Expanding medical insurance coverage of hearing and vision can reduce health inequalities


New research shows that expanding Medicare’s coverage of vision and hearing services will significantly expand access to the most vulnerable U.S. residents, with the lowest cost to taxpayers.

According to a survey, Medicare beneficiaries with incomes below the federal poverty line spend less than half of their annual expenditures on vision services, and spend almost three times more on hearing services than their peers with higher incomes. analyze From the Urban Research Institute. Data shows that low-income medical insurance beneficiaries have a huge demand for glasses, hearing aids and other related care, and the quality of these items may be low.

Rebuild a better version of the bill House recently passed Hearing services will be provided for medical insurance enrollees from 2023. But policymakers have cut vision and dental services in the latest version of the bill to reduce costs.

“If high-income people have their needs for glasses, hearing aids, etc., this indicates that the needs of low-income people have not been met. Spending gaps also indicate that high-income people have better quality frames and hearing aids,” said Anuji, senior research assistant at the Urban Research Institute · Said Anuj Gangopadhyaya. “There is a lot of correlation between hearing loss and health care use, quality of life, and the ability to pay attention to and listen to the problems of health care providers-it can also have an impact on other parts of health care.”

Researchers found that compared with the total medical insurance expenditure of 1.1 trillion US dollars, the expenditure on vision and hearing services is relatively small. The Congressional Budget Office estimates that the cost of expanding hearing, vision, and dental services for Medicare beneficiaries will only cost $358 billion in 10 years.

Dr. Harry Greenspun, Chief Medical Officer of Guidehouse, a consulting firm, said: “By gradually improving the coverage of hearing and vision services, a virtuous circle has been created.” “Expanding benefits relative to expenditures will generate tremendous value. It is also vitally important. , High out-of-pocket expenses have a disproportionate impact on low-income people.”

According to the research briefing, medical insurance beneficiaries spent US$8.4 billion on vision services in 2020, of which US$5.4 billion were covered by the insured person’s own pockets. The beneficiaries spent US$5.7 billion on hearing services last year, of which US$4.7 billion went to the registrants.

The beneficiaries often have to choose between food, medicine and other necessities, and hearing aids or glasses. Experts say that although it is difficult to quantify these trade-offs.

“The purpose of medical insurance as a social insurance plan is to put low-income and high-income beneficiaries on the same platform,” Gangopadhyaya said.

Studies have shown that about one-third of the elderly suffer from eye diseases that reduce vision, and about half are hearing impaired.

As hearing and vision deteriorate, it becomes more difficult to socialize, read, and process information. Although the policy brief did not quantify the relevant downstream impact on health care outcomes and costs, hearing and vision loss may exacerbate mental health problems and reduce quality of life. Experts say that getting more preventive care can avoid serious health complications and reduce health care expenditures, especially among the most vulnerable.

Gretchen Jacobson, vice president of Federal Funds Medicare, said: “Helping people afford glasses seems basic, but it can help avoid slips and falls, which can lead to expensive emergency room visits, hospitalizations and longer stays in nursing homes. “It is important to consider the short-term and long-term costs of these types of services and place them in the context of their improvement to the federal budget and the well-being of the people.”

Biogen’s Alzheimer’s disease drug Aduhelm costs approximately US$56,000 per year Supplier questioning Does it even work. Greenspun said that the return on investment will be much greater in terms of gradual improvement in the coverage of basic services.

“All health outcomes are very dependent on the ability to communicate and obtain information,” he said. “We are willing to spend trillions of dollars to buy drugs that have slight improvements in certain areas – and cause many side effects – but ignore the basic blocking and handling things we can do, which are much more expensive than treatments. Show more value.”



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