A new report from the Commonwealth Fund finds that cost is a large barrier to care for older adults in the US, larger than it is for older adults in 10 other wealthy countries. Consequently, many older adults in the US postpone needed care or forgo it altogether.
Congress is aware that cost is a barrier to care for people with Medicare. In response, it is looking at add vision, hearing and dental benefits to Medicare. That could be a huge help for the 63 million people with Medicare, so long as their out-of-pocket costs are minimal. Otherwise, these costs could render the additional benefits meaningless for a large cohort of people with Medicare; they would be functionally uninsured.
Today, older adults in the US spend more on healthcare than older adults in other nations. About 8.5 percent of older adults in the US skip or postpone needed care because of the cost. In sharp contrast, in Germany, the Netherlands, Norway, and Sweden, fewer than two percent of older adults report facing financial barriers to care. Even in Switzerland and Australia, which impose high out-of-pocket costs on older adults, older adults are less likely to skip or delay care than older adults in the US.
Not surprisingly, older adults in the US are also twice as likely not to fill their prescriptions and skip doses because of the cost than older adults in other countries. A recent NBER study found that an increase in prescription drug copays of as little as $10.40 keeps more than one in five older adults from filling life-saving prescriptions. As a result, thousands of people with Medicare die prematurely every year.
Some Democrats in Congress are saying that the government doesn’t have the money to cover a larger share of health care costs for people with Medicare. In fact, right now, Medicare Advantage plans are getting government rebates of $140 per enrollee per month, along with billions a year in overpayments relative to traditional Medicare. Congress could take some or all of that money and put it towards lower out-of-pocket costs and a reasonable out-of- pocket cap in both traditional Medicare and Medicare Advantage.
More people with Medicare would not feel the need to forgo critical care if Congress reallocated those tens of billions of additional dollars towards lower out-of-pocket costs for everyone with Medicare and an out-of-pocket cap in traditional Medicare.
Warning: Medicare Advantage plans might look inexpensive because premiums are usually low. But, if you get sick and need costly care, your out-of-pocket costs, copays amd deductibles, could be as high as $7,550, depending on the plan you choose. Your out-of-network costs are additional.
Here’s more from Just Care:
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