AUGUST 14, 1995 VOLUME 3, NUMBER 7
Republicans in Congress have made it clear they hope to trim $270 billion from anticipated Medicare increases in future years, but have so far failed to explain how they intend to accomplish this result. It has become clear, however, that they expect about $60 billion of that savings to come from higher premiums charged to Medicare participants.
Currently, Medicare beneficiaries pay $46.10 per month for Part B. Usually, this premium is deducted from Social Security benefits. On average, this premium pays 31.5% of the government's cost to provide Part B coverage.
Congressional Republicans have proposed indexing Medicare premiums so that the percentage of remains fixed at 31.5%. Based on best estimates of future Medicare costs, that means premiums would jump to $97.50 per month by 2002.
Medicare's premium rates were originally set to cover 50% of the cost of the program, but rising costs led to a reduction in the percentage recovered through premiums in recent years. Current premium rates were set five years ago and were intended to provide 25% of the cost of coverage; since costs increased more slowly than expected, the premiums actually covered a larger share of the cost than intended.
The White House has proposed returning the premium level to 25% of the cost of Medicare. Under that proposal, beneficiaries could expect to pay about $77.40 per month by 2002. Clinton's plan would only raise $16 billion to help reduce the anticipated Medicare shortfall in the next five years, but would save beneficiaries slightly more than $20 per month in premiums.
Restraints In Nursing Homes
About one of every five elderly nursing home residents will be restrained for some part of their nursing home stay. At least that is the estimate of Professor Marshall Kapp, recognized as a leading expert on long-term care issues.
Nursing home rights advocates have fought for reduction of the use of restraints for several years. Among the arguments Kapp makes:
- Serious injuries are more common when mechanical restraints are used long-term. Residents are often hurt when they become agitated and attempt to escape from the restraints, or when staff fails to monitor and adjust restraints in time.
- Facilities using restraints frequently provide inadequate training in how to use, monitor and adjust the devices.
- Nursing homes have made more dramatic strides in reducing restraints than hospitals or other acute care facilities.