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It seems to me it depends on how the implementation of the Affordable Care Act (hereafter referred to as Obamacare) works out. If low income people are able to access medical care via subsidies or Medicaid, it doesn't matter when they become eligible for Medicare. Will it depend on the individual states, thus making Medicare just as indispensable as it presently is? Do we have to fight to keep Medicare as it is just until Obamacare is fully functional? Will Medicare ultimately become unnecessary?

I ask these questions because I know how indispensable Medicare is. I became eligible for Medicare early, and it has been a lifesaver, literally. I was approved for Social Security Disability at age 59. As many of you know, with SSDI you have to wait two years to begin receiving Medicare. When I received my Medicare card, it was a joyful day. Finally, home free! I had spent most of my life without insurance, but I was fortunately also healthy. When health became an issue, I was able to access health care at a local clinic. It wasn't ideal, but it was something. Receiving that Medicare card meant I could go to my chosen doctor. It made a real difference. The details aren't important.

So it's not about me. I just want everyone to have the security of knowing that if they need medical care, they can access it. What do you think? Will Obamacare make the necessity for Medicare, or the age at which it kicks in, less important, or not important at all? Would our time be better spent fighting to make sure Obamacare becomes a better program, or do we still need to fight to keep Medicare as is?

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Comment Preferences

  •  not the same coverages (8+ / 0-)

    many people won't be able to remain employed, it will create more disability claims,   as we saw with the late economic downturn, and cost the system more money.

    This is hate and spite and Republican math.  We should resist it.

    •  The point of Obamacare is to allow people who (0+ / 0-)

      aren't employed to access insurance at the same group rate they would have if they were employed.

      Perhaps what is covered is different. I need to check into that.

      •  people without income (6+ / 0-)

        because the SS age has gone up o 67 as well, have a hard time buying insurance,  if they have sufficient savings, all is great, they stay on a group plan.

        Medicaid isn't as good as Medicare.  Further,  private insurance, small group pricing, suffers when you have some over 65 people on it.  

        •  I thought the purpose of the mandate was to (0+ / 0-)

          make the groups large enough to absorb sicker people. Isn't that right?

          •  yes, to give the groups (3+ / 0-)
            Recommended by:
            HappyinNM, tardis10, qofdisks

            younger well people, to cut back the age variance in pricing, and to have larger groups overall, to provide subsidies to those in lower income brackets or provide expanded Medicare.

            But is it just the same as Medicare?  No.  Medicare runs a few pennies on the dollar of administrative costs, leaving more money for health care, private insurance still is allowed 20%, eating dollars of premiums for advertising, bonuses, and bullshit,  many blue collar/physical labor jobs, see increasing numbers of people drop out from the mid fifities on,  seeing them in less well paying or part time work, making it harder to afford premiums so they will be subsidized, maybe as much or more than the cost of traditional Medicare because they will be in high risk pools, etc.

            So better on the overall health insurance/medicaid coverage is not the same as the more all inclusive care of Medicare if you fall into the 65-67 bracket and are not able to stay employed.  Health insurance reform made it better, it is still not Medicare.

            •  All of what you said is spot on. (0+ / 0-)

              The problem I'm concerned with is how Medicare can be financially sustained. Obama said Obamacare extends Medicare for eight years. What happens after that? We're going to have to come up with a better source of funding than what exists now. With the economy still floundering, can we raise the percentage of withholding? Don't know.

              •  better source of funding (1+ / 0-)
                Recommended by:
                HappyinNM

                you mean move away from a payroll tax?  Or just slightly increase the payroll tax and negotiate drug costs as other civilized nations do, get some more rational pricing guidelines,  and crackdown on idiocy in test gathering.

                My 82 year old mother with fairly advanced dementia, can't walk because of Parkinsonism, is starting to lose her ability to swallow,  and her doctor is worried about her thyroid and whether she should be seeing a heart specialist.   Or maybe just more tests so that they can justify the cost of a visit. While some of her Parkinson symptoms can be like hypothyroidism,  weakness, confusion, etc.,  why go looking for additional disease to treat for the same symptons when the Parkinson's has been diagnosed and progressing for 8 years?   And we are going to be able to keep her alive longer, is that the goal?  How many years should people who can't remember their grandkids, confuse their child with long deceased siblings, and can't care for their daily needs be kept alive just because more drugs can be sold and more tests run?

                •  I'm sorry about your mother, and sorry for you (1+ / 0-)
                  Recommended by:
                  qofdisks

                  having to observe her decline. And I'm certainly not equipped to offer a solution. It's just very sad.

                  My concern in writing this diary was to begin a conversation. It seems the people who read it are opposed to the discussion, as I've never written a diary that hasn't gotten any tips or rec's. People keep saying that they don't want any changes to Medicare, and get angry with Obama when it seems he is suggesting that. Medicare isn't sustainable in the long run as it exists presently. And I don't know what to change to make it so.

                  •  HappyinNM (1+ / 0-)
                    Recommended by:
                    jfromga

                    None of our present systems for human provision is currently sustainable.  Why pick on the common good...again.  
                    Think about it.  Housing? The cost of housing is crazy unaffordable and Wall Street does not allow the cost of shelter to self correct to correlate to prevailing wages.
                    Higher education?  This is creating long term debt slaves of our youth.
                    Private insurance.  Obama care expressly folded private insurance companies into an attempt at universal health care but, Obama care does not contain the rising cost of premiums, co-pays, exclusions and deductibles.  The Insurance is being made usniversal but the actual care is a different story.  It is increasing the burden of greater and greater risk taken on by working people and small businesses.
                    Corporate agriculture is strip mining the soil. breeding and processing toxic and immoral food.
                    Our infrastructure is crumbling into third world status while there is plenty of work, there is no pay.
                    Those that are working are being worked so hard that they cannot have normal human lives.

                    Why pick on the old folks?  The wealth strippers are raking them leaving very little to successive over-populated generations.
                    Our nation's schools are overcrowded and are over regulated such that a common teacher has no hope of ever jumping through all the required hoops.
                    Nothing is working.  It is all broken and unsustainable.
                    The bastards are just singling out the old folk's support system because they are a relatively easy target.

              •  Standardized pricing and treatments would help. (0+ / 0-)

                No more predatory corporate bureaucratic gaming would help.

  •  Why funnel any more dollars into (8+ / 0-)

    private insurance? Why take the younger and healthier out of Medicare to make the FIRE sector grow larger?  & since Obamacare subsidizes premiums,this is just another way of allowing private insurers even more access to federal funds.

    "George RR Martin is not your bitch" ~~ Neil Gaiman

    by tardis10 on Tue Nov 13, 2012 at 11:51:55 AM PST

    •  Good thought. (1+ / 0-)
      Recommended by:
      tardis10

      At least I hadn't thought about that. Could that hasten the end of private insurance by including older and sicker people? Could it speed the eventuality of single payer?

      •  I'm sure actuaries for the insurance (2+ / 0-)
        Recommended by:
        HappyinNM, qofdisks

        industry know just where their sweet spot is.But I don't.
        Another consideration is that when people spend more of their savings early in retirement,say by having to pay premiums to insurers,they may run out of savings earlier at the other end of their lives. So the money spent on private insurance premiums at 66 means some would qualify for MedicAid sooner.
        Could this get us to single payer faster? Can't say but I do know it is not soon enough ;)

        "George RR Martin is not your bitch" ~~ Neil Gaiman

        by tardis10 on Tue Nov 13, 2012 at 12:13:43 PM PST

        [ Parent ]

  •  I've been wondering the same thing. (1+ / 0-)
    Recommended by:
    HappyinNM

    With Obamacare in place, won't we all have access to affordable health insurance until Medicare kicks in, whenever that might be? I would be ok with Medicare eligibility being needs based up until the age of 67 when everyone would be enrolled.

  •  People die for one thing (9+ / 0-)

    Raising Medicare age is backwards, we should be advocating for lowering the Medicare age and a Medicare buyin or Medicare for all.

    "Lets show the rascals what Citizens United really means."

    by smiley7 on Tue Nov 13, 2012 at 11:58:10 AM PST

  •  Also, the savings from raising the medicare age (5+ / 0-)

    simply are not as big as R's want to make them out to be.  Raising the medicare age is much more about a gradual path to its demise than a path to cost savings.

  •  While I think we should fight to keep it as it is (1+ / 0-)
    Recommended by:
    HappyinNM

    I think you bring up a very valid point.

    If people are able to get affordable insurance from their work or the exchanges, it will have an impact on the necessity of keeping the age at 65. Of course, that remains to be seen.

    The other point I would make is that since full retirement age for Social Security benefits has already been raised, and since therefore, many people continue to work until their full retirement age, many of those people do not opt in for Parts B and D until they retire. Businesses with more than 20 people (I am pretty sure that is the correct  number) still have to keep people who are 65 or older on their health insurance policies. Part A serves as the primary insurance for their hospital benefits now, but they mostly defer on Parts B and D until they retire.

    If the expansion of Medicaid is implemented and the subsidies for the exchanges provide adequate accessibility and affordability, then people will still have access to healthcare at 65 and 66 even if they do not have Medicare. The comparison of Medicare premiums and exchange premiums is the important factor here. If the exchanges offer insurance at the same rate and with the same subsidies as Medicare, then a change in the program could be painless. If not, that's a different ball game.

    You can't scare me, I'm sticking to the Union - Woody Guthrie

    by sewaneepat on Tue Nov 13, 2012 at 12:03:44 PM PST

    •  Someone mentioned above that the different (0+ / 0-)

      plans may offer different coverage. The needs of older people are different than younger people. I'm going to check it out. It's important.

    •  True, but an additional issues is states (2+ / 0-)
      Recommended by:
      HappyinNM, qofdisks

      (eventually) paying half the tab for Medicaid costs under Obamacare, but the Fed Govt paying the bill for Medicare.  Won't states want Medicare to kick in earlier  in order to get these costs off their books earlier?  Perhaps this could be a nice "wedge" issue for us to use in the red states?

  •  To answer your question.... (0+ / 0-)

    I never vote Dem again. Off limits. Period. Even if its used to get the gopers to back down on taxes.

  •  I don't see any sense in raising the (6+ / 0-)

    Medicare age. Seems to me that lowering it would bring more money in from younger, healthier people to subsidize older, sicker ones. Or better yet, Medicare for all.

    Stay fired up: now is the time to focus on downticket change! #Forward

    by emidesu on Tue Nov 13, 2012 at 12:13:20 PM PST

    •  I agree. And I believe that ultimately we will (0+ / 0-)

      move to single payer. I guess what I was asking is whether we should fight for keeping the present age, or go for the longer view of single payer (Medicare for all). If the savings from Obamacare only extend Medicare eight years, what happens then?

      •  Well, single payer is not going to happen until (0+ / 0-)

        the boomers all die off.  I really don't think it will happen even then.  We have Climate Change down the pike.  I hear that we could have an extinction event in the next generation or two.
        If our species survives, perhaps we will have learned to take care of each other better.
        Doubt both outcomes.

    •  Maybe I'm just being dense... (0+ / 0-)

      ...but how would it bring in more money?  People on medicare don't pay premiums.  They pay for services, but that doesn't really have a subsidizing effect.

      (Forgive my ignorance...I've been reading cases for three hours...)

  •  Let's separate the Social Security (1+ / 0-)
    Recommended by:
    HappyinNM

    and the Medicare questions.
    As we live longer it may be reasonable to increase the Social Security age and do means testing as well.
    Maybe increase the retirement age by 1/2 years every 5 years for the next 40 years. However, limit or reverse this automatically if average life expectancy starts reducing for some reason.
    Medicare can remain at the same age as now and for those who qualify for SSD like the writer of this diary.
    I am all for means testing since I do not see why people who have maybe a million or more in their 401Ks or retirement accounts, millions in property etc. should get a few thousand from the government as well. It should got to the "bottom 98%".
    Medicare age should not be increased and health insurers will fight that as well. They don't want to start insuring people in the late 60s and early 70s when a lot of things start going wrong. It should be the government as we can afford it and dictate reimbursement rates as well.
    Having private insurers do this will just increase costs.

    •  In 1983 my SS eligibility age was raised to 67 (7+ / 0-)

      now you think it reasonable to raise it again to 68 1/2.

      Thanks.  I am sure when I am 65 I will look forward to the 3 1/2 years of working to go.

      Means testing turns a social insurance program into welfare.  That is specifically what FDR sought to avoid.  Why?  Because welfare can be easily attacked and terminated see Clinton circa 1996 "the end of welfare as we know it."

      Means testing is a step in the GOP's strategy to do away with SS altogether.  Raising the age again or lowering COLA or changing the basic bargain for those of us who have been paying premium for 30 plus years also discredits the program.

    •  I don't agree with raising age for SS either. (6+ / 0-)

      Just because people are living longer, that doesn't mean that they should or can work longer too.  Plus, doesn't everyone want to have a few nice years of retirement after working many years?  I'd happily pay more in SS throughout my working years to retire early.  Also, opens up jobs for younger workers.

      •  Social Security should be totally off the table. (3+ / 0-)
        Recommended by:
        tardis10, Roger Fox, qofdisks

        According to Sen. Sanders, the fund doesn't have anything to do with the deficit, and it's doing fine financially. Medicare is the problem because medical costs are so high. We need to push for what we want, so I asked some questions to find out what we want and what is feasible.

      •  why do people need to touch SS? (3+ / 0-)

        but get wishy washy on job creation.

        Is there some disconnect here, if we create 20 million jobs.....

        .... thats a shitstorm of new FICA payments.

        FDR 9-23-33, "If we cannot do this one way, we will do it another way. But do it we will.

        by Roger Fox on Tue Nov 13, 2012 at 01:29:10 PM PST

        [ Parent ]

      •  Working longer is totally occupation-dependent. (3+ / 0-)

        The problem is that Congress looks at someone like Diane Feinstein who was just re-elected to office this year at age 79 and say, well see? People are working into their 80s!

        But if you've spent your career working on cars, moving furniture, logging, as a sanitation worker, or as a roofer, your hands or back or knees (or all three) are barely holding it together until 65.

        As you say, we might live longer, but work-life expectancy hasn't kept pace.

        And, as you also note, as a gen-Xers, it's been incredibly frustrating that top positions are clogged with people in their late 60s and 70s who apparently have no plans to go anywhere: some because they choose not to, but many because they can't afford to. It's not healthy for them. It's not healthy for organizations. Younger bright driven people get frustrated and move on, so there is brain drain and no sense of loyalty.

        As a country, we need to value our elders and give them opportunities to contribute to society in ways other than the 9 to 5 corporate grind. I look at the volunteering work my parents are doing now in their retirement years, working with disadvantaged youths (a very minimal retirement, but they make do) and it is some of the most important work they have ever accomplished.  And it almost certainly will save society more money than the paltry savings of their having retired a year later.

        © grover


        So if you get hit by a bus tonight, would you be satisfied with how you spent today, your last day on earth? Live like tomorrow is never guaranteed, because it's not. -- Me.

        by grover on Tue Nov 13, 2012 at 01:55:42 PM PST

        [ Parent ]

    •  not in favor of means testing (4+ / 0-)

      it will just make it easier to paint Medicare as a "welfare program". The rich pay into it and should get their benefits, too.

    •  SS: never designed to exist in a 20 yr recession (1+ / 0-)
      Recommended by:
      HappyinNM

      Youre selling the farm on SS, but not even giving lip service on job creation......

      WTF MAN...... theres fooking 25 million of us who would take a full time year round job if offered.

      Now do the Fookin math, creating 25 million jobs is how much FICA at 40 hrs at Min wage?

      if average life expectancy starts reducing for some reason.
      Isnt that special?

      It just might be that for the 50 million folk without healthcare, our life expectancy has already started to decline. I'm guessing , you know, going out on a limb here.

      FDR 9-23-33, "If we cannot do this one way, we will do it another way. But do it we will.

      by Roger Fox on Tue Nov 13, 2012 at 01:37:21 PM PST

      [ Parent ]

    •  Why are you assuming that (3+ / 0-)
      Recommended by:
      grover, Brooke In Seattle, qofdisks

      life expectancy is increasing? It is not, except for the wealthy. And older people, whether or not they are prevented from getting Social Security and/or Medicare because of an increase age of retirement, are much more likely to become permanently unemployed at that age.

      •  People assume that citizens are living longer (1+ / 0-)
        Recommended by:
        qofdisks

        Because that's the narrative that they're being fed. When everyone is lumped together (including the wealthy) there is a bit of an increase; and the reach-back is pretty significant. They reach back to 1900 or 1915. "Americans are living longer than they were 100 years ago."

        Yeah. Ok. That's news. I guess. But the increase was mostly due to major medical advances in the early 20th century:  from 47 years old at 1900 to 68 years old in 1950.

        Regardless,  that becomes the hair-on-fire narrative because Conservatives have to try to sell the cuts to SS and Medicare as the only way to prevent a crisis. Folks won't simply buy the truth: that they've wanted to kill these programs since they were signed into law.  

        © grover


        So if you get hit by a bus tonight, would you be satisfied with how you spent today, your last day on earth? Live like tomorrow is never guaranteed, because it's not. -- Me.

        by grover on Tue Nov 13, 2012 at 02:09:27 PM PST

        [ Parent ]

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