The cry for Medicare-for-all is indeed appealing and many people are on board, but I wonder if they understand exactly what it means.
One thing is for sure, everyone would have health care coverage, but beyond that what do people understand?
First, Medicare doesn’t work on its own. It works when beneficiaries buy supplemental coverage. Medicare does not have out-of-pocket limits. Medicare considers as an eligible charge only 80% of the market price of services. The private sector picks up the difference. We could easily say, so what, that’s a way to lower health care costs. Maybe so, but there are consequences when applied to the entire population.
Medicare is not cheap. To cover a couple currently costs $26,174 a year. Add in the cost of supplement coverage and prescription coverage currently paid by beneficiaries and the total jumps to $31,813.
While it’s true that on average seniors are more expensive to insure, there are some offsetting factors in the younger population like maternity care, neonatal care, pediatric care, etc.
Keep in mind too that Medicare has several deductibles on hospital stays, prescription drugs, physician services. The point is, we cannot enroll the US population in Medicare and assume it moves forward as is. That simply won’t work. And it won’t be cheap.
Going forward managing growing costs will be a challenge just as it is for every single payer system in the world. That means that receiving health care will not be business as usual.