A new study published in JAMA finds that people with public insurance say they fare better than people with private insurance when it comes to access to care, costs and satisfaction. The study confirms what the polls show, that the public supports a public health insurance option. That said, it does not break down people’s preferences as between traditional Medicare and Medicare Advantage. Only traditional Medicare is true public insurance, without a for-profit insurer coming between patients and their doctors.
The study treats both traditional Medicare, government-administered insurance, and Medicare Advantage, private insurance offered by the federal government, as public insurance. Unfortunately, the data is not available for the researchers to distinguish between them as far as people’s experiences are concerned. But, traditional Medicare is far more cost-effective according the MedPAC. People with traditional Medicare also have better access to care than people in Medicare Advantage.
The researchers believe that Congress should be focused on lowering people’s out-of-pocket health care costs. However, little research has been undertaken on the different experiences people have with the health care system depending on the type of coverage they have. That said, Medicare and VA coverage tend to be the least costly and the most comprehensive.
Dr. Salomeh Keyhani, one of the researchers explains: “While the conventional wisdom is that private coverage is better, our findings suggest that Americans have better experience with Medicare and VA/military coverage. The findings are especially interesting as private insurance tends to cover individuals that are younger and healthier.” Put differently, you might think that people with fewer health care needs would have better experiences with the health care system than people who use it more; that is not the case. Public insurance is preferred.
People with employer coverage tend to have less health security because their jobs can change at any time and with them, their health insurance. They also tend to face even higher deductibles and copays than people with public insurance. Consequently, they tend to value their health insurance less than people with Medicare.
The same can be said for people who buy their coverage through the state health insurance exchanges or, on their own, through some other channel. They are less satisfied with their coverage than people with Medicare.
The situation is different with Medicaid as compared to employer coverage or individual coverage. People with Medicaid struggle more to see a doctor. And, they struggle more to pay for their health care.
But, medical debt is more prevalent among people with private insurance of whatever type. And, overall, people with private insurance have worse experiences with the health care system than people with public insurance. It has largely been the case over the last several decades that people with Medicare are more satisfied with their coverage and costs than working people.
Of course, generalizing about people with Medicare is a mistake. Older and disabled Americans with complex and costly conditions often struggle significantly to have their care needs met if they are in a Medicare Advantage plan or in traditional Medicare without supplemental coverage, which picks up most or all of the deductibles and copays. Only people with traditional Medicare and supplemental coverage have comprehensive protection from financial risk if they need costly care.
Here’s more from Just Care:
- Americans with Medicare are more satisfied with our health care system
- Why does private health insurance work well in Europe?
- Coronavirus: For the public health, profits should not drive our health care system
- Well-kept secrets of Medicare Advantage plans
- Four things to think about when choosing between traditional Medicare and Medicare Advantage plans
