I find it interesting that we have a Medicare-for-All movement largely unquestioned by its enthusiasts, while Congress today and in the past struggles to manage current Medicare costs.
Three years ago Congress changed the supplemental plans to require some additional cost sharing by beneficiaries on the theory that if every service is effectively free, it will be used more often, including unnecessarily.
That, of course, is the same theory behind high deductible health plans. Why should paying a reasonable portion of every health care bill not be standard? But as I have said before, nobody thinks they should spend their money on health care.
The argument against requiring the deductible as outlined below “if someone has the funds to actually purchase first-dollar coverage, why shouldn’t they be able to?” is invalid because it’s not their premiums that are the issue, but the portion of the bills paid by Medicare and taxpayers once you are encouraged to enter the health care system.
The impact of requiring beneficiaries to pay a once a year deductible is minimal in the scheme of Medicare costs, but not so if you extend “free” to the entire population. That is why a Bernie Sanders version of Medicare-for All is so dangerous; no deductible and no cost at the point of service. Why should anyone care about what they spend on health care?
But you see someone will care, government bureaucrats and Congress and even taxpayers will care as costs rise, but Sen Sanders and his supporters never talk about how costs will be managed after we all have “free” health care.
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act. Part of this legislation will outlaw the sale of Medigap plans (on or after January 1st, 2020) that pay for the Part B deductible to a newly eligible Medicare beneficiary. In 2018, the annual Part B deductible is $183.
Since Plan C and F both pay for this deductible, they will no longer be available to new beneficiaries. The reasoning behind the law is that Congress doesn’t want people to have plans that pay for literally everything because that might encourage people to access medical care more often.
Individuals who know they must pay for their own Part B deductible once a year might think twice about visiting the doctor for a minor ailment. Fewer doctor visits equal less spending by Medicare itself.
To be sure, there are many people who don’t agree with the thinking behind this. Opponents of the legislation pointed out that Plans C and F cost more than other Medigap plans. So, if someone has the funds to actually purchase first-dollar coverage, why shouldn’t they be able to?