|
|
| In Focus: The Graying of America: Elderly Healthcare Consumers |
By: HealthBond - Anne Marie Talbott, MA, MBA
|
|
The third in a series of four articles concerning the American consumer's viewpoints on healthcare, this week's article looks at an interview with two elderly Americans and how they see the healthcare system today.
As American citizens enter their middle and late years, healthcare becomes a very important part of their lives, and so do the costs associated with it. Price increases hit those with fixed incomes doubly hard, and as we age, we often develop chronic conditions that require long-term treatment. How do we afford these treatments or medications? What are the options available to us as elderly American healthcare consumers?
"The graying of America will have obvious effects on the Medicare system. According to the report, 10% of the Medicare populations in 40 states are 85 or older. States in the upper Midwest - the Dakotas, Minnesota, Nebraska, Kansas and Iowa - have the highest population of what the report dubbed 'old elderly.' " (USA Today)
Americans are aging, costs are rising. "At an April 26 White House briefing, Families USA said the average cost of the 50 drugs most used by seniors rose 3.9% in 1999, higher than the 2.2% inflation rate."(Business Week, 8 May 2000, page 62). The growing burden on the elderly is a major worry for them, and as a nation, we have to come up with a way to alleviate it somehow. Costs are rising, but so is consumer awareness. Elderly Americans are learning to lobby effectively and speak out.
"Poverty among the elderly has dropped nearly two-thirds since the creation of Medicare in 1968. But the number of beneficiaries will double to 80 million over the next 30 years and the study warned that Medicare must change to deal with the increase. 'Medicare has not been given the tools it needs to be as competitive and efficient as it needs to be in the 21st century,' according to the study. 'Despite modern medicine's reliance on pharmaceuticals, the program does not cover prescription drugs.' " Political competition about Medicare plans and benefits is increasing, as a presidential election draws near. (USA Today)
Medicare is changing, too, trying to adapt to the needs of the modern consumer population. "Medicare plans to clarify criteria used to decide which new health care products and services the nation's insurance program for the elderly and disabled will pay for. The Health and Human Services Department announced Thursday that upcoming regulations will more precisely define Medicare's long-used rule that care must be 'reasonable and necessary' to qualify for coverage. Under the new rules, two tests would have to be met:
- Clinical evidence would have to exist showing medical benefits.
- The product or service would also have to have ``added value'' over existing coverage, such as lower cost, improved health outcomes, or a new treatment choice, such as medication in place of surgery.
The regulations will be formally proposed after a 30-day comment period, the agency said. Then, they would not become final until after an additional public vetting." (NY Times)
The perception among healthcare consumers--especially elderly ones--is that healthcare insurance is too difficult to understand--is one that concerns many older Americans. "As senior citizens, we agree that the perception of consumers about insurance being hard to understand is correct. It is very difficult to understand. The problem would be eliminated," Bob and Dorothy, two elderly healthcare consumers interviewed by In Focus recently, noted, "if the initial insurance forms would indicate what amount of the medical bill would be our responsibility."
"We do feel that if senior citizens cannot afford a supplemental insurance premium that Medicare should pay more to them," Bob said, and Dorothy agreed. "We are very satisfied with our own healthcare policies through AARP and Medicare."
When asked if the average healthcare consumer is willing to make cost-cuts now in order to get better service in the long run, Dorothy and Bob didn't think so. They felt that cost cuts now wouldn't have an effect on services in the long term, and that people wouldn't be willing to do that, no matter what was promised "down the road". They also noted that "…we do not believe medical savings accounts would be beneficial. The percentage billing (process) is better because costs vary."
Third party help with the billing process would be of great assistance, the couple, both in their mid-70s, thought. "Yes! We believe that third parties helping with the billing process could prove beneficial. However, if (people) live in a small town, as we do, the doctor's billing clerk can be very helpful." Established relationships with healthcare personnel make the difference here. The small-town effect is noticeable, too. The clerk has more time to spend with the elderly couple, explaining the billing process, whereas in a larger community, this might be impossible due to time and work constraints.
Should private insurance packages include preventative as well as the more usual healthcare coverage? Dorothy said yes, definitely. "Yes, if insurance packages would include preventative coverage the overall cost would be better. At the present time, AARP allows mammograms free of charge and with our AARP health card we receive a 50% deduction on our medicines." Elderly Americans are just as focused on maintaining good health as younger citizens are, and outreach to this population could be very effective. Preventative measures, if covered, would increase the early detection of some problems, thereby reducing costs and increasing quality-of-life across the board.
As far as what they think about consumers versus insurance companies making the best choices, Bob and Dorothy felt that "a person's monthly income should be considered" in the decision-making process, and that consumers can make good choices if provided with enough information in a user-friendly format. "We think that insurance companies would prefer that consumers would rather make their own decisions, but that it wouldn't always be to their (the insurance company's) best interest."
"Usually, people get the information they need from the newspapers or television advertisements. We haven't used the Internet, but from what we have read we would probably feel it's a great asset," Bob and Dorothy commented, when asked where they obtain their healthcare information. They have been members of AARP since 1984, and "we've found that they are very informative and the premiums are much less than some other health supplements." They think the information they obtain from AARP is very good, and fairly easy to read and understand.
Elderly people are less likely to use the Internet as an information access tool, but this will change as the Baby Boomer generation ages. Insurance companies as well as healthcare providers should focus on this demographic change over time, and tailor their information output to reflect that. The positive experiences Bob and Dorothy have had with associations like AARP indicates that someone's doing something right as far as presenting information to an elderly population, and other groups could emulate the success story behind the AARP's information presentation policies.
Both Bob and Dorothy are veterans, both having served in the Navy during World War Two; in fact, that's how they met. After the war, Dorothy left the military and married Bob; Bob left the Navy and joined the Army for a career as an enlisted man. In Focus asked them about veteran's benefits, and they had this to say: "We have never discussed health care with the Veteran's Administration because we prefer to go to a doctor located close to our home plus the fact that the VA Hospital is too far from our house." But while Bob was on active duty, "for forty-one years," Dorothy noted, "we went to military doctors on post and received excellent care." Veteran's benefits are important to the couple, but they have very strong ties to their local doctor and healthcare provider system in the small town where they live, and the VA facilities are too far away from them to be very useful.
Small-town elderly healthcare consumers may be less likely to use benefits they earned through service to their country, and in a way that's a shame. If they are qualified for the healthcare benefits, but feel the facilities are too far away, maybe the facilities could be mobile, and brought to the consumer. More elderly healthcare consumers might take advantage of healthcare resources if they had more access to them. In today's world of rising costs, making healthcare resources more available may help hold down overall costs by providing intervention and treatment before problems become chronic or severe.
Bob and Dorothy, as elderly healthcare consumers, have definite opinions, likes and dislikes. Healthcare providers, insurance companies, government agencies--all these entities have an effect on their lives, and some have more positive effects that others. The couple is representative of many elderly, small-town American healthcare consumers, and their opinions matter. How they view the system as a whole--and how they obtain information about their healthcare benefits and responsibilities--illustrates both the strong and weak points of the American healthcare system, especially when looking at insurance benefits and information exchange.
We have to ask ourselves how we can improve things for elderly healthcare consumers. Making information more readily accessible, and easier to understand, is one step. Making benefits for which they are entitled more available, and possibly bringing the benefits to them as opposed to the other way around, would also be another step. Encouraging elderly healthcare consumers to ask more questions, to pursue preventative healthcare measures, and to expand their usage of the Internet as an information provider tool, are other topics to explore when we think about elderly Americans and their health coverage.
As the society we live in ages, as we ourselves age, we need to learn from the experiences of those who have gone ahead of us. We can stand to learn a great deal, both as individual people and as healthcare providers, from people like Bob and Dorothy, if we take the time to listen to what they're saying. Their opinions matter--our opinions matter--and if we listen, we can hear solutions to problems being discussed. Elderly healthcare consumers have special needs, and issues, but some of them are ones that affect all of us as healthcare consumers, no matter what our age or occupation is.
For more information about AARP
In Focus for May, Consumers in Healthcare. Previous articles for May.
May 1-7, 2000, Consumers Care!
May 8-12, 2000, Meeting the Bottom Line
Anne Marie Talbott, atalbott@healthbond.com
|
|
Printer-friendly format
|
|
|
|
