From The Cleveland Plain Dealer, 7/2/03:
http://www.cleveland.com/living/plai...9035317570.xml

Medicare bill would require co-pays for seniors' lab tests

Susan Jaffe and Stephen Koff
Plain Dealer Reporters

Congress wants to add prescription drug coverage to Medicare, but it
also might trim a benefit that could cost seniors billions of dollars.

Buried deep inside the hundreds of pages of the Senate's Medicare bill
is a provision requiring Medicare patients to pay 20 percent of the
costs of their clinical lab work, such as blood tests and urinalysis.
Seniors would have to start paying in January.

Some physicians predicted many of their patients would be unable to
pay the new fees and wouldn't get the tests they need.

"Every time you add co-payments, you limit service for people who
can't afford it," said Dr. Peter DeGolia, medical director for
long-term services at Metro Health Medical Center.

"It's another way of rationing care."

The Senate measure, now being reconciled with the House version, would
reverse a 1984 decision in which doctors, hospitals and labs agreed,
with a nod from Congress, not to charge patients co-payments for lab
tests.

Fees for blood tests to check cholesterol levels, electrolytes for
dehydration and glucose for diabetes and to make dozens of other
checks for chemicals, antibodies or bacteria typically run $25 to $40,
said Mark Biren baum, a microbiologist.

Birenbaum is the administrator of the American Association of
Bioanalysts.

Nationwide, the co-payments could total $18.6 billion over the next 10
years, said the Clinical Laboratory Coalition, which is campaigning
against the provision.

Co-payments for seniors on Medicare, the health insurance plan for 40
million elderly and disabled Americans, would be $5 to $8 a test.

But seniors who need regular tests could quickly see those fees add
up.

"Medicare is supposed to be helping us, but we're paying more and more
out of our own pockets," said Anne McKinley, 78, who lives in Lake
County.

"Somewhere it has to stop."

Blood tests are especially important to monitor the condition of older
patients, who are more likely to have multiple chronic health
problems, said Dr. Robert Palmer, director of geriatric medicine at
the Cleveland Clinic.

The tests can detect adverse side effects of the many medications
older patients rely on.

"There's a rational reason for these tests," he said.

"I might as well be practicing in a jungle if I don't have a
laboratory."

In the case of about 185,000 low-income Ohio seniors who are also
covered by Medicaid, the state-run program for the poor, the state
would have to make the new co-payments.

The prospect of additional expenses worries state officials struggling
to keep up with rising health-care costs.

Medicaid is already the fastest-growing portion of the state budget,
and program officials have been looking for ways to cut costs, said
Dennis Evans, a spokesman for the Ohio Department of Job & Family
Services, which runs the Medicaid program.

"If we're required to do it, we've got to come up with the money," he
said.

Bill Hoagland, director of budget and appropriations for Senate
Majority Leader Bill Frist, Republican of Tennessee, said the
co-payments would provide money to help pay for other benefits for
seniors.

But Robert Hayes of the Medicare Rights Center said, "It obviously
defeats the purpose of providing a drug benefit if you pay for it by
picking the pockets of senior citizens."

The House version of the Medicare prescription-drug bill, which like
the Senate bill also passed last week, does not contain that
provision.

Lawmakers will start resolving differences between the two bills this
month.

But senior staffers in both chambers don't expect a final bill to be
ready for a vote until fall.

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Another right-wing screw-the-seniors bill.

Harry