Never mind that President Clinton says his health reform plan would be a boon to elderly Medicare beneficiaries. Ida and Terry Kinney of Pacoima are convinced that it would drive up their premiums and put another dent in their already-tight family budgets.
The 86-year-old retired teacher and her 93-year-old husband, a onetime laborer, live on a fixed income of $23,000 a year from Social Security, Terry's union pension and Ida's teacher retirement annuity. They have no room in their budget for an increase in their health care costs.
The plan would offer them a new prescription drug benefit and a better chance of getting financial help for long-term care. But the Kinneys are focused on the $864 a year they now pay for their Medicare premiums; Ida said she is worried that could rise by 10% or more under the Clinton plan.
"It'll put us under an awful strain," she said. "We're against that health bill 100%."
"To be sick is expensive. But just to live is expensive too," she said. "We pay over $157 a month for light, gas and water. The telephone runs us around $25. That's like $200 a month before we even buy food."
Clinton has pledged that any increase in Medicare premiums will be devoted strictly to providing the new drug benefit. Premiums will fund 25% of the new benefit, but the exact cost has not been specified. The drug benefit would have a $250 annual deductible, after which beneficiaries would pay 20% of the price of each prescription up to $1,000.
But even though the Kinneys' premium might go up to cover the drug benefit, experts predict that it could mean lower rates for their supplemental insurance, which currently covers the cost of some drugs.
At present, Ida supplements her Medicare coverage with private insurance from the New York Life Insurance Co., a plan she has had for years. The premium for that is $1,200 a year.
Earlier this year, Ida went into Holy Cross Hospital in Mission Hills for four or five days of treatment for diverticulitis. The bill came to about $5,000, of which Medicare paid $3,000 and her private insurance covered the balance.
Her husband was covered until this summer under a health maintenance organization but dropped out because he felt the doctors were inexperienced, according to Ida. Terry is considering buying new supplemental insurance through the American Assn. of Retired Persons. But even with such a policy, he still would not be covered 100%.
In the meantime, he is vulnerable to heavy out-of-pocket expenses if he suffers catastrophic illness, because Medicare would not pick up the full tab. The couple has only about $5,000 in a bank savings account.
For people of all ages, the Clinton plan would direct states to create a program of community-based long-term care, including homemaker assistance, adult day care services, rehabilitation and home health care services not covered by Medicare. Recipients of these services would be required to pay an unspecified co-insurance payment.
If Ida's husband has to go into the hospital under current circumstances, she said she would be forced to take out a mortgage of their home to pay for it. She would much rather give the house, unmortgaged, to her great-grandchildren.
In general, Ida simply does not trust Clinton's program.
"It's rotten to the core," she said. " . . . It's got a lot of loopholes in it. The insurance companies are going to get the best deal. We're going to pay a lot more out of pocket. We pay $36 a month each and that's going up, not down."