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Assessing America's Health Risks: How Well Are Medicare's Clinical Preventive Benefits Serving America's Seniors? How Will the Next Generation of Preventive Medical Treatments be Incorporated and Promoted in the Health Care System?"
Subcommittee on Oversight and Investigations
Ms. Viola Quirion
Thank you, Chairman Greenwood
and all of the Members of this subcommittee, for this invitation to testify
today. I am Viola Quirion from
Waterville, Maine and a member of the Alliance for Retired Americans. I am
accompanied today by John Carr, president of the Maine Council of Senior
Citizens. The Alliance for Retired Americans, which was established in January
2001, now has 2.5 million members across the nation.
Retirees from affiliates of the AFL-CIO, community-based organizations
and individual seniors have joined the Alliance to create a strong new voice for
retired workers and their families. I want to congratulate you for
holding this hearing as I believe that preventive services under the Medicare
program are very important. Because
of Medicare coverage of pap smears, mammograms and flu shots, many lives have
probably been extended. I think
physical exams also should be considered a preventive service. For many people
on a limited income, however, the 20 percent co-payment for most preventive
services may be an immediate luxury they cannot afford even though it may
ultimately be life-saving. As I mentioned, I am from
Waterville, Maine. I worked in the
Hathaway shirt factory there for 44 years until I retired in 1994.
I live on two small pensions and Social Security, which comes to $1,466 a
month. I never had to worry about
health care expenses until I retired. I
now have a supplemental plan to cover some of the costs Medicare does not cover,
but it is not sufficient for everything. I was diagnosed with ovarian
cancer in late December 2000, and had surgery in mid-January, 2001. The surgeons who operated found that different parts of the
cancer had cemented together in my ovaries and if they tried to cut it out, I
would have bled to death. Consequently,
I took a series of chemotherapy treatments lasting 5 ½ hours each time.
It took 7 days for me to recover after each of these treatments.
For these treatments and my recovery, I was in a nursing home for six
months. In December of 2001, I had knee
surgery. While recovering at home,
I suffered from a number of infections. I
needed intravenous transfusions but since Medicare does not pay for those at
home, I had to go into a skilled nursing facility for six weeks where they are
covered. Consequently, Medicare
paid for the skilled nursing care and the IVs which was much more costly than
the $400 treatments I could have received at home. Although IV transfusions may
not be considered a preventive service, it does not make sense to me to spend
extra money unnecessarily. Currently, I am taking 1 ½
hour chemotherapy treatments and don't experience negative after effects.
And the numbers on the blood tests show that the mass is dissolving.
I am happy to say that Medicare does cover the chemo treatments.
Follow-up is just as critical to survival as preventive services. I am here today to tell you of
the importance of prescriptions drugs as a preventive measure that has extended
and enhanced the quality of everyday life for millions of Americans.
Technological advances in treating diseases include use of new drugs that
can arrest or cure many cancers, heart disease, high blood pressure and other
life-threatening conditions. Prescription
drugs have saved costs in reducing surgeries and hospital and nursing home care.
However, new drugs are more expensive than old drugs and three times more
costly than generic drugs. I have taken 7 bus trips to
Canada over the past few years which were sponsored by the Maine Council of
Senior Citizens and the Alliance for Retired Americans.
I take Prilosec for stomach ailments, which in the U.S. costs me $5 a
pill, and Relafin for my back and knees. I
estimate that I saved $1,000 every trip. Unfortunately,
it took me a week to recover from the last trip because of my knees.
I probably won't be able to make any more.
But I am not alone, there are so many people that could benefit from
these trips but are physically unable to board a bus. The real point is, however, that we should not have to make these trips at all. Prescription drugs should be one of the benefits of the Medicare program. Despite all the hopes placed in the Medicare+Choice program, it is not a solution. The share of Medicare+Choice enrollees with prescription drug coverage declined from 84 percent in 1999 to 67 percent in 2001. At the same time, premiums and co-payments are more costly. In half of the 33 states with Medicare+Choice plans with drug coverage, the average premium rose more than 100 percent in the past 3 years. Sadly for Maine residents, even if some were able to afford these increases, it doesn't make any difference-there is no Medicare+Choice plan in Maine. So trying to add preventive services coverage here would be no help either. The Alliance for Retired Americans has developed a set of principles for a comprehensive Medicare prescription drug program. The program should provide full access to all medically necessary medications. Most importantly, the benefit should be affordable. It should include a monthly premium of no more than $25, 20 percent co-insurance, a $100 deductible, and a $2,000 out-of-pocket annual cap. Mr. Chairman and members of the committee, I would like to close by telling you about a husband and wife that I met on the bus trips who both take a number of medications. However, they can't afford them. They have "resolved" this dilemma by taking turns buying their medications. One month, they pay for the husband's prescription drugs, the next month, it is his wife's turn and so on. Neither bus trips nor cutting back on medications that are necessary, not only for health but for life itself, are the answer. As you probably know, the state
of Maine has taken steps on behalf of its citizens to ensure affordable
prescription drugs because of inaction on the federal level.
However, the Maine Rx Program has been challenged in the courts by the
pharmaceutical companies all the way up to the Supreme Court.
While we in Maine support our state's actions, we also believe this is
a national policy problem. The real
solution is within the power of Congress and that is to add a prescription drug
benefit to the Medicare program as well as increase access to other preventive
services. Thank you.
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