Arizona: A Scary Lesson In Medicare HMO's?

Since 1998, approximately 54,000 senior citizens, many in rural counties of Arizona, have been dropped from Medicare HMO coverage, usually because the Medicare HMO pulls out of Arizona or ceases offering the coverage. Medicare Blue pulled out of Arizona on July 1, 1999, along with some other providers. PacifiCare and Intergroup are two providers who will dump another bunch of seniors as of January 1, 2024. Others may also drop as of that date.

Nationally, the figures from the web sites searched indicate that as many (or as few) as 700,000 Americans who rely on Medicare HMO's may lose that coverage. These figures were attributed to the American Association of Health Plans.

California ranks No. 1 in the nation for number of resident retirees, with Oregon No. 2 and Arizona No. 3. (Sorry, Florida, I guess the hurricanes scared them away.) In 1996-97, Arizona had a significant number of Medicare HMO plans and almost all of these have either pulled out or suspended benefits as HMO's. When a Medicare HMO pulls out of an area, such as the rural Southern or Northern Arizona counties, often the sole recourse for the former HMO members is to go with traditional Medicare benefits. Many of these folks either go to Mexico for their prescriptions or do without the medication they cannot afford. Many areas in Arizona do not have hospital facilities less than 60 miles away. Some are blessed to have even an urgent care facility nearby.

What happened in 1997 to produce the subsequent exodus of Medicare HMO's from Arizona? As deficient a healthcare system as they are, many of us can afford no alternative to a Medicare HMO. It would have been nice to see them have to compete for our business and offer better benefits as incentives for joining their plan. The providers openly state they cannot afford to do business at a loss. The Balanced Budget Act of 1997 put a cap on Medicare (HCFA) payments to the Medicare HMO's, another brilliant move by our government to cut costs at the expense of the needy.

Several recent articles published in Arizona's major newspaper reflect that citizens of these rural areas are doing without prescribed medication, even for such chronic ailments as diabetes. Some residents of the affected areas note that the mortality rate is climbing for people aged 65-70, although there is no official release of statistics to verify that, it is an observation only.

It is safe to conclude that if people cannot afford to buy the medication they need for ailments such as diabetes or heart conditions, some will die from the lack of such prescribed medicines. Since we have one of the most liberal administrations to come along since the days of Franklin Delano Roosevelt, where is all this compassion for the poor? And why does this administration boast of the budget surpluses while medical benefits are being effectively withheld from those who need them most and can afford them least?

Are the so-called "compassionate" liberals willing to push their agenda at the cost of the lives of the poor, disabled and the elderly? They've already put the cap on Medicare that has forced the HMO's out of all but a few areas of Arizona! HCFA (the Health Care Financing Administration, which is the Medicare policy-making and payor agency under Health and Human Services) caps costs in the face of cost increases. The insurance providers state they can't do business at a loss and leave, so where are all the bleeding heart liberals who champion the cause of the poor, the lame, the old?

Perhaps, like Rep. Ed Pastor (D. Ariz.) who represents a hunk of Arizona, including Tucson, the liberals are busy pushing for "universal healthcare."

Wasn't that the Clinton agenda in 1992?

We, the American electorate, said we do not want socialized medicine. Perhaps if enough of the disabled and the elderly die from lack of facilities, medical care and medications, the electorate will come to its knees and beg for socialized medicine? Is that their real agenda now?

Oh sure, I have another conspiracy theory! Checking into the price of prescription drugs in the United States versus the price in nations like Mexico would lend credence to the notion that the pharmaceutical houses are gouging American consumers to pay outrageous prices while other countries do not. So the pharmaceutical houses make big bucks off the Americans who invested in their companies, or whose insurers paid their outrageous prices, while not giving up lucrative global markets by selling at reduced prices. And our government doesn't see anything wrong with that?

Somehow, our projected $2.17 trillion surplus over the next decade (if such exists in more than ink on paper) doesn't quite jibe with the cuts made to the most needy Medicare recipients.

Would the government like to explain that? If we hammer loudly enough, we might give them a blinding headache so that in a rash moment, we'd get an explanation. But, perhaps that's just wishful thinking.

It's a fearsome thing when you love your country and don't trust your government!

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