The second part of Medicare for All is to get everyone to really think and comprehend what is being discussed.
By taking over 17% of the gross national product means the government is in control of healthcare. They already did this with the affordable care act and we all know how well that is going. Let’s examine the changes that the affordable care act has caused and see how well that is going.
- You could keep your insurance and keep your doctor. We all know that didn’t happen and it was never meant to happen. The affordable care act was supposed to be the precursor to a one payer system.
- We all had national networks as part of your individual coverage before the affordable care act and we don’t have that option now. Medicare has that option in all plans except the MAPD-HMO’s. The PPO’s and Original Medicare has that option. What will happen when we have Medicare for All?
- The plans are getting more expensive. Before the affordable care act, a male under 35 could buy a $1000 deductible; $1000 max out of pocket for under $100 per month. Today that plan not only doesn’t exist but the alternative costs anywhere from $255-$498 per month. These plans have deductibles between $3000-$7900 and the max out-of-pocket of $7900. None of these plans offer national coverage unless there is an urgent or emergency situation and the insurance companies only pay what they estimate the cost should be leaving the insured to pay any excess charges themselves.
Now consider Medicare for All.
- How will the networks be addressed? Under Original Medicare a provider needs to be contracted with Medicare or Medicare won’t pay the bill. What will happen when we have Medicare for All?
- Then the issue of assignment of benefits needs to be addressed. If a provider takes the assignment, then they have to write off about 15% of the bill. If they don’t take an assignment then they can bill you 15% and you have to pay for it. Currently, hospitals accept assignment while many doctors don’t. Will this change for the better or worse?
- Assignment of benefits could be eliminated meaning all provers have to accept what the system pays regardless of the cost. Will there be no allowances for different areas of the country with different costs of living?
- As this scenario evolves, what happens to all the seniors on either a MAPD or Medicare Supplement? The MAPD’s under a Medicare for All would either go away as it is controlled by private insurance or become nationalized to become the backbone of the new system? The Medicare Supplement is a contract between the insured and insurance company and also the federal government. These contracts are guaranteed renewable as long as the premium is paid. That is a requirement that the federal government put into all the Medicare Supplement contracts. How is that going to be resolved? The contracts cannot be voided, which means they have to be maintained. How is that going to work? Everyone but Medicare Supplement clients get to keep their system until the last survivor? Or are they going to be converted to Medicare for All with no maximum out of pocket?
- Or is there going to be a maximum out of pocket?
- Those that have group coverage through their employer will lose that coverage which also means since the employer is paying at least half of the employees’ premium the cost to that employee will increase by 50%. That also means that the employer will save 50o% and lose any tax deduction they had by paying for the employees premium. THAT APPEARS TO BE A LOSS FOR BOTH THE EMPLOYER AND EMPLOYEE.
- If Congress doesn’t go on the new plan it also means that the government will still be paying half of the Congress person’s premium. JUST HOW IS THAT FAIR AND EQUITABLE?
As you can see there are more unanswered questions then there are questions with answers. The questions need to be addressed before the system is thrown at the American public. Any of these questions and I’m sure many others, need to be addressed first. Congress with having the task of determining the answers and with the diversity that currently exists; your guess on the outcome is as good as mine.
The politicians haven’t thought this out but are merely throwing around a catchphrase that sounds good until the real details are revealed. Then it doesn’t look so good. Much like the affordable care act.
The Barend Agency Inc.
Len Barend, broker