By Ricardo Alonso-Zaldivar
Associated Press, May 21, 2019
Generous benefits. No copays. No need for private policies. The “Medicare for All” plan advocated by leading 2020 Democrats appears more lavish than what’s offered in other advanced countries, compounding the cost but also potentially broadening its popular appeal.
While other countries do provide coverage for all, benefits vary. Canada’s plan, often cited as a model, does not cover outpatient prescription drugs and many Canadians have private insurance for medications. Many countries don’t cover long-term care.
But the Medicare for All plan from Vermont Sen. Bernie Sanders would charge no copays or deductibles for medical care, allowing only limited cost-sharing for certain prescription drugs. Sanders would cover long-term care home and community-based services. Dental, vision and hearing coverage would be included. The House version of the legislation is along similar lines.
“Medicare for All proposals would leapfrog other countries in terms of essentially eliminating private insurance and out-of-pocket costs, and providing very expansive benefits,” said Larry Levitt, a health policy expert with the nonpartisan Kaiser Family Foundation. “It raises questions about how realistic the proposals are.”
Economist Sherry Glied, dean of New York University’s Wagner school of public policy, says the offer of generous benefits may be needed to persuade Americans satisfied with employer coverage that they would be better off in a new government plan.
“You are going to have to be very generous if you want this to be politically appealing to lots of people,” said Glied, who was a senior health care adviser in the Obama administration.
By Don McCanne, M.D.
In dismissing Medicare for All, politicians such as Nancy Pelosi and Donna Shalala note that Medicare’s benefits are not very good, thereby seeming to suggest that Medicare is not a good model for a universal health care financing system. What they do not acknowledge is that that the single payer Medicare for All proposals describe the most comprehensive health care benefit packages available anywhere – far better than the employer-sponsored plans that they keep touting.
Single payer Medicare for All is not the traditional Medicare program that has been neglected for decades by Congress and by Republican and Democratic administrations, as they continue to enhance the private Medicare Advantage programs. But even Medicare Advantage plans do not begin to match the blockbuster benefits of a well designed single payer Medicare for All model.
The public has to understand that the single payer model of Medicare for All would be the most comprehensive health care program of all nations. It is not our current traditional Medicare program – a program that requires supplemental plans to provide adequate protection. Do not let Pelosi, Shalala and others get away with their efforts to defeat single payer by their false implications that the traditional, neglected Medicare program is the same as comprehensive, single payer Medicare for All.
And scaring seniors into thinking that they would lose their current Medicare? That is dishonest unless the seniors are told that they would be receiving far more comprehensive benefits, without deductibles and other cost sharing, and without the restricted provider networks that the private Medicare Advantage plans use.
And the union members with retiree health benefits they don’t want to give up? No union health benefit program is as comprehensive as single payer Medicare for All. And what about those payroll deductions they made all those years? Go back to the negotiating tables and maybe those reserves could be used for more generous pensions, or whatever else is fair.
But there is no legitimate argument that should cause people to want to reject the most comprehensive health care financing system possible, providing affordable health care for all. If they say they don’t want it, then find out why, because it is clear that they don’t understand what they would be missing out on.
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