Dylan Dusseault, Executive Director of Business Initiative for Health Policy, explains that presidential candidates Beto O’Rourke and Kirsten Gillibrand are helping out commercial health insurers in their support of Medicare for America. Unlike Medicare for All, Medicare for America is a health reform proposal that would allow people to keep their commercial insurance if they wanted to. By so doing, it would fail to rein in health care costs and to guarantee Americans access to care.
Medicare for America, introduced in the House by Congresswomen Jan Schakowsky and Rosa DeLauro, is a health care reform proposal that delivers universal health care. It leaves commercial insurers in place, while giving people the option to have traditional Medicare or a Medicare Advantage plan. And, it automatically enrolls everyone who is uninsured and newborns in Medicare. But, so long as commercial insurers can “compete” with Medicare, they will continue to game the health care system and undermine people’s access to care.
O’Rourke and Gillibrand see Medicare for America as an incremental step towards Medicare for All that they mistakenly claim is more feasible politically than Medicare for All. But, Medicare for America introduces additional health care spending and more government involvement in people’s health care. For these reasons, it is no more feasible politically than Medicare for All.
Medicare for America could also be a step backward from Medicare for All. It does not take on the lobbying power and political influence of the health care industry. Instead, it allows this power and influence to grow. Medicare for America would enable Medicare Advantage plans to expand their business at government expense. It also would further empower the health care industry, allowing providers to drive health care prices higher.
Medicare for America, unlike Medicare for All, does nothing to rationalize health care prices. Rather, it increases national health care spending. Not only would we continue to pay high prices for our care, we would also continue to pay the hundreds of billions of dollars in administrative costs and profits that come with commercial health insurance. Millions of Americans would still not be able to afford their health care.
Moreover, simply giving people who are uninsured Medicare might not be enough to get them access to care. Medicare for America would pay doctors Medicare rates, which are lower than commercial rates. But, it would not require doctors and hospitals to take Medicare patients. As a result, Medicare for America could make it a lot harder for people with Medicare to find doctors who will see them.
With Medicare for America, doctors and hospitals would not see the administrative savings they get with Medicare for All. One-fifth of their income would continue to go to administrative expenses related to the commercial health insurance system. It would be challenging at best to get providers to support Medicare for America, let alone to get these doctors to treat more Medicare patients if they did not have to.
Yes, Medicare for America places a catastrophic cap on traditional Medicare, a big improvement. And, it delivers universal coverage, another good thing. But, that’s not enough if that coverage still involves large out-of-pocket health care costs.
Medicare for America does not address underinsurance, inadequate coverage that comes with high out-of-pocket costs. Underinsurance is a growing problem, even for people with employer coverage. Except for people with low incomes, Americans would pay high premiums, deductibles and coinsurance.
Medicare for America also could weaken traditional Medicare. If Medicare Advantage plans’ up-front costs were lower than traditional Medicare’s–as they are today–healthier people would likely accept their restricted networks in exchange for lower costs. Sicker people would opt for the freedom to choose doctors and hospitals that only traditional Medicare offers, driving up its costs.
Medicare for America simply does not deliver what we need: Good affordable health care for all.
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Here’s more from Just Care:
- Eve’s story: Commercial health insurance, inhumane choices
- Seven reasons commercial insurance cannot meet our health care needs
- Judge finds UnitedHealth illegally denied care to thousands
- Trump budget proposal slashes Medicare, Medicaid and Social Security
- Four things to think about when choosing between traditional Medicare and Medicare Advantage plans