miércoles, 3 de octubre de 2012

: Secretary Kathleen Sebelius, Department of Health & Human Services

: Secretary Kathleen Sebelius, Department of Health & Human Services

The biggest change we can make isn't how we provide health care - it's when.  Right now, we have a sick care system, and we need to invest in a health care system. - Secretary Kathleen Sebelius
Photos by Chris Smith

National Hispanic Council on Aging

October 3, 2012
Washington, DC

Thank you for that warm welcome. But more importantly, I want to thank you for your commitment to the health and well-being of Hispanic older adults and their families.
That work is more important than ever. Last year, the first Baby Boomers turned 65. Since then about 10,000 Americans have turned 65 each day. And the number of Hispanics 65 and older is expected to grow from 2.9 million in 2010 to 13.8 million by 2050. For years to come, the Hispanic population will shape the aging of America.
As a nation, we recognize how hard seniors have worked and the sacrifices they’ve made. We count on them as parents and grandparents, neighbors, colleagues, and community leaders. And we believe that every American deserves the opportunity to grow old and retire with the security and health care they have earned.
Today, I want to talk about two ways that this Administration has worked to honor that fundamental commitment. The first is by strengthening Medicare for today and tomorrow. The second is by ensuring that older Americans can get the services and support they need to continue living in their homes and communities, whenever possible.
It can be easy to forget that before Medicare was enacted in 1965, most Americans lost their insurance when they retired -- their access to health care decreasing with their incomes. Nearly half of all seniors had no coverage at all. But Medicare changed all that. Nineteen million Americans enrolled within a year of its creation.
Over time, it reaffirmed just how fundamental health care is to building a future for ourselves and our families. The healthier we are, the more freedom we have to continue contributing to our families and our communities. The more time we have to travel with our loved ones and play with our grandchildren.
Medicare has made America a stronger, more prosperous nation. And this Administration is dedicated to protecting and strengthening it.
That starts with one key principle: A commitment to safeguarding Medicare’s guaranteed benefits. Every American should know that the benefits promised to them will be there when they retire -- no matter what age they are today, 65 or 55, 45 or 25.
We also need to strengthen those benefits where we can, to meet seniors’ needs. And that’s exactly what we’ve done thanks to the Affordable Care Act.
For example, we know that in the past, as many as one in four Medicare beneficiaries may have gone without some of their medications because of costs from the coverage gap we call the donut hole. That's just not right.
So starting last year, people with Medicare in the donut hole began getting a 50 percent discount on covered brand-name drugs thanks to the health care law. And by 2020, the donut hole will be closed completely. Seniors in the donut hole have already saved an average of $641 in the first eight months of 2012. And this includes $195 million in savings on prescriptions for diabetes, and $75 million saved on cancer drugs.
We also know that in the past too many seniors went without critical preventive care such as cancer screenings because they couldn't afford these services. Now, thanks to health care reform, seniors no longer have any co-pays and deductibles for key preventive screenings such as mammograms. Already in the first eight months of 2012, more than 19 million people with original Medicare received at least one preventive service at no cost to them.
At the same time, we also know we have to put Medicare's finances on a more sustainable path. When we took office, the Medicare Trust Fund was on track to run out just four years from now. Under the Affordable Care Act, we’ve already added 8 more years to the life of the Trust Fund.
And we continue taking steps to put the program on sounder footing.
For example we’ve put in place more tools to stop fraud – including more law enforcement boots on the ground and more time in prison for criminals. As a result, prosecutions of health care fraud cases are up 75% since 2008.
But for all of our new technology and investigative muscle, the most valuable resource we have in the fight against Medicare fraud are the millions of seniors who serve as our eyes and ears.
That’s why we’ve partnered with NHCOA to launch the National Hispanic Senior Medicare Patrol -- which uses culturally and linguistically appropriate resources to close the gap in Medicare fraud education among Hispanic older adults.
We’ve seen this work pay off. I heard from a Medicare beneficiary in Texas who was asked to sign a work order for his diabetes supplies. Normally he wouldn’t have paid it much attention. But a presentation from the National Hispanic Senior Medicare Patrol, or SMP, at his adult day center showed him why he should look a little more closely. And that’s how he noticed he was being charged $7,000 for one month’s supply.
So he asked his home nurse to help him call the National Hispanic SMP. And together they figured out that the supplier was going to charge Medicare for 100 boxes of diabetes test strips and 100 boxes of lancets, even though he’d received only one of each.
The SMP helped resolve the case and made sure that Medicare only paid for the supplies he actually needed and received.
We’ve heard stories like this in communities around the country. And they are a reminder that everyone has a role in keeping Medicare strong.
Now, providing access to quality health care is an important part of our commitment to seniors. But we also recognize that there are other key steps we can take to improve their lives and the lives of their families and caregivers.
Today, approximately 10 million Americans need long-term services and supports. That number is rising steadily. By 2020, it’s expected that 15 million Americans will need some kind of long-term care. But for too long, too many of these people have faced an impossible choice between living in a nursing home away from their loved ones -- or living at home without the long-term services and supports they need. Our philosophy is simple: we want to give them better choices.
So over the last three and a half years, this administration has made an ambitious commitment to make sure seniors have the support and services they need to live as independently as possible in their homes and communities.
We have extended and enhanced the Money Follows the Person program, which helps people with disabilities transition from institutional to community settings.
Forty-three states and the District of Columbia participate in the program. And nearly 20,000 people have already transitioned out of institutions with its support. Now the health care law is adding 5 more years and $2.25 billion to expand and build on that success.
The law also gives States the option of establishing a new Medicaid category for people who receive home and community-based services -- even if they don’t meet the requirements for nursing home care. This creates new flexibility to design and tailor services to meet people’s needs in the community.
At the same time, we continue to provide grants to invest in a range of supports to help family and informal caregivers care for their loved ones -- training, individual counseling, and respite care.
And last month, we awarded $300,000 in health literacy grants to NHCOA to train and deploy Promotores in community-based settings where they will teach older Hispanic adults with chronic diseases, as well as their caregivers and families.
What all of these steps represent, in my opinion, is the strongest commitment we’ve ever seen across the federal government to a community-first approach to long-term care.
We recognize that this work builds on a foundation laid over many years by leaders like those here today. For nearly 40 years, NHCOA has been a strong voice for Hispanic older adults. And when the national conversation has turned to programs like Medicare and Medicaid, we’ve looked to you to remind us what’s at stake.
Today, those stakes are higher than ever. As you know Republicans in Congress have proposed their own plans for Medicare and Medicaid. They passed a budget that would turn Medicaid into a block grant program -- and slash its funds by $750 billion. And it would end Medicare as we know it by turning it into a voucher program.
The fact is that nearly 50 million Americans count on Medicare. And two-thirds of Medicaid spending goes to provide care for older Americans and people with disabilities. We cannot afford to take these programs for granted.
Seniors have given a lifetime of hard work and sacrifice to this country. In return, they deserve the basic dignity that comes with quality care and the support to live at home and in their community
Over many decades, our nation has built programs like Medicare and Medicaid that fulfill this fundamental promise.
And we’ve worked hand in hand with our partners to protect and improve them.
By working together, we can continue to honor that commitment for this generation and those to come.

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