By Paul D. Jacobs
Health Affairs, February 2021
Medicare pays for roughly one in four physician visits in the United States, yet a rigorous understanding of how Medicare currently affects access to and affordability of care for its enrollees is unavailable. Using data from the Medical Expenditure Panel Survey–Household Component and the National Health Interview Survey, I tested for changes in access to care and affordability around age sixty-five, when most people gain eligibility for Medicare. I found that Medicare eligibility is associated with a 1.5-percentage-point reduction in reports of being unable to get necessary care (a 50.9 percent reduction compared with the percentage at age sixty-four) and a 4.1-percentage-point (45.3 percent) reduction in not being able to get needed care because of the cost. Recently, policy makers have proposed various ways of extending Medicare coverage. These results suggest that incremental Medicare expansions could have positive access and affordability benefits for enrollees compared with the insurance options available to them before they turn sixty-five.
By Don McCanne, M.D.
Much of America currently advocates expanding Medicare to include everyone. Those who have studied the issue realize that Medicare is still not adequate and thus should be improved if it is to be used as the basis of a universal program.
Today’s report confirms that Medicare is nevertheless an improvement in both access and affordability over the typical coverage at age 64, just before the onset of eligibility for the existing Medicare program. Medicare is associated with a 1.5 percentage point reduction in reports of previously being unable to get necessary care (50.9 percent reduction compared to age 64). Medicare is also associated with a 4.1 percentage point reduction in not being able to get needed care because of the cost (45.3 percent reduction compared to age 64).
That’s not bad, but just think how much better those numbers would be if we replaced Medicare with a new and improved version and then expanded it to include everyone. What are we waiting for?
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