HEARING - U.S. Senate Special Committee on Aging

HEARING - U.S. Senate Special Committee on Aging HEARING - U.S. Senate Special Committee on Aging

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103 Itmr 4 COMMENTS OF CONSUMERS UNION* ON CATASTROPHIC ILLNESS EXPENSES (DEPARTMENT OF HEALTH AND HUMAN SERVICES REPORT TO THE PRESIDENT) January 8, 1987 INTRODUCTION AND SUMMARY Catastronhic Illness Expenses (Department of Health and Human Services Secretary Bowen's Report to the President) (hereinafter, the Report) identifies three important segments of the health care problem facing Americans -- the need for, 1. acute care catastrophic protection for the elderly; 2. long-term care protection alternatives; and 3. catastrophic health expense protection for the general population. The Report recommends (among other things): 1. restructuring the Medicare program to provide catastrophic protection for the elderly with an actuarially sound additional premium; 2. providing incentives through the tax system for savings earmarked for long-term care expenses and for the purchase of long-term insurance; and 3. encouraging state initiatives to extend catastrophic insurance protection to the general population. *Consumers Union is a nonprofit membership organization chartered in 1936 under the laws of the State of New York to provide information, education and counsel about consumer goods and services and the management of family income. Consumers Union's income is derived solely from the sale of Consumer Reports, its other publications and films. Expenses of occasional public service efforts may be met, in part, by nonrestrictive, noncommercial contributions, grants and fees. In addition to reports on Consumers Union's own product testing, Consumer Reports, with approximately 3.5 million paid circulation, regularly carries articles on health, product safety, marketplace economics and legislative, judicial and regulatory actions which affect consumer welfare. Consumers Union's publications carry no advertising and receive no commercial support.

104 - 2-- Consumers Union suV orts the recommendation to restructure Medicare Part B to provide for catastrophic protection for the elderly, financed by an additional premium. The proposal will greatly benefit the elderly with the most severe medical expenses, and is funded, appropriately we believe, by all beneficiaries. However, Consumers Union disagrees with several policies contained in the Report. Section I of the following comments describes the inappropriateness of using the private Medicare supplement insurance market as a model for long-term care insurance. In this section, we both explain why some of the Report's recommended options are not desirable and identify further options that should have been considered. Section II takes issue with the Report's reliance on the tax system as a mechanism to subsidize the savings plans and the purchase of long-term care insurance policies. Section III describes why the Report's treatment of the under age 65 population is inadequate. I. THE PRIVATE "MEDIGAP" MARKET HAS NOT WORKED WELL AND SHOULD NOT SERVE AS A MODEL FOR THE LONG-TERM CARE INSURANCE MARKET. The Report attempts to form a "partnership" between the private sector and the government, similar to the medicare/medigap dichotomy, to facilitate access to long term care insurance. In pursuing this partnership, the Report: (A) fails to acknowledge or give adequate weight to the private market's shortcomings; (B) recommends options that are destined

103<br />

Itmr 4<br />

COMMENTS OF CONSUMERS UNION*<br />

ON CATASTROPHIC ILLNESS EXPENSES<br />

(DEPARTMENT OF HEALTH AND HUMAN SERVICES<br />

REPORT TO THE PRESIDENT)<br />

January 8, 1987<br />

INTRODUCTION AND SUMMARY<br />

Catastr<strong>on</strong>hic Illness Expenses (Department of Health and<br />

Human Services Secretary Bowen's Report to the<br />

President) (hereinafter, the Report) identifies three important<br />

segments of the health care problem facing Americans -- the need<br />

for,<br />

1. acute care catastrophic protecti<strong>on</strong> for the elderly;<br />

2. l<strong>on</strong>g-term care protecti<strong>on</strong> alternatives; and<br />

3. catastrophic health expense protecti<strong>on</strong> for the<br />

general populati<strong>on</strong>.<br />

The Report recommends (am<strong>on</strong>g other things):<br />

1. restructuring the Medicare program to provide<br />

catastrophic protecti<strong>on</strong> for the elderly with an<br />

actuarially sound additi<strong>on</strong>al premium;<br />

2. providing incentives through the tax system for<br />

savings earmarked for l<strong>on</strong>g-term care expenses and for<br />

the purchase of l<strong>on</strong>g-term insurance; and<br />

3. encouraging state initiatives to extend catastrophic<br />

insurance protecti<strong>on</strong> to the general populati<strong>on</strong>.<br />

*C<strong>on</strong>sumers Uni<strong>on</strong> is a n<strong>on</strong>profit membership organizati<strong>on</strong><br />

chartered in 1936 under the laws of the State of New York to<br />

provide informati<strong>on</strong>, educati<strong>on</strong> and counsel about c<strong>on</strong>sumer goods<br />

and services and the management of family income. C<strong>on</strong>sumers<br />

Uni<strong>on</strong>'s income is derived solely from the sale of C<strong>on</strong>sumer<br />

Reports, its other publicati<strong>on</strong>s and films. Expenses of<br />

occasi<strong>on</strong>al public service efforts may be met, in part, by<br />

n<strong>on</strong>restrictive, n<strong>on</strong>commercial c<strong>on</strong>tributi<strong>on</strong>s, grants and fees.<br />

In additi<strong>on</strong> to reports <strong>on</strong> C<strong>on</strong>sumers Uni<strong>on</strong>'s own product testing,<br />

C<strong>on</strong>sumer Reports, with approximately 3.5 milli<strong>on</strong> paid<br />

circulati<strong>on</strong>, regularly carries articles <strong>on</strong> health, product<br />

safety, marketplace ec<strong>on</strong>omics and legislative, judicial and<br />

regulatory acti<strong>on</strong>s which affect c<strong>on</strong>sumer welfare. C<strong>on</strong>sumers<br />

Uni<strong>on</strong>'s publicati<strong>on</strong>s carry no advertising and receive no<br />

commercial support.

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