Free Medicare for all?

By Randall Poulton | Nov 28, 2019

How about free Medicare for me! After paying ridiculously high health insurance premiums for the last few years, I am officially “old” and thus eligible for Medicare (in every cloud, a silver lining). Based on all the carping from the liberal left, I assumed Medicare was free. Would that it were. And not only is it not free, it is very complicated.

Like you, for my entire working life, I have had money taken out of my paycheck to pay for “free” Medicare when I turned 65. But what I have recently learned is that what I have been paying for is only Medicare Part A. So, now it is time for me to decide if I also want: Medicare Part B, Medicare Part D, Medicare Supplemental Insurance or Medicare Advantage. I told you it was complicated! Here is how this all works:

Medicare Part A is hospital insurance. If it happens in the hospital, and I stay overnight, I will be covered (outpatient procedures are not covered under Part A). Since I have been paying for this coverage my whole life, it will now be “free.” Yay!

But Medicare Part A does NOT pay for medical appointments and procedures that take place outside the hospital. If I go see my “provider” or a specialist, I will have to pay for that out of pocket. Or, I can buy more insurance. So much for “free.” My choices are to buy Medicare Part B thru the government or buy a certain type of private insurance that qualifies as a Medicare Advantage Plan. Either way, doctor’s insurance coverage costs the same: $145 per month. And, either way, that $145 is deducted from my monthly Social Security check. Ouch! Not free!

Next, I need to decide if I want insurance to help pay for any prescription drugs I may need. Right now, I am not taking any medication but, of course, that could change tomorrow. And, if I decide to not buy drug coverage now, either via Medicare Part D or Medicare Advantage, then, if at some point in the future I do want to buy it, the same drug coverage will cost more. To summarize: I need to pay for Part D now, in case I need it later. How very nice.

After studying all the options, I decided to go with a Medicare Advantage plan that includes drug coverage. That will cost me another $89 per month. So, my Medicare premiums are $145 + $89 = $234 per month or almost $3,000 per year. Not free! And what does this cover?

My Medicare Advantage Prime is a very good plan, but it still has co-pays and deductibles, just like the insurance I have now. How much are the co-pays? Here is a good example. If I were to get in a serious car wreck or have a heart attack, the costs would be as follows: Ambulance transport to hospital - $295; Emergency Room visit - $90; five days in the hospital - $1,625. My out-of-pocket cost - $2,010 total. Not a huge bill but certainly not “free.” And I am sure many retired people are in no position to come-up with $2,000 to cover an unexpected accident or illness.

So, is it feasible to make Medicare truly free? No, absolutely not. Those politicians who promise free Medicare for all are either ill-informed or flunked high school math. Right now, there are about 55 million people enrolled in Medicare. If the government decided to make Medicare free for just me and my 55 million old friends, it would cost over $200 billion a year. That is about the same as the annual combined federal spending on education and transportation. Or, to put it on a more personal level, every taxpayer would have to ante-up an extra $2,000 or more a year. And that only gets me and my “old friends” free Medicare!

Want to provide free Medicare to the other 275 million younger Americans? That’s when the numbers get truly mind-boggling. Most estimates agree the cost would be $3 trillion a year or more. For context, currently, the entire federal budget is about $4.5 trillion a year. To cover this extra $3 trillion, taxes would have to double or even triple, depending on exactly who would be paying for what. Don’t forget, my 55 million friends and I paid into Medicare our whole lives. And what about illegal aliens? Do they get free Medicare?

Many Democrats claim there would be some offsetting savings, since the people who now pay for private health insurance could drop it and sign up for free Medicare. But surely any savings on the individual level would be offset by far, far higher taxes. So, what would free Medicare look like? Here is my vision:

If it is free, people will abuse it. You may have noticed, in my Medicare example above, ambulance rides have a $295 co-pay. That is because some people, when they need a ride, call an ambulance rather than pay for a cab.

If it is free, people will overuse it. Rather than suffer with a head cold or a sore foot, people will flood emergency rooms. Unless hospitals hire a bunch more doctors and nurses, which costs money, waiting times will increase and quality of care will decrease.

If it is free, that means the government is running the show. And our government has proven time and time again that anything it does takes too long and costs too much. The way our government holds down Medicare costs now is it underpays providers. Fortunately, today, providers can make up this loss by charging private-pay patients more. If we have Medicare for all, there will be far fewer private-pay consumers. How now, brown cow? Do you want an underpaid and overworked surgeon cutting on you? I don’t!

Randall Poulton is a columnist for The Republican Journal. He lives in Winterport.

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