Here's the take home message, the money quote, if you will, of this important new Commonwealth Fund study.
The experiences of people covered by Medicare and those with private employer insurance can help inform policy debates over the federal budget deficit, Medicare’s affordability, and the expansion of private health insurance under the Affordable Care Act. This article provides evidence that people with employer-sponsored coverage were more likely than Medicare beneficiaries to forgo needed care, experience access problems due to cost, encounter medical bill problems, and be less satisfied with their coverage. Within the subset of beneficiaries who are age sixty-five or older, those enrolled in the private Medicare Advantage program were less likely than those in traditional Medicare to have premiums and out-of-pocket costs exceed 10 percent of their income. But they were also more likely than those in traditional Medicare to rate their insurance poorly and to report cost-related access problems. These results suggest that policy options to shift Medicare beneficiaries into private insurance would need to be attentive to potentially negative insurance experiences, problems obtaining needed care, and difficulties paying medical bills.
Here's a link to the full report in the journal Health Affairs.
Let me add something personal. Have you ever been with a Medicare recipient at a medical visit? I have. I often take my elderly mother to her appointments. It is a very different experience from what the rest of us endure with our very defective private insurance.
My mother has traditional Medicare, and yes, she is blessed to be able to afford a Medigap policy. I recognize MediGap is a luxury few Americans are able to afford. But even if she didn't have MediGap coverage, she goes in and out of a doctor's office without anyone demanding a co-pay, a credit card, cash, or telling her she hasn't met a deductible.
All Americans should be entitled to this.
There is talk of adding co-pays, deductibles and all manner of means testing to Medicare, this would be unacceptable and unthinkable.
Medicare is not free, not by a long shot, there is a significant monthly premium deducted from the Social Security payment, the premium is a fraction of what we pay for private junk insurance.
And most important, the costs of administering the Medicare program are a fraction of the costs associated with private, for-profit insurance, which devours a huge amount of every premium dollar on profits for Wall Street, sales, marketing and administration of their very defective product. Just think of the number of hours you spend on the phone fighting for a claim to be paid.
Imagine for a moment, life without Medicare. Medicare is a single-payer program that covers every senior, and though it doesn't pay for every last procedure, because of Medicare's universality, there are essentially no uninsured seniors in America. American seniors are not subject to the grotesque mercies of the for-profit insurance industry. You don't hear very often of seniors being denied coverage. Seniors do not need to worry about their pre-existing conditions or their lifetime limits, co-pays, co insurance, deductibles and all the other indignities those of us still able to pay for private insurance face. As I said, imagine life without Medicare for your mother, father, grandmother or grandfather.
And let me leave you with what I consider to be a truly frightening report from Families USA breaking down the crisis of pre-existing conditions state by state. As most of you know, in 2014, if Obama is re-elected, insurers will no longer be permitted to turn you down simply because you need medical care. In this country, we consider this bold new paradigm to be a radical change. It is a radical change in our country because, for those under 65, Americans have for-profit healthcare, a system which no other industrialized nation would tolerate.
Our heathcare costs are the highest in the world (though we have 50 million uninsured) and our outcomes are shameful. All of this is a subject for many other diaries which will follow in the coming days, weeks and months.
