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Marilyn Moon

Publications and source records attributed to Marilyn Moon.

10 recordsLinked to original sources
PubMed2004

How beneficiaries fare under the new Medicare drug bill.

The Medicare Prescription Drug Improvement and Modernization Act (MMA) provides the largest benefit expansion in Medicare's history while enacting major changes to the program's structure. Offering $410 billion in new drug benefits will certainly help many beneficiaries now struggling with the costs of prescriptions, particularly those with low incomes. It is difficult to determine, however, whether beneficiaries will be better off in the long run. The drug benefits will not grow with the needs of beneficiaries, and other changes that prove to be unworkable or that place some beneficiaries at risk will create added costs. In the meantime, favorable treatment of private plans will create new inequities. Additional legislation and carefully crafted regulations could mitigate a number of these issues; in the meantime, they will require close scrutiny.

Cost Sharing↗
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Are women better off because of the new Medicare drug legislation?

The passage of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 will help to reduce the out-of-pocket burdens women will face in 2006 once the full drug benefit is introduced. Nonetheless, the legislation is less than ideal and creates a number of issues that should be improved to meet women's needs. Three key elements of the legislation that were essential in gaining its passage stand in the way of such improvements: limits on the amount spent on the benefit, requirements to rely on the private sector, and a failure to adequately arrange for future financing. A major overhaul is unlikely, but it is possible that modest improvements to aid Medicare beneficiaries will be considered in the future. Several of those improvements are described here.

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Comparing Medicare and private insurers: growth rates in spending over three decades.

Over the past three decades both Medicare and private insurers have initiated cost containment mechanisms to control the growth of spending on personal health care. To compare spending growth between these two payers, we present four measurement principles that should be implemented when drawing such comparisons, and we apply them to the National Health Accounts data files. We attribute Medicare's ability to equal--and using our measures, actually exceed-the private sector in controllingthe rate of health spending growth to Medicare's ability to price aggressively for the services it covers.

Health Care Surveys↗
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Medicare means-testing: a skeptical view.

In response to claims that Medicare is unsustainable over time, Mark Pauly has suggested a means-testing approach as a solution to its financing problems. To obtain enough resources in this way, however, it is necessary to ask middle-class beneficiaries to pay much more for their health care, by subjecting them to vouchers. The spending limits Pauly suggests are arbitrary and would likely place an untenable burden on beneficiaries with modest incomes. A better approach to financing would be to examine the ability of both taxpayers and beneficiaries to pay in the future-likely resulting in a different outcome.

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Medicare extra: a comprehensive benefit option for Medicare beneficiaries.

The proposed Part E, Medicare Extra, outlined in this paper adds a comprehensive benefit option to Medicare, eliminating the need for beneficiaries to purchase a private drug plan and Medigap supplemental coverage. Financed by a budget-neutral beneficiary premium, it has the advantages of greater simplicity, efficiency, and value without adding to federal costs. Beneficiaries now enrolled in Medigap plans would save money, as could employers by choosing a lower-cost alternative to current retiree health plans. Eliminating some of the excess payments to Medicare Advantage plans would yield savings that could be used to help finance premium subsidies for low-income beneficiaries.

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