As we prepare ourselves for the onslaught of political rhetoric associated with the 2020 presidential and Congressional campaigns, we have all heard the term “Medicare for All” as a means to fix our healthcare system. I must admit, the more I hear the talk about Medicare for All, the more questions I have. As an insurance agent who works to place Medicare beneficiaries into appropriate coverage, I can tell you that most people I talk to do not really understand our current Medicare system when they become eligible. Based on much of what I have heard from politicians, it seems to me they also don’t understand Medicare.
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I should disclose, I do have some personal interest in how Medicare for All would come to be. Obviously, if commercial insurance companies were cut out your proposed system, me and thousands (if not millions) of people would have to find a new livelihood. Having said that, I would support any functional system of healthcare over what we have now for people not eligible for Medicare.
Our current system, the Affordable Care Act (ACA), is in most cases actually affordable for those whose income is less than 400 percent of the Federal Poverty Level (FPL) because they are subsidized. For anyone whose income does not qualify them for subsidy, the word “Affordable” should be eliminated from their healthcare vocabulary because it does not apply. For that reason, at least on the surface, it appears a Medicare for All system may be the answer depending on how that system would be managed. After all, I frequently tell my clients that turning 65 (or otherwise becoming eligible for Medicare), is the greatest day in their healthcare lives.
What makes the Medicare system so great, in my opinion, is the systematic amalgamation of a government program joined at the hip with commercial insurance. Commercial insurance has played a key role in the success and popularity of Medicare for many years. Without knowledge of all the breakdowns in terms of cost, I can only assume that a single option, single payer system would be at least as expensive as our current system (proportionally), if not more expensive.
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1. Would the single payor system (similar to Original Medicare), still require a 20% co-insurance for most services as our present system? If so, who would provide coverage for the 20% of healthcare costs not currently covered under Original Medicare if there were no commercial insurance companies? There are currently supplemental insurance plans (provided by commercial insurance companies) available under our current Medicare system that beneficiaries may obtain to cover those extra costs associated with the 20% co-insurance (out-of-pocket costs).
2. What would happen to Medicare Part C or Medicare Advantage? Medicare Advantage Plans have many benefits above and beyond what Medicare covers. Additional benefits may include, dental, chiropractors, acupuncture, Over-the-Counter (OTC) benefits, and more. These are provided by commercial insurance companies because of the competition in the open marketplace. Often, Medicare Advantage plans are provided at no additional charge above and beyond what people have to pay for their Part B premiums
3. How will Part D be implemented? Part D of course is the coverage for prescription drugs. In the current version of Medicare, Part D Prescription Drug Plans are provided by commercial companies with government oversight (we hope someday the costs can be regulated by the government so our beneficiaries can pay reasonable co-pays). Many Medicare Advantage Plans currently in the market provide prescription drug benefits within their plans at no additional premium. People on Original Medicare have to purchase their drug coverage separately.
4. How much would this cost tax payers and/or beneficiaries? Right now, Medicare beneficiaries pay (on average) $135.50 per month for their Part B. Would that stay the same? If not, would the beneficiaries under the current system have to pay more than they do now?
These are merely some high-level questions I would ask just to make sure you know the basics and in the hope that you would start providing some details on what your vision of a Medicare for All plan would look like.
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Because I consider myself a consumer advocate, I am posting this letter as blog for the purpose of generating more questions from constituents and potential voters. I do not intend to make a political statement but to push politicians to provide more details because the system you now describe is more a Medicaid for all than Medicare for all.
The next election is still quite a way off; but I can tell you that for me, any candidate that provides these types of details would get my attention. If your plan includes a system similar to our current mix of government and commercial insurance companies, then you just may get my attention as a voter.
Marc Manor is a 30-year military veteran who is now dedicated to teaching his
fellow Americans how to make the most of their Medicare and Supplemental Insurance
benefits. As an independent agent, Marc has access to a wide variety of carriers with
an abundance of resources to find tailored solutions. There is no charge for a
consultation so call 904-222-0698 or email: marc@marcmanor.com.
Great article Marc! The truth be told is that politicians do things for political purpose of getting elected not necessarily for the long term benefits of the voters. Any system chosen must be able to sustain itself and needs to find ways to lower cost.
ReplyDeleteIt's about time someone held politicians feet to the fire for the mess they've made of healthcare in this country.
ReplyDeleteAbsolutely. A detail Q & A is needed. Medicare for all is have a income qualify scales and rates? How is going to work with employers that provide Healthcare as a benefit? How family plans will work? What are going to be the wait times for open heart surgery? Knee and hip replacements? Organs recipients? and so on.
ReplyDelete