AARP Board of Directors Public Policy Meeting – Day 3

Medicare reform, Medicaid and state budgets, health care systems around the world, and predatory mortgage lending practices were topics at today’s final meeting of the AARP Board of Directors’ annual Public Policy Meeting in Washington, DC.

Senate Majority Leader Bill Frist (R-TN) offered a broad overview some of the issues confronting this Congress. The Board also heard from Kevin Concannon, Commissioner of the State of Maine Department of Human Services on state budget crisis and its impact on health care and Medicaid, and Willis Goldbeck, Chair of the Institute for Alternative Futures, on challenges facing health care systems around the world. Franklin D. Raines, CEO of Fannie Mae, outlined the organization’s efforts in fighting predatory lending practices.

Senator Frist offered an overview of the issues facing the 108th Congress including the need for a stimulus and growth package to grow the economy. He called for acceleration of rate reduction and tax relief including a dividend exclusion noting that the double taxation of dividends is “morally wrong and not what taxation is all about.”

He said he was honored and privileged to work with AARP on a range of concerns including health care and health care security. Today, he said, America’s seniors are being denied “the miracle of modern medicine” promised by President Johnson when he signed Medicare legislation into law in 1965, because of a lack of access to prescription drugs. He said this Administration was absolutely committed to developing a health care security package, “a modern, up-to-date plan that will have access to the miracle LBJ promised.”

Noting that the half life of medicine gets shorter and shorter, Frist said our challenge is making sure Medicare is a modern system that includes a plan that is fiscally responsible that gives prescription drug coverage. “I am convinced we can put out a responsible plan that includes prescription drugs for all seniors,” he said. But, he added, “it is dishonest to promise a prescription drug plan that can’t be sustained.”

Concannon praised the evolution of AARP’s state office system noting that he, and other states, have relied on AARP at the state level to help move agenda items along.

States, he said, are facing revenue problems not because of overspending but because of revenue shortfalls and the question Maine and other states face is how to reconcile priorities including health care, with issues of financing and cost.

Noting that “words have come to replace actions in politics on action on prescription drugs at the federal level,” he said the prescription bus trips by older Americans to Canada represent “a powerful symbol of disparity.” Those buses, he said, should instead be sent to Washington. He said US drug importation policies are misdirected and are unduly influenced by the pharmaceutical industry.

Concannon said that Medicaid now spends more than Medicare, that prescription drugs represent the fastest rising cost element in the program, and that 218,000, or one in six Maine residents, were on Medicaid with another 112,000 verging on eligibility. About 705 of Maine nursing home residents are on Medicaid, he said.

He said he favored the broader use of waivers and warned that “we should be wary of putting a cap, or anything like it, on the Medicaid program. This is not the time to sign up for a health care program that has caps on it.”

Goldbeck said that although all countries are the beneficiaries of aging populations, none have a clue about how to pay for their health care needs. He said there are plenty of places in Western Europe where you can have wonderful medical care, where everybody is included and where the lights go on. Disparities in care are rooted in cultural and philosophical approaches to service, he said noting that Europe is ahead of the US by about a decade in terms of its aging population.

It is unfair to look at Europe for consistency since snot all countries are the same. Although there is no European-wide insurance program like Medicare, there is an effort to collectively build a capacity to produce equity in hospitals throughout Europe where patients are served appropriately wherever they are.

Europe also has taken the lead in extending the concept of health to the environment and since 1991 has created health centers in environmental monitoring in France, the Netherlands and Italy. Long-term care is not well resolved in Europe. It is treated not as a healthcare issue but as a social welfare issue.

The issues that AARP cares about passionately in the U.S. are debated everywhere, he said. We need to increase our communications with other nations, where answers will come from that dialogue.

Raines provided details of Fannie Mae initiatives to advance and protect the American dream of homeownership and to counter the tactics of predatory mortgage lenders. He praised AARP’s leadership and support in combating predatory lending, a problem he said continues to target older homeowners. Although the concept is easy to grasp, he said, solutions are not simple and Fannie Mae continues do everything it can to focus on the problem.

The challenge, Rains said, is to drive out the bad money without driving out the good. Fannie Mae, he said, can and does bring access to good financing, good lenders and good information to homeowners.

Homeownership represents the single largest source of savings, a shelter and a potential source of retirement income, he said. He said Fannie Mae would continue to enlist AARP in a partnership in its efforts to fight predatory lending practices.