Thursday, 07 March 2019 21:32

Medicare for all: Reality or fantasy?

Written by Dr. Daliah Wachs
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Senator Bernie Sanders during the 2016 Presidential Election called for a single payer system to cure our healthcare woes. Now Democratic contenders for the 2020 election are calling for the same. Some voters are salivating at the thought, tired of high insurance premiums and deductibles. Others are cringing at the idea of the government running our healthcare system. Yet most are confused and want more details. So let’s break it down.

What is Medicare?

Medicare is the health insurance offered by the federal government for those over 65 and with disabilities. According to medicare.gov they breakdown medicare as the following:

Medicare is the federal health insurance program for:

  • People who are 65 or older

  • Certain younger people with disabilities

  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

The different parts of Medicare help cover specific services:

Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)  

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

Medicare Part D (prescription drug coverage)

Part D adds prescription drug coverage to:

  • Original Medicare
  • Some Medicare Cost Plans
  • Some Medicare Private-Fee-for-Service Plans
  • Medicare Medical Savings Account Plans

These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans

Medicare Advantage (also known as Part C) is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.

What is Medicare For All?

Originally suggested by Senator Bernie Sanders, Medicare for All would essentially allow all Americans to qualify for Medicare. According to Unitedmedicareadvisors.com:

Medicare for All promises to cover numerous healthcare products and services, including the following:

  • Inpatient and outpatient health care services

  • Preventative, emergency, and nonemergency health care services and treatments

  • Primary and specialty healthcare, including palliative and long-term care

  • Care for vision, hearing, and oral health problems

  • Mental health and addiction services

  • Prescription medication

  • Medical equipment and supplies

  • Diagnostic tests

The concept sounds nice but Medicare doesn’t currently cover many of the above such as hearing aids, dental exams, and long-term care.

How would Medicare For All be subsidized?

Unitedmedicareadvisors.com reports the following:

MEDICARE FOR ALL, ESTIMATED TO COST AROUND $1.38 TRILLION A YEAR, WOULD OPERATE WITH FUNDING FROM THE FOLLOWING SOURCES:
  • $630 BILLION FROM A 6.2 PERCENT INCOME-BASED PREMIUM PAID BY EMPLOYERS
  • $210 BILLION FROM A 2.2 PERCENT INCOME-BASED PREMIUM PAID BY HOUSEHOLDS MAKING MORE THAN $28,800
  • $110 BILLION FROM PROGRESSIVE INCOME TAX RATES FOR AMERICANS WITH YEARLY EARNINGS OVER $250,000
  • $92 BILLION FROM TAXING CAPITAL GAINS AND DIVIDENDS IN LINE WITH EMPLOYMENT INCOME
  • $15 BILLION FROM LIMITING TAX DEDUCTION FOR AMERICANS WITH YEARLY EARNINGS OVER $250,000
  • $21 BILLION FROM A NEW RESPONSIBLE ESTATE TAX APPLIED TO THE HOMES OF AMERICANS INHERITING MORE THAN $3.5 MILLION
  • $310 BILLION FROM SAVINGS AS HEALTH-RELATED TAX EXPENSES BECOME OBSOLETE

Unfortunately, tax hikes on employers could lead to price hikes and less employment.

So the concerns I have are Medicare doesn’t currently cover what Medicare for All is touting and the expense may be underprojected.

Moreover many healthcare providers do NOT take Medicare so access can be an issue.

However, until premiums and deductibles go down, and more Americans become insured, plans such as this will gain attention and popularity.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, if expressed, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Last modified on Thursday, 07 March 2019 22:35