What would "Medicare for All" Mean for you?

Since this is such a politically-charged topic, I try my best to steer clear of the discussion. 

However as we get closer to the 2020 election it is important that everyone starts to get educated on the "Medicare For All" proposals that are being discussed.

KFF.org released an article last week that provides a nice summary of each of the options being discussed, which range from a complete Single Payer Plan (everything is free for everyone) to a public option for the ACA Plans, to Medicare Buy-In Option.  The KFF article provides a lot of detail, and I have just provided my thoughts below.
 

Medicare-For-All Single Payer; e.g. Sanders Plan - S. 1129

• In theory, this sounds great.  Free Insurance for everyone.  No Premiums. No Cost-Sharing.  
• In reality, the costs for such a dramatic change to the healthcare system would be astronomical (most projections show $30 Trillion +).  
• This Plan would also completely replace the health insurance for the 180 million people who currently have Private Insurance Plans (majority of which are satisfied with their plans).
• Additionally, this plan would completely replace the current Medicare system.  What impact would this have on the current Medicare beneficiaries who are generally very satisfied with their coverage?

Public Plan through ACA Marketplace; e.g. Cardin's Plan - S. 3

• This Plan would provide a Public (Government run) Insurance Plan that would be available in the ACA Marketplace.  
• This Plan would leverage the Medicare Platform/rules.  
• Based on the current Medicare system (without adding all of these incremental millions of pre-65 individuals), The Medicare Trustees Report estimates the depletion of the Hospital Trust Fund by 2026.
• By adding incremental millions of people (in addition to the 10,000 people per day turning 65) onto the Medicare system, this would likely create additional financial strain on the Medicare system.  What impact would this have on the current Medicare beneficiaries who are generally very satisfied with their coverage?

Medicare Buy-In Options, e.g. Stabenow's Plan  S. 470

• This Plan would provide a "buy-in" option into the current Medicare system starting at age 50.
• In theory, this is also an interesting option that would provide indidviuals an option to buy-in to Medicare at a younger age than 65.
• Similar to the Public Plan through the ACA Marketplace, this would likely create additional financial strain on the Medicare system.  What impact would this have on the current Medicare beneficiaries who are generally very satisfied with their coverage?

 

What Should we Do?
I completely agree that our Health Care system is flawed in this country and we need some significant improvements.  Some key areas, I believe we need to address are below:
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• Cost Transparency - anyone who has ever tried to decipher an EOB (Explanation of Benefits) can appreciate the horrendous lack of clarity and transparency with regards to Medical costs in our country.  The billed amounts, approved amounts, etc. create confusion and stress for anyone affected by high medical bills.  Trying to understand (and potential shop) the pricing for a Procedure prior to scheduling it, can be extremely frustrating.  Bottom line, we need better pricing transparency.  Fortunately, Medicare released a Procedure Price Lookup tool at the end of 2018 to start providing more clarity around pricing.  My initial review of the tool back in February 2019 seemed to indicate the pricing data in the tool is not accurate when compared to actual Medicare claims data found on myMedicare.gov.  I am hopeful that the data will improve over time and we will be able to get more accurate pricing information.
• Prescription Drug Costs - My frustration peaks when I think about Prescription drug costs in this country.  Folks with chronic conditions are essentially held hostage to the costs of their medications, even those medications that have been around nearly 100 years (such as Insulin for diabetics).   This country does need improvements to the entire Supply Chain and Pricing Practices for Drugs including the ability to negotiate with Drug Manufacturers.  
• Stabilize the ACA Marketplace- The Affordable Care Act never realized its goal of truly 'Affordable" healthcare.  It did improve access to Healthcare to 10 million+ individuals who did not have Health Insurance prior.  Thus, the ACA should NOT be repealed; it needs to be stabilized with a reintroduction of the ACA Mandate penalty which helps keep health people in the health insurance pool (which helps keep premiums more stable across the board).  Also, there are several proposals that would create high-risk pools backed by the government which would help to cap the exposure in high-claimant situations.  High-claimants (less than 20% of people) make up 80+% of healthcare costs in this country.  These high-risk pools would help address these costs so that the premiums can be kept stable across the board.

This is by no means a fully comprehensive Plan.  However, I believe these are some of the key areas that we need to focus on to improve our Health Care system.





With any proposal you study, be sure to ask yourself... What impact would this have on the current Medicare beneficiaries (who are generally very satisfied with their coverage)?

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