The nation’s largest advocacy group for seniors says it’s nonpartisan, but its support for the Obama administration’s health care push places it on the side of bigger government yet again.
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He added that a major goal for AARP is to make sure that any reform eliminates the so-called “donut hole,” which is a gap in subsidies under the Medicare prescription drug plan.
The Medicare proposals outlined by the Obama administration include reducing hospital subsidies, slashing payments to private insurers as part of the Medicare Advantage program, and eliminating waste, fraud, and abuse.
In 2006, when Bush proposed far smaller Medicare cuts of $105 billion over 10 years, USA Today quoted an AARP spokesman as saying, “The Congress, in an election year, is not going to pass these disastrous provisions.”
But Certner said that was different. “We oppose across-the-board type cuts,” he explained. “These are cuts that don’t really look at trying to get efficiencies or savings that make sense, they just whack across-the-board and can harm the health care system.”
Conservatives have argued that the Obama administration’s proposal to employ “comparative effectiveness research” will open the door for rationing care in the United States as such research has done in government-run health care systems. In Britain, for instance, the National Institute for Health and Clinical Excellence (NICE) places a monetary value on life and allocates health care resources accordingly. Such a system tends to disproportionately affect elderly patients who are nearing the end of their days. Certner said it was wrong to argue that Obama is proposing something similar for the U.S.
“You’ve just described comparative effectiveness research in an English way,” he responded. “I think we’re talking about a different kind of understanding of what we need to do in our system, which is evidence-based research, which is to do more research on what drugs and procedures work best, and then be able to give that research to doctors and patients so they can make the best choices for themselves.”
Jim Dau, an AARP spokesman, added: “This is really about providing doctors and patients about the best possible tools. It just seems like a no-brainer.”
Asked to name a single initiative on which AARP has opposed the Obama administration, both Dau and Certner drew a blank, before rejecting the premise of the question.
“It’s a little premature for that question just yet,” Certner said, stressing that the administration was still in its infancy and that no final health care legislation that can be tied to Obama yet exists. The group, did, however, criticize the Senate Health, Education, Labor and Pensions Committee (HELP) bill for language that would prolong the development of generic alternatives to costly biologic drugs, Certner noted.
While AARP representatives argue that the organization just wants what’s best for its members, philosophically, the group’s tendency is to support legislation that would expand the role of the federal government.
In making the case that AARP is truly nonpartisan, representatives noted that they were attacked by liberals for cooperating with the Bush administration on the Medicare prescription drug bill. But that was an example of a Republican president pushing the largest expansion of entitlements since the Great Society.
While AARP is generally supportive of the current effort to increase government’s role in health care, representatives swept aside many small-government alternative proposals as wrong-headed and insufficient.
Asked about proposals to allow individuals to purchase insurance across state lines, which would make it easier for Americans to obtain more modest health insurance coverage with lower premiums, Certner argued, “The problem is that you’d have all the regulation at the state level undone, and everybody could get cheap and under-regulated insurance from the state that has the lowest standards.” That was precisely the argument that Obama used against Sen. John McCain during last year’s campaign.
Certner said that while AARP would be open to the idea of changing the tax code that currently subsidizes employer-based health care to the disadvantage of individuals purchasing coverage on their own, he insisted that health care legislation would also need to include more regulations aimed at forcing insurers to cover those with preexisting conditions, and to limit their ability to discriminate based on age.
AARP will continue to work with both parties toward legislation that had wide support, he said, but like the Obama administration, the group would be satisfied with a partisan bill if necessary.
“We’ve been keeping up our drumbeat of trying to get a broad coalition, and a broad bill passed by Congress,” Certner said. “But we are also determined to try and get health care reform done this year.”
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