GOVERNMENTTight funds may hinder Bush move on Medicare preventionLawmakers propose expansion of Medicare's colon cancer screening benefit.By Markian Hawryluk, amednews staff. Feb. 25, 2002. Washington -- President Bush has called for an expansion of preventive benefits for Medicare beneficiaries in his 2003 budget plan. But facing deficit spending and controversy over an existing benefit, Congress may find the usual hurdles to passing preventive measures much higher this year. Beginning in 1998, Medicare has added coverage for only a handful of preventive services, including mammograms, prostate cancer screenings, flu vaccines and colonoscopies. But in most cases, Medicare still imposes a 20% co-payment and kicks in only after beneficiaries exceed their $100 annual deductible. "As a result, healthy Medicare beneficiaries can face costs in the hundreds of dollars each year, just to keep up with recommended preventive treatments," the White House said in its Medicare reform plan, released last year. By contrast, private plans have moved toward limiting the out-of-pocket costs for preventive health services, often providing screenings and tests for free. The cost barrier has led to an underutilization of Medicare's preventive services. Last year, a General Accounting Office report said the addition of a new colon cancer screening benefit in 1998 increased the percentage of beneficiaries undergoing colonoscopies by only one percentage point, to 3.8%. Meanwhile, a study published by Dartmouth University said only 28% of women 65 to 69 get mammograms. In his 2003 budget, Bush proposed $113 billion over five years for comprehensive Medicare reform, part of which would be used to exempt preventive benefits from the co-payment and deductible provisions.
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