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Thank you for the opportunity to submit some of our Senior Citizens of ranville, Inc.,

thoughts, relative to l'edicare.

We plan to attend the roaring. Unfortunately, I will be

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this week. Today, I received your letter, which does not allow

sufficient time for me to notify many interested members, nor to more vividly express

our thoughts.

Wo naturally are deeply concerned about the future of Hodicare-liedicaid and all

other 3enior Citizen Programs, as indeed we were and are concerned ahout the final

outcome of Social Security.

Wo hear and read about more cuts -- increases in deductibles and co-payments in

Medicare and modioaid

benefit reductions in other lealth Care areas, oto.

In 1981

Medicaro Recipients were "hit" with a 27% increase in out of pocket costs.

We understand

that some Committee members, who are studying the Medicare System and Program and are

antrusted to make recommendations for economic changes, are not versed well enough on

the subject of Medicare to make a fair impartial judgement,

bany elderly today -- fearful of escalating medical costs and reductions in the

Medicare-ledicaid Program, are paying large premiums for supplementary Insurance

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The Whitehouse Conferenoe on Aging Coruittees, who participated on the topio of

Medioare, ma de many worthy recommendations.

We suggest that the Medicare Study Cammi

Senior Citizens of Manville, Inc.


101 South Main Street Manville, New Jersey 08835


ttee, currently charged with this task, review these recommendations and propose


action on those with beneficial merit.

Encourage families to maintain elderly relations (pa rents, in-laws, etc.) in their

homes and allow them meaningful tax credits.

Establish a National Health Insurano o Policy, through Public or Private Insurance


Establish a Schedule of surgery charges

Hospital charges, etc.

Compel more

Doctors to accept these charges. Payment to Hospitals, only for the amount of necessary

cost incurred. Doctor and Hospital charges should be so devised, as to eliminate the

incentive to perform more services than required.

Eliminate the cost-plus fee for

service plan.

Institute an across-the-board limit on increases in Medicaid reimbursement to

Hospitals by all Third Party payers, inoluding Medicare and Medioaid.

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would not be able to shift their costs onto private-pay patients. Thus, they would have

to initiate economios.

All Plans and payments, should be subject to more thorough audit.

Congress should

enaot strong Foderally man dated penalties and enforcement against fraud in the MedioareWedicaid Programs.

Penalties should be dealt to Hospitals, Dootors, Technicians and/or

to recipients of service, as warranted.

Why not reduce some of the Defioit spending and allot some of this mozisy to Medicare.

For example, We would not impair our proparedness, by eliminating one of the nuo lear

Airoraft barriers, planned for construotion.

Rooonsider the sensibility of the 1x

Missle System

perhaps strike the B-1 Bomber from the plans. (The B-52 18 8 worthy

present-day and near future weapon). As a 0. S. Marine Corps, Purple Heart Veteran,

I certainly want this Great Country to be ever ready to defend itself.

Senior Citizens of Manuelle, Ine.


101 South Main Street Manville, New Jersey 08835


Perhaps, a nominal increase in Payroll taxes, paid by employers. They have already


beon granted generous tax credits and allowanoes.

Repeal this year's 10% tax credit -- which really will not greatly benefit the

average family. There was really little beneficial economic uplift with the last 5%

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In conclusion, we plead with your committee to do all in your power to ourb the

runaway Health Care Inflation rate.

It certainly is a burden and ourse on the elderly.

We certainly trust that your most important Committee will again serve the interest

and welfare of our elderly, as you have done in the past.

Respectrally submitted,

Frank Sterbinsky, President
Senior Citizens of Manville, Inc.
1008 June Place
Manville, N.J. 08835

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My name is Peter Shields, Director of the Union County Division on Aging for the past ten years, one time County Welfare Personnel Officer and prior to that retired as a Field Representative from the U. S. Social Security Administration with over 30 years federal service,

I'm presently Chairman of the Long Term Care Canmittee of the New Jersey Association of Area Agencies on Aging, a member of the State Nursing Home Task Force, Immediate Past President of the New Jersey Association of Area Agencies on Aging and former Legislative Chairman of the National Association of Area Agencies on Aging.

I'm also Chairman of an Advocacy Conmittee representing the state's Area Agencies, Visiting Nurses, Home Health Aides, and Medical Social Workers.

I am honored to be invited to express my thoughts on the future financing of

The possibility of increasing the payroll tax for allocation to the Medicare Trust Fund would be unpopular with the working population, but a moderate increase is probably unavoidable,

The recommendation to increase beneficiary co-payments for hospital stays with "so-called catastrophic" protection after 60 days seems totally unacceptable to senior citizens and a misinterpretation of what "catastrophic" coverage means to most of them. I believe they consider it in-patient hospital days beyond "life-time reserve" and extended nursing home stays. The proposed recommendation to pay co-insurance through the 60th day is financially unacceptable to senior citizens. Since the average stay is 11.5 days the burden for payment would be on the seven million elderly annually admitted to hospitals for the benefit of about 170,000 patients (a small percentage of the seven million) who stay longer than 60 days. Implementation of this proposal would cause chaos in the Medicare Gap insurance with seniors scrambling to protect their interests at presently unestimated but surely prohibitive costs.

Most senior citizens do not have the financial ability now to carry supplemental Medicare insurance and if the proposed co-payments become effective most of those who now have supplemental coverage would have to drop this coverage due to inability to pay for it.

Most of the seniors I talk to are more satisfied with Part A than Part B of Medicare, because even some who can barely afford it have protected themselves for their co-insurance through Medigap Insurance. However, the change in hospital billing to the DRG (Diagnosis Related Group) system must be evaluated carefully. Since this system is in use in New Jersey, it should be possible to obtain detailed information from the New Jersey Department of Health to compare the costs prior to DRG and now for hospitals in a variety of locations. Most people are of the opinion that DRG places the burden of payment for "bad debts which includes patients who can't or won't pay their hospital bills" in one year on patients admitted the next year when the new DRG rate is set. This places an unfair responsibility on those who need to enter a hospital and have provided for this possibility. It would seem the cost of care for non-paying patients should be the responsibility of all people, not just those who become ill. Concerning Part B - the seniors are disillusioned with the "reasonable charges" allowed as they are unrealistic and a very small number of doctors accept assignment. Seniors are frequently told to ask their doctor this question before being treated. This is impossible in some instances particularly when the patient needs anesthesia and has to use the group in a particular hospital. Placing a one year freeze on "reasonable charges" would only add to their problems. The only solution for the patient would be if doctors accepted assignment and reasonable charges were realistic. If this could be accomplished, most beneficiaries would not oppose having a 75% 25% ratio used for Part B reimbursement. Social Security and Medicare have helped many people stay out of poverty. TO preserve this protection I would agree to the use of general revenues if at some point the trust funds are threatened. In that case, on a temporary basis use of general funds might be acceptable. I am fearful that use of general revenues could nullify the original goals of Medicare and lead to possible future application of a means test. It could also work adversely against cost-containment in the event a future Congress was tempted to use an increase in Medicare benefits to gain support in an election.

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