Town Hall Meeting on Health Care Reform for Older Americans

Vice President Joe Biden kneels on the floor to talk to a woman in a wheelchair, after a Middle Class Task Force meeting on health care at Dr. Oswald Durant Memorial Center in Alexandria, Va., July 16, 2009. Photo by David Lienemann/The White House

The Obama administration sent three of its top officials—including Vice President Joe Biden—to a small community auditorium in Alexandria, Va., yesterday where they assured a group of older Americans that health care reform is real, imminent and in their best interests.

“Everyone sees we need change, and we’re going to get it right this time,” the vice president told the audience at the intimate town hall meeting on health care. The meeting—this one focusing on health care and older Americans—was one of many he has held across the country as part of his task force on the middle class.

“We not only have to have our American people healthy,” Biden said, “we’ve got to have a healthy health care system in America. And it’s not healthy now. It’s sick.”

Sharing the microphone with Biden were Kathleen Sebelius, secretary of Health and Human Services, Nancy-Ann DeParle, director of the White House Office of Health Care Reform, and A. Barry Rand, CEO of AARP, which is actively supporting reform. “Older Americans need health care reforms as much as anyone else,” Rand said.

But it was the vice president—who promised “plain talk” on the sometimes arcane details of reform—who held sway at the meeting as he avoided what he called “the buzzwords and jargon” of health care options to answer questions that included how reform would affect Medicare and how the proposed sweeping changes would be paid for. Will my brother lose his private insurance and be forced into an HMO? How can we afford costly reforms? When will drug prices stop climbing?

Biden repeatedly assured the audience of older and retired men and women—many of them members of AARP—that the reforms now being hammered out in Congress would ensure that, as Americans age, “their health care is stable, it’s secure, it’s available and it’s effective.” And, he insisted, the price tag for improvements would be paid for in the package itself by cost savings—from, say, better preventive care that would reduce the number of expensive illnesses and hospitalizations, and from crackdowns on fraud and waste. The one new tax he mentioned would affect people making $350,000 or more.

Here is what Biden had to say on some key health care reform issues for people over age 50:

Coverage for 50- to 64-year-olds

“People 50 to 64 years old, buying coverage in the open market, pay three times what their peers with employer coverage pay. Others are automatically excluded because of preexisting conditions. Health care reform will give those 50 to 64 years old the [coverage] they don’t get. And we’ll guarantee that they can’t be turned down because of health problems or charged exorbitant rates because of their age.”

Creating a national insurance exchange

“If you don’t have insurance through your employer, it means you’re negotiating one on one [instead of as part of a group with more negotiating power]. Well, the exchange gives you a little leverage. If you jump into the exchange, you’ll have a whole lot of options. In order for any insurance company to sell insurance within this exchange—and they’ll want to, because there will be millions of new customers—they’ll have to agree to cover preexisting conditions. So if you haven’t been able to get insurance because of preexisting conditions, now you’ll be able to get it.

“And those people who can’t afford to buy insurance in the exchange because of low income will be subsidized. We’re going to help you pay for it. That’s how this exchange is going to work: fair prices and decent benefits.”

Doctor choice

“People will be able to keep and choose their own doctors. My mom wants to go to her doctor. Why? Not because my mom is a cantankerous old lady, but because my mom knows that her doctor knows her.” Patients will be healthier, he said, seeing their own doctor who knows their health care history.

Keeping the status quo

“The status quo is simply not acceptable, totally unacceptable. And it’s completely unsustainable. The amount our government spends now on Medicare and Medicaid, because of the way health care costs are skyrocketing … If we don’t change that, guess what? Medicare and Medicaid will eventually grow larger than what our government spends on everything else combined. Every penny we spend on the FBI, the Defense Department, education—add it all up. We can’t do it. That’s why even conservatives are coming round … not only is it morally wrong [not to do reform], it is also fiscally irresponsible … We have more businesses coming to us and saying we need health care reform than we have labor unions.”

On preserving Medicare

“Now, for example, we repay hospitals added money for Medicare patients to make up for what they spend on treating the uninsured. Once everyone is covered, then we don’t have to pay that additional money from Medicare and Medicaid. The irony of ironies is that once everyone is covered, we will actually save money—save money and make Medicare more solvent down the road. I want Medicare to be around … It is up to our generation to guarantee it.”