THE WHITE HOUSE
Office of the Press Secretary
PRESIDENT CLINTON'S RADIO ADDRESS TO THE NATION
PRESIDENT CLINTON HIGHLIGHTS IMPROVING PREVENTIVE BENEFITS IN MEDICARE July 10, 1999
Today, in his weekly radio address, President Clinton will highlight the preventive benefits improvements contained in his plan to strengthen and modernize Medicare. Recognizing that preventive services can prevent health problems and higher Medicare costs, the President proposes to eliminate financial barriers to these critical services, educate beneficiaries about the importance and availability of these services, and test the cost-effectiveness and scientific merits of additional preventive services. These improvements would help prepare Medicare for its challenges in the 21st century.
PREVENTIVE SERVICES ARE ESSENTIAL TO HEALTHY AGING. Older Americans are the fastest growing age group in the United States, and they carry the greatest proportion of chronic disease burden and disability. For example, 88 percent of those over age 65 have at least one chronic health condition, many of which are preventable. Early detection, health screening programs, and appropriate follow-up care can significantly reduce morbidity and possibly prevent or postpone functional disability. For example, studies indicate that if prostate cancer is detected before it spreads, the survival rate is at least 99 percent. If it is not, the survival rate is 31 percent. Breast cancer and colon cancer have similar rates of survival after early detection.
MEDICARE BENEFICIARIES HAVE DIFFICULTY ACCESSING CRITICAL PREVENTIVE BENEFITS. Medicare currently charges beneficiaries for 20 percent of the cost of certain preventive services, and other such services count towards the Medicare deductible. However, studies have found that cost sharing decreases use of preventive benefits for all age groups and that Medicare preventive services are underutilized. For example, research indicates that 75 percent of women in their sixties are not tested as recommended for breast cancer.
FINANCIAL BARRIERS ARE NOT THE ONLY REASON BENEFICIARIES DO NOT RECEIVE PREVENTIVE CARE. Eliminating cost sharing is important but not enough to ensure that Medicare beneficiaries receive the recommended levels of preventive care. The vast majority of Medicare beneficiaries do not know that Medicare covers preventive benefits; almost 70 percent of beneficiaries who stated that they knew about the range of Medicare services did not know about all the preventive benefits Medicare covers.
ELIMINATING COST SHARING AND IMPROVING PREVENTIVE BENEFITS. The President's proposal to modernize the Medicare benefits package would address these barriers to preventive services. It would invest about $3 billion over ten years to make preventive services more affordable, educate beneficiaries about these services and their importance, and evaluate new services to assess their scientific merit and cost effectiveness. Specifically, it would:
Eliminate all existing preventive services cost sharing to reduce significantly and in some cases totally eliminate barriers to services. To ensure that beneficiaries can access critical preventive services that have the potential to prevent disability and death as well as improve quality of life, this proposal would waive the Part B deductible and 20 percent co-insurance rate for all preventive services not already waived under current law. Co-payments would be waived for screening mammographies and pelvic exams. Deductibles and co-payments would be waived for hepatitis B vaccinations, colorectal cancer screening, bone mass measurements, prostate cancer screening, and diabetes self management benefits.
Create a new health promotion education campaign. The Department of Health and Human Services (HHS) would launch a two-year, nationwide education campaign beginning in 2001 to promote the use of preventive health services by older Americans and people with disabilities. The campaign would have three parts:
Educating all Americans over age 50 and people with disabilities about the importance of preventive health care. HHS, the Social Security Administration (SSA) , and private sector partners would launch a public education campaign to raise awareness of the value of prevention. HHS would distribute information on health promotion and disease prevention through State Health Insurance Assistance Programs, Area Agencies on Aging, and the Social Security Administration's 1,300 field offices. SSA would include information on preventive health care on the Cost Of Living Adjustment (COLA) notice, which is sent to approximately six million people with disabilities, on the Personal Earnings and Benefit Estimate Statement, and in brochures on retirement and survivors' benefits. Finally, SSA would expand the section in its Medicare brochure to include a fuller discussion of the importance of health promotion activities and Medicare benefits.
Encouraging Medicare beneficiaries to use its preventive benefits. This campaign would provide information about the importance of regularly receiving preventive health care benefits, such as vaccinations and mammograms, and would encourage individuals to access these benefits under Medicare. All 39 million beneficiaries would receive comprehensive information on preventive benefits on the Medicare Summary Notice statement, the Explanation of Medicare Benefits, and the Medicare Part B benefits statement. HHS would also develop a health status assessment tool to help beneficiaries identify important health issues that should be discussed with a health care provider.
Launching an education and awareness campaign to help the elderly avoid falls. HHS would launch a nationwide media campaign to educate older Americans about how to avoid potentially harmful and debilitating falls, including cost effective ways to modify their homes. Among the elderly, falls are the most common cause of injuries and hospital admissions for trauma, accounting for 87 percent of all fractures among people aged 65 years or older.
U.S. Preventive Services Task Force study on new preventive services for older Americans. The Secretary of HHS would direct the U.S. Preventive Services Task Force to conduct a series of new studies to identify preventive interventions that can be delivered in the primary care setting that are most valuable to older Americans. In addition, studies would include evaluation of services of particular relevance to older Americans in the mission statement of the Task Force. Despite the potential for preventive services to improve the quality of life for older Americans, few clinical guidelines focus on preventive care for older Americans.
Launch a smoking cessation demonstration project. HHS would launch a demonstration project to evaluate the most successful and cost-effective means of providing smoking cessation services to Medicare beneficiaries. The four leading causes of death - heart disease, cancer, cerebrovascular disease, and chronic obstructive pulmonary disease - are strongly related to smoking. Studies from the last three decades have shown that when people stop smoking, their risk of tobacco-related morbidity and mortality decreases significantly. For example, the risk of myocardial infarction diminishes by almost one-third after the first year of smoking cessation and reaches the level of people who have never smoked by the third or fourth year of quitting.