statistic as part of last month's speech at the Walters Art Museum , during which she released a consultants' report about the city's long-term finances. The unhealthy state of Baltimore's workforce contributes to the high cost of municipal health care, the mayor said.

After reading the GOP is returning once again to their outrageous voucher system for senior medical care plan ("Medicare next target of GOP," March 3), and reading Steven Brill's article about exploitive hospital charges published in Time magazine and listening while it was further discussed on the Diane Rehm Show last week, I feel certain of the answer to outrageous medical cost and poor health care outcomes. We should, as Mr. Brill suggests, open Medicare coverage to those under 65 willing to pay for the coverage at a cost somewhat below equivalent insurance costs.

The president and a few other prominent Democrats are openly suggesting that Social Security payments be reduced by applying a lower adjustment for inflation, and that Medicare be means-tested. This is even before Democrats have begun formal budget negotiations with Republicans -- who still refuse to raise taxes on the rich, close tax loopholes the rich depend on (such as hedge-fund and private-equity managers' "carried interest"), increase capital gains taxes on the wealthy, and cap tax deductions or tax financial transactions.

University of Maryland St. Joseph Medical Center said Friday that it has received a new Medicare provider agreement, allowing it to again seek reimbursement for treating patients on the federal government's health program. The Towson hospital has not billed Medicare patients since the University of Maryland Medical System voluntarily declined to keep St. Joseph's prior federal certification when it bought the hospital Dec. 1. St. Joseph officials now hope to recoup some of those losses.

University of Maryland St. Joseph Medical Center loses about $400,000 every day it's not certified by Medicare to collect payments from the federal health care program. The big question is how much that will ultimately cost the Towson hospital. Tens of millions of dollars could be at stake. The University of Maryland Medical System voluntary gave up the Medicare certification when it bought St. Joseph from Denver-based Catholic Health Initiatives in a $206.3 million deal that closed in December.