Medicare for all - fixing US healthcare

[Big Dog]

Big Dog thank you for explaining it the simplest way that I definitely understand. Do you have an idea how much does Medicare shoulders for Covid patients? Thanks Big Dog!

CF, Medicare is complicated. Part A, the hospitalization comes with deductibles and copays depending on the hospital stay. Part B pays about 80% of docs and labs. Neither A nor B have an annual limit, aka, stop-loss, so Medicare alone could result in a senior owing thousands of dollars for a long hospital stay. Thus, many people purchase a Medicare supplement from a private insurer (United Health Care/AARP plan is extremely popular). There are ~10 supplements; Plan F, which is no longer offered to those turning 65 in 2020, covers everything that Medicare does not pay. Plan G has a ~$200 annual deductible, but covers everything else.

There is no charge to enroll in Medicare Part A. Part B costs $144.50/mo., but premiums increase for those making over ~$170k, MFJ.
Supplements can run $200-300/mo. in my zip code, depending on the benefit level you desire. The poor may also qualify for Medicaid.

Part D - Rx is completely separate and must be purchased directly from insurers. Rates can run from $15/mo with few benefits to $250/mo for those who use lot of prescriptions (my zip code). The poor can qualify for subsidies to offset Rx premiums.

Now, if you don't like all of those Original Medicare choices, you can sign up for a Medicare Advantage Plan. (Think of the mass of commercials for Medicare on TV; they are all nearly HMO-type plans.) For one monthly fee, a Medicare Advantage Plan combines Part A, Part B and Part D into one plan. Some Advantage plans also offer vision and dental. (Ever see Joe Namath's commercials?) Kaiser offers a strong Advantage plan in California.

So, the short answer to your question, if a patient has Original Medicare AND a Plan F supplement, they'd pay zero for hospital and docs and only have to pay a copay for any Rx that they might need while recovering at home. Don't forget, they were also already paying $300-$450/mo. for Medicare insurances (depending on individual income).

Hope that helps.

 

[eevee-fan]

Hm... so seems if we have Medicare for All, there are still plenty of private insurance opportunities...

 

[Pismo]

I am Australian living in the US - and married to a Surgeon here in the USA. I guess this is my consensus.
Charge a (2.5-4%) tax for Medicare on a sliding scale (more you earn, less %)
Australia charges you to go the ER, Free to your local public PCP

• Have the government cover patients in the hospital - thats why hospitals cover 5x more, since you're paying for you and the other 4 nutjobs coming in without insurance (I say nutjobs, since my wife does EGS an Trauma)
• Single payer for drugs - that way nothing is overpriced.
• Biggest attribute to MFA - is covering preventative stuff. If people would come in for check up and stay on top of things, it would actually save money
  • Eg. 55yr old man, vascular issues, doesnt see check ups since too much $$$ - Aorta bursts,
  • AAA - costs minimum $40,000 - Big surgery, ICU for a week and then in hospital another few weeks.
• Have the option to have multi teirs -
  • What this means is if you want a private doctor - you can. You just need to pay the difference.
  • Eg. You need a outpatient procedure - Govt says it costs $100, private doctor says it costs $150 - you pay the $50
    • Or in Australia, private health insurance covers this gap.
• Surgeons and docs for the most part will get paid the same, depending on their speciality.
• Hospitals don't run at a loss, since they are getting reimbursed for every patient.
• Those 22million who lose their jobs to public healthcare would find plenty of jobs within the state run or smaller private insurance companies
  
• Pre-existing injuries, such as pregnancy and cancer would be scrapped, as well as pretty much all of this.
• Yes- there sometimes is a wait, for example - in Aus, I had to wait three weeks to get my ingrown toenail fixed, since it wasnt urgent. I was able to stay out fo school for a bit, so it didnt bother me.
  • All emergencies would take priority - like they do now

Notes in 2020

• I would pay 4% of my salary knowing that I wouldnt be one accident away from bankruptcy
  • This would also take away the scary thought of emergency surgery at a hispital in network, but a surgeon on call who doesnt accept your insurance and you get a bill for $40k
  • I feel most people would pay 2.5-4% knowing they couldnt become medically bankrupt
• We have learned that insurance tied to employment is a bad idea with Covid-19
• Your medicare-for-all card is also your voting enrollment.

I am now ready for your to shred this apart.

 

[Big Dog]

Biggest attribute to MFA - is covering preventative stuff. If people would come in for check up and stay on top of things, it would actually save money

That is common wisdom, but it is actually incorrect. While preventive services may help your vascular hypo, on a mass scale, Prevention costs more money than it saves. If you search back thru the ACA research, the then Director of the Congressional Budget office even admitted to Congress that Prevention has a net cost to the ACA. (And don't forget, that both houses of Congress was controlled by the Dems, so if Nancy Pelosi or Harry Reid didn't like his answer, they could have replaced the Director at any time.)

That said, saving your vascular individual is probably worth it. As many other peeps with chronic conditions can be helped as well.

• Surgeons and docs for the most part will get paid the same, depending on their speciality.

• Hospitals don't run at a loss, since they are getting reimbursed for every patient.

Does your wife make the same profit from Medicare and Medicare as she does from private insurance patients?

 

[israndy]

I am Australian living in the US
[...]
Free to your local public PCP
[...]
my wife does EGS an Trauma

PCP?

EGS?

MFA? Medicare for All, OK, got one.

 

[Atari2600]

Since people keep talking about Medicare for all vs a new Universal Healthcare we should do what was discussed by some politicians which was adding dental and vision to medicare and retooling the existing benefits. Last time I checked my eyes and teeth were actually part of my body. Eyes are critical and dental infections can cause permanent heart valve damage, injure people with joint replacements etc.