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By Dorothy Anne Seese


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The concept of improving the Medicare Health Maintenance Organization (HMO) could be the first step in providing better medical care for senior citizens, particularly those who are not critically ill.  The seriously ill need a special HMO status for proper care.  Dozens and dozens of insurers that formerly provided a Medicare HMO to seniors have been forced out of business during the Clinton-Gore Administration by the placement of payment "ceilings" on services for which Medicare would pay.

But let's back up a bit and see who these HMO seniors are, because there's a bad aroma in the air from the notion that such recipients are all lazy, former welfare cases and people who wouldn't work or didn't have sense enough to plan ahead. Talk about profiling ... this nation has some horrific "age profiling" that knows no racial or ethnic distinctions, just the crime of growing older and not having saved or invested for retirement.  Was it because they were too stupid to do so?  Not in the cases I know (including my own), it was because the money was not there.

From the 1950's well into the late 1970's, investments, particularly the stock market, were the property of the professional or well-to-do business classes, not the average working class people of my 42 working years.  In fact, I recall that in 1976 the Dow Jones ranged around 700 ... and $700 a month was approximately my salary for supporting myself and my mother.  My single investment was in my home, to build equity.  In 1973, I bought a house for $18,990 and lived there 25 years, and sold it for over $50,000.  That was the way the average working poor built any retirement equity, but housing was a lot more affordable in 1973.

Now we have all these seniors reaching 65-plus who didn't work for large corporations with pension funds or government agencies with pensions.  Some were able to save, others saved a little bit and found it didn't last long, and others planned to continue working,  but found that some disability nullified their plans.

In short, the best laid plans don't always work!

I belong to a Medicare HMO.  The co-pays are rising every year.  At 65, I have been "retired" four years due to disability ... a spinal fracture from a fall at work and subsequent misdiagnosis.  My great retirement plan was truncated early, and my few IRA's didn't last long once the Friday paycheck stopped.  The HMO isn't wonderful care.  In fact, it doesn't provide for the most productive of all health care programs: preventative medicine.  A member of my HMO has to have a medical complaint in order to see the doctor, perhaps one that could have been avoided with preventative care.

But this HMO, which belongs to a community-based health care provider, is at least still in business and has several thousand members here in Sun City and surrounding areas in the Northwest Phoenix metro area.

The HMO was the government's first big plunge into providing senior medical care and other group health care.  To me, it doesn't belong in the work place and surely isn't satisfactory for most working people or their children.  It can be useful to seniors with some modifications from dear old Uncle Sam ... since the government caused most of the health care mess we're in, they can get busy and correct its problems!

Step One would be to provide preventative care, within reason, particularly annual physical checkups for all the HMO's members.

There are a lot of other steps but ... maybe the government can start with, and put into effect, just one?  That would be a big improvement over their regressive actions of the past eight years.  I would like to see the Medicare HMO repaired for those seniors who just cannot afford standard Medicare deductibles or expensive Medicare supplemental policies.

News reports indicate that fewer and fewer corporations and businesses are able to provide health care coverage for employees and even more are doing away with retirement plans and pension funds.  So the future for the working class below executive level pay isn't that good, particulary for families with children and/or parents to care for.  Again, highly paid employees can save, the average working person cannot, and it doesn't appear to be an improving situation, but a deteriorating one.

Yoo hoo ... anyone in Washington listening?  Or is Congress so divided that the members would rather squabble and call names rather than put the people's interests first?  Medicare reform and any HMO reform will have to be a bi-partisan effort.  With rising costs, increasing layoffs, bigger income gaps between the average worker and the hi-tech or professional employees, there's a whole bunch of people out there facing a bleak future when they retire.

I would have preferred that government stay out of health care in the first place, but that's about 30 years too late.  We have it, and because of it, we've come to need it.

Let's make them earn their keep on Capitol Hill by demanding they do something intelligent for a change.

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Dorothy Seese, 2024

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View expressed are those of the author and do not necessarily reflect those of Political USA.

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