John Rother, Executive VP for Policy and Strategy, AARP
Biography provided by participant
Mr. Rother has served as AARP's principal policy and strategy leader since 1984. Prior to coming to AARP, he was staff in the US Senate to Senators Jacob Javits and, as Staff Director for the US Special Committee on Aging, to its chairman John Heinz. He serves on several Boards and Commissions in the health and retirement security fields, and as Chair of the Generations United board.
An Ongoing Issue Affordability for healthcare insurance is a function of three elements: premium cost, cost sharing, and scope of covered services. Ideally, no one should be required to pay more than 10% of their incomes for total health costs, but the ceiling of $900b on the net cost of a health bill makes this an impossible standard to meet. While the House bill would greatly lower the cost for many people in the individual and small group markets, it would still impose costs above 10% for moderate and middle income individuals and families -- roughly those between 300 and… Read more
Insurance is the spreading of risk, not only between the healthy and the sick, but also among those in high risk occupations, those who live in high cost areas, and those who face higher risk because of their age. The broader risk is spread, the more affordable insurance can be for everyone. Employers don’t vary premiums by age, and neither does Medicare, the federal employee benefit program, or insurance programs in other countries. Keeping premiums level for all is a key to keeping them affordable for everyone over the lifecourse. There is little relationship between income and age – a… Read more
I've worked on a face to face basis with Sen. Ted Kennedy for the past 33 years, ever since I came to work as a young legislative assistant to Sen Jacob Javits on what was then the Labor and Human Resources Committee . His passing last night leaves a huge leadership vacuum in the ongoing effort to better our health system. But while his legislative accomplishments were huge, my memories of him keep coming back to three themes: 1. His joy in life and in legislating. It seemed he always had a smile and always was glad to engage others. … Read more
Prescription drug policy is a rich area for debate in health reform. On the one hand, prices seem to escalate without restraint and profits have been robust. On the other, we count on the industry to innovate and develop new cures and there’s lots of evidence that drugs can lower the need for other types of care. Too many people risk their health by taking too many different pills at once, and yet too many do not adhere to prescriptions that could save their lives. The U.S. has by far the most expensively priced brand drugs in the world, yet… Read more
The trustees report on the status of Medicare’s Hospital Insurance Trust Fund will show some deterioration from last year, mostly due to lower payroll receipts as a consequence of the economic downturn. I do not interpret this as requiring major cuts in Medicare, instead I see the trust fund situation as symptomatic of the need for reforms that promote greater efficiency and lessen the need for hospital based services among beneficiaries. I offer three observations to support this conclusion. First, what’s happening in Medicare is also happening across all of healthcare. Revenues are down as fewer people have jobs, while… Read more
Medicare needs to be updated for many reasons. Perhaps the most pressing is the scheduled expiration of the Sustainable Growth formula for physician payment at the end of 2009. Other reasons are the need to generate budget savings to help fund overall health reform, and the pressures of the trustees forecast for the solvency of the Part A trust fund. There should also be a reexamination of Medicare benefits to align them with any standard benefit package adopted for the under 65 population in connection with universal coverage. Finally, most Medicare expenses today are a consequence of chronic conditions, and Medicare’s fee for… Read more
Let’s Make the Medicare Buy-in Work Sen. Max Baucus’s proposal to allow an immediate buy-in to separate Medicare coverage for older adults 55+ offers many attractive benefits for the millions of Americans who have the most trouble finding meaningful insurance protection in the individual market today. There are several design and financing considerations, however that must be addressed to make the idea workable. The 55 – 64 age group needs meaningful insurance protection because they are most likely to need and use medical services. In a market that’s currently underwritten and age-rated, it’s not surprising that over 4 million currently… Read more