The contenders for the Democratic nomination for president have been debating the possibility of “Medicare for All.” Might that be a viable option to provide healthcare to Americans and to reduce the current high cost of health care? There’s generally agreement that health care is expensive in the U.S. With the exception of Switzerland, the United States’ per capita expenditure on health care is double that of other developed countries. Our northern neighbor, Canada, spends $4826 per capita, while America on average spent $10,224 per person in 2017. According to the Peterson-Kaiser Health System Tracker, in 2016, the U.S. spent 8.5% of its GDP (gross domestic product) on health from public funds, similar to other countries. Private spending, however, is much higher, at almost 9% percent of GDP, compared to 2.7% in other countries.
Why do we pay so much, even with insurance? What is the best answer? Would Medicare for all work? I really don’t know, and will have to trust those whose economic education continued past high school to help me better understand what is at stake. But what I do know is that while Medicare for all is not the law of the land, “Medicare for Me” is definitely on the horizon for this woman of a certain age, as evidenced by the varied mailings cluttering my mailbox, social media, and inbox in the past few months. How do they know I am getting old(er)?
Yes, my sixty-fifth birthday is less than four months away, and I will soon join the ranks of Medicare recipients. No longer will I be able to cling to the last gasps of midlife, as I will be anchored solidly among the elderly. As such, I am being invited to consider a variety of supplemental plans for medical coverage to care for me in my dotage.
As the AARP has helped me understand, basic Medicare coverage definitely has some gaps. It doesn’t cover routine eye exams, glasses or contacts. Nor does it cover hearing aids, often a $6000-$8000 expense, out of reach for low income seniors. Dental work? Nope. An appendectomy in Paris or a broken leg in Nepal? No again. Nursing home care? Rehab after hip surgery, yes, but not long-term nursing home care. As for face-lifts, nose jobs or tummy tucks, we’re out of luck if we expect Medicare to pay for such frivolity!
Then, of course, there are the various parts of Medicare. Medicare Part A provides inpatient hospital coverage, Part B, at $135.50 or so per month, is for outpatient/medical coverage, Part D offers prescription drug coverage, and Part C is an alternate way to receive Medicare benefits. Medicare Advantage Plans (Part C) provide all Part A and Part B services, but can do so with different rules, costs, and restrictions. That’s what my e-mail and snail mail correspondents are wanting me to choose, because those plans are run by private companies – thus the opportunity to profit!
According to the Kaiser Family Foundation, gross margins for Medicare Advantage plans averaged $1,608 per covered person per year between 2016 and 2018, a figure that’s about double the average gross margins for individual plans and for group markets, making these Medicare Advantage plans a lucrative investment for insurers. It pays for them to maximize the enrollments, especially among the youngest cohort of Medicare recipients (like me!).
Did you know there’s even a Medicare Café, where I can combine light refreshments with Medicaid information from one of the local providers? I could get breakfast there, do lunch with free samples at Sam’s Club, and then take advantage of the invites we get for investment presentations at local restaurants – no need to buy groceries.
I’ve often said that locating the needed resources to survive poverty can be a full-time job. I’m beginning to think the same is true as I move into the world of official senior citizenship. Why does it have to be so difficult to understand? Just have one of those cute guys in the brown shorts deliver my silver sneakers to the door and I’ll be happy. Oops – does that sound politically incorrect or sexist? You’ll have to excuse me – after all, I am getting older.
No comments:
Post a Comment