Medicare and Private Insurance

I am on Medicare. After a working lifetime of benefiting from employer-sponsored insurance purchased in the private sector, I now benefit from this government-sponsored program—Medicare.  Medicare administered by a private insurance company.

For anyone who has not yet become Medicare eligible, you may be surprised at your options when you become eligible.  Medicare has four components—A pays for hospitals, B for doctors, C paid through companies that have a contract with Medicare to coordinate and pay for services, and D, the drug benefit.  When you enroll you have a choice to be on “straight Medicare”, or fee for service, buy a Medicare supplement plan, or enroll with a part C private provider (also called Medicare Advantage, or MA).  You can also choose to enroll in part D to cover drugs—or not.

Whatever your choice, you pay.  There is a Medicare tax deducted from your Social Security check.  With some exceptions, you also pay deductibles and co-pays.  I get my Medicare through an MA private provider.  In addition to the tax deducted from my Social Security, I also pay a monthly premium to the insurance provider.  I pay deductibles, co-pays, and higher fees for out of network services. I kept my doctor. Not much different than when I had employer-based insurance.

Opponents of Medicare for All contend it would cost trillions more in taxes.  It would destroy the private insurance market.  It would starve providers, instill rationing, and have you give up your doctor.  I’m not so sure.  For starters, the U.S. currently spends about 20% of GDP on health care, or over $10,000 per capita.  This is twice as much as other developed countries that have universal health care. Why are we paying so much more? For a variety of reasons, which include middle-men, administrative fees, hospital “charge-masters” that no one can decipher, high reimbursements that drive up costs, and an unchecked drug companies that jack up prices just because they can.  To those who think Medicare for All is a bad idea, consider the offset of reducing our per capita expenses by half to be more in line with what other countries do while providing health coverage for all.

This fall I was inundated with solicitations from private insurers trying to capture my Medicare Advantage business.  Ask yourself: if Medicare for All is such a bad idea then why is the private sector scrambling to get my business?  Truth is if we continue with Medicare as currently structured there is a place for private insurance—yes, probably with less money going into the pockets of seven figure CEOs.  What’s wrong with that?  We can afford universal health care without breaking the bank, limiting choice, or cutting out the private sector.