And Medicare is not that simple. There's Part A which we get for free. That covers hospital stays and a few associated health services. However, there is a deductible of $1,364, as well as some caps on benefits.
Part B covers, typically, 80 percent of outpatient care and medical supplies. This costs us $135.50 per month, per person -- or more. If you're single and your income is over $85,000 per year, you pay $189.60 per month. And it goes up from there, as a person's income level goes up. And Part B also has a deductible of $185 per year.
And neither of these pays for drugs. For that we need a drug plan, which we can get through a Medicare Advantage Plan or else a supplemental Part D plan. The cost for the drug plan varies, but ranges from $30 to $40 per month and up. (Again, higher premiums begin for singles with incomes over $85,000 a year.). And the drug plan also hits us with a deductible.
Plus, Medicare Part B only pays 80 percent of outpatient costs. For the other 20 percent we need some kind of supplemental insurance, which could be Medicare Advantage or something else. Also, Medicare does not pay for glasses, dental bills, hearing aids, non-prescription drugs. Some supplemental plans cover a portion of these costs, others do not.So you see, Medicare is not free. It doesn't cover everything. And it's also complicated.
Still and all, most people on Medicare are glad to have it (I know I am) . . . because while it doesn't provide medical care for free, it does make it reasonably affordable. And besides, other medical insurance options are very limited for us since we're no longer working.
Do you think most younger Americans would like to be on Medicare? Would they be willing to pay for it? Would they support the mandatory enrollment that would be necessary to make it viable?
And then, what happens if people have Medicare, but they don't sign up and pay for a supplemental plan? What happens when they have a real medical problem, and their 20 percent comes to several thousand dollars?
The obvious problem is that most people want top-notch health care, but they don't want to pay for it. The Sanders single-payer experiment in Vermont, for example, failed when people found out it would raise the payroll tax by 11.5 percent and the income tax by 9 percent.
And a recent poll from the nonpartisan Kaiser Foundation found that some 70 percent of Americans approve the idea of Medicare for all that would "guarantee health insurance as a right for all Americans." But when the question included the reality that any new system would raise taxes, or that people would not be able to keep their current insurance or could potentially face delays in medical tests, the level of support fell to just 30-something percent.
I hope you don't expect a simple retirement blog like mine to provide all the answers. I sure don't have them. But if you're interested, you can go on to read Bernie Sanders's Medicare for All Explained, and related articles in the New York Times. À votre santé!
17 comments:
Yeah, I don't think Medicare for All will work. We can't even pay for the current Medicare system. It's supposed to be insolvent in 6 years.
Hi Tom! Good for you for tackling such a tricky subject. I am in the camp that believes everyone should have access to medical care as a basic human right...and I'm willing to pay for it too. While my husband Thom just hit medicare age and we choose to go with Plan F as a supplement, we are still thrilled with the lower cost because as self-employed people we have been paying HUGE amounts for high deductible insurance for the last 10 (?) years. I turn 65 next year and can't wait. Even though the costs for medicare for all would raise taxes, I would still rather pay that towards medicare for all than turn it over to the insurance and drug companies for what appears to be an unlimited license to charge whatever they want. Costs are CRAZY and the entire system needs to be reworked. The only people who don't want the increased cost IMHO are those who've had someone else (like their boss or the government) pay for their health insurance and don't really know what the cost really is. But as more and more employers stop covering them, I can't imagine that the percentage of people demanding change will grow. We'll see. ~~Kathy
Tom, this is an extremely complex subject, and I thank you for tackling it. I am Canadian, and grew up with universal health care. That meant that all doctors' visits, all hospital stays, all operations were covered.(still are). But it isn't perfect. Drugs are not covered completely, dental care, hearing aids, glasses are not covered. We have a great deal, but there is still a way to go. Taxes are high, but no one would want to end our health care and go it alone. It's comforting to know that illness or misfortune won't bankrupt us.
Growing up, and working within the British National Health Service, I can honestly say most people are willing to pay a little more in taxes to have a “ free at point of service” (not free) health care.
I have a Medicare Advantage plan and pay a monthly premium of $33 above and beyond the $135, and a co-pay of $20 for my regular physician and $40 for a specialist. And as you said, there is still dental (which I pay separately) and glasses. As long as I don't have a catastrophic illness, I can manage it all, but I do wish we had something affordable for the younger people.
It's certainly a difficult topic. The UK has the National Health Service which provides free medical care, but not for everything. It seems that it is similar to Canada from what Diane Dahli has written, in that there are various carve outs, such as dental, opticians etc. Plus my understanding now is that if you want to see your GP the waiting time is around two weeks (not sure how helpful that is when you call because you're sick now), and then there are generally multi month long waiting lists if you need an operation. The general feeling is that the health service continues to be under greater pressure.
I think medical care should be available to all free of charge at the point of use. Naturally this has to be paid for somehow, but so does private medical insurance.
The difficulty is that all methods seem to be struggling to find the right solution.
There are no easy answers any more. Perhaps there never were.
Really good comments. I wouldn't mind paying "a little more in taxes" either; but I think 11.5% + another 9% is a lot more than "a little more." But I'm wondering if the plan is mandatory (a la Obama) then younger healthy people would subsidize the more expensive older people and it wouldn't be that much. Also, doesn't free point of service encourage overuse? What's wrong with a modest $20 or $40 co-pay that could be waived for poor people?
My DH got sick when we were in England a couple of weeks ago. He called the 111 national health service number, talked to the representative and got a referral to a GP in the area we were in. Called the GP and got an appointment for that afternoon. He was diagnosed with pneumonia, was issued a prescription, paid 60 pounds ($110) for the visit, and the two antibiotics prescribed were free because he is over 60. I said, "but we don't live here" when the pharmacy tech said the Rx was free. Didn't matter. That's our experience with the British National Health System.
Sheila
I don't know how medicare for all would work, but I do believe that everyone should have the right to medical care. We have Medicare, a Medicare supplement, and a Rx Medicare plan. It isn't free, but it's doable, and I'm extremely appreciative that it's available. I would be willing to pay a little more in taxes to ensure everyone had coverage... of course what that little more might be is the big question.
Never an easy subject. But what I hate about our current situation is how insurance ties you to a job you no longer want.
We have no way of paying for Social Security and Medicare already. GAO numbers show that Uncle Sam must spend less and tax more within the next decade. Medicare for All...from what I have read....will cost a lot more than "11.5% + another 9%". The topic is very complex when you throw in non-compliant patients, smokers, drug users, much older people that need very expensive care, etc. In the mean time, Congress has no interest to even bring down the cost of prescription medicines. As long as our Congressmen are bought and paid for, Medicare for All won't be happening.
We have lived socialized medicine for our entire married life. My children never suffered a fever, broken arm or ear infection that was not looked at. I never had a problem that I could not get looked at. I don't know my GP- and part of that is me not willing to fight for a slot. My husband's medicines are all free (as have all of our meds in the past). Our four hospital stays cost us about $400 all together. We ONLY get generic drugs if they are possible. Surprisingly, many of our drugs come from---Canada! I love that a Private as a Major.
Here is the rub. The military cannot hang on to doctors. Their highest pay in in the mid $150K and that is pittance for the outside. We are sent out for orthodox, cancer and just about anything else that is not within the block. That means that the military pays much more- making it not a socialized system.
Also when the military was really big, our care went down significantly. There are about 10 million using the system right now. When it gets to 13m family members have a difficult time getting in.
I can see how Canada (37m), England (57 mil) and even Germany (87m) can do it. They pay their doctors much less, but those doctors go through school without charge. Their hospitals are all public (and their rich come to the states for the "outside the box" help). They also started at the beginning of modern medicine. What will happen if 327 mil show up tomorrow at the clinic - with 25 million undocumented in tow? I can see current doctors running for the door and the luxury health care market booming.
Tom, some of your posts take some deep thinking to get to the heart of the feeling. I am lucky enough to have Medicare, Drug Policy and Supplemental Policy. The Supplemental Policy costs more than the Medicare and, I haven't checked the Drug Policy this year as it is deducted each month from my SSA check, but it could well be over the monthly Medicare fee too. An example of the whole problem is this. I ran out of one of my insulin drugs (I take 2 different insulins each day) late in the evening. My fault. I should have monitored better. I usually get the drug at Walmart pharmacy for $25 over the counter price but since the pharmacy was closed, I went to Walgreens. At Walgreens they charged my insurance co. $106 and me $35 as copay. This is the same drug I buy at Walmart for $25. As long as our government allows the drug companies to gouge us there is no hope. We will be like the Wild West. If you get sick or hurt you die. Without this medicine every day I will die. Fact. I am only one of millions. And this is only one of a million types of medical problems that people live with. We have to fix this.
Sanity and happiness are an impossible combination Cara Mengobati Flek Paru-paru
I got on Medicare/Medi-Cal in December and so far it's been pretty good. I switched to Kaiser which has been nice with no waiting. As for younger people, I think there should always be a choice to have whatever type of insurance they want or an employee program. Although Canadian healthcare is good, people still have to wait months to be seen unless they are diagnosed with something serious and that can be dangerous.
You shared an excellent post about Medicare Leads with us, thank you. It was a pleasure to read your post.
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