JustCare

Tag: Public option

  • Americans want health care system overhaul

    Americans want health care system overhaul

    A new survey of Americans finds utter and complete dissatisfaction with our health care system, reports Amanda Seitz for AP News. Nearly nine in ten Americans say that health care is not handled well or extremely well, including health care for older adults. Most Americans want Congress to overhaul our health care system and think Medicare and Medicaid should be expanded to cover long-term care. They want guaranteed access to care.

    The Associated Press/NORC poll finds that more than half of Americans think the US is not handling health care too well or well at all. Just slightly more than three in ten Americans, 32 percent, think the US handles health care somewhat well. Only 11 percent believe that the US is handling health care for older adults very well or extremely well.

    On top of the dissatisfaction with our health care system writ large, almost 80 percent of Americans worry to some degree about being able to get the care they need when they need it. As it is, tens of millions of Americans are forced to choose between health care and other basic necessities, forcing many of them to forego critical health care.

    As for the cost of prescription drugs, more than nine in ten Americans believe our government is not handling this issue appropriately. How could they? Drug companies are raking in mega profits as millions of Americans die because they can’t afford their medicines. And, though millions of Americans import low-cost drugs from abroad, they are technically forbidden from doing so, even when it could save their lives. Prices abroad can be 90 percent less than in the US.

    What’s the solution? Most Americans–two-thirds–want the federal government to step in and ensure access to care for all Americans. Support for the federal government to step in has grown significantly in the last five years. In 2019, 57 percent thought guaranteeing health care was a government responsibility. In 2017, 52 percent thought so.

    Of course, the simple most cost-effective solution would be for the federal government to negotiate fair prices for health care services, as every other country does, and expand traditional Medicare to everyone. But, only four in ten people polled in this survey supported this solution.

    A majority of people like the idea of a “public option,” allowing people to choose to buy health insurance administered through the government. I once liked it as well…until I came to appreciate how powerful and influential the corporate health insurers are in undermining the public option. We see it today with Medicare Advantage, which is corporate health insurance that has been killing traditional Medicare. Corporate health insurers market and design health plans to attract the healthy, make it difficult for many people to get costly and complex care, and encourage the people with the greatest health care needs to use the public option.

    People too often don’t appreciate that they could get diagnosed with a costly and complex disease or to suffer a major accident in the unforeseeable future. Anything short of comprehensive coverage–one policy that will meet whatever needs you have from whichever physicians you need to see–is a gamble.

    One study, published in June in the Proceedings of the National Academy of Science, found that Medicare for all would have likely saved 338,000 lives lost to Covid-19.

    As Congresswoman Pramila Jayapal tweeted last week, “In the richest country in the world, no one should die or go into debt just because they don’t have access to healthcare.” “We need Medicare for All now.”

    Here’s more from Just Care:

  • States lack power to take on health insurers and guarantee affordable health care

    States lack power to take on health insurers and guarantee affordable health care

    So far, President Biden has done little to move forward with health insurance reform at the federal level; most states lack the will and the skill to take on the health insurance industry and guarantee affordable health care to their residents.  Those few states with the skill and the will to undertake health care reform, appear to lack the power and the resources even to offer their residents the option of public health insurance. We likely will need democracy reform coupled with federal action if we are ever going to get guaranteed affordable health care coverage for all.

    So, what’s going on in the states? Julia Rock reports for the Daily Poster. Spoiler alert: Tremendous and effective pushback from the health insurance industry and its allies.

    During the last round of health reform, the public health insurance option was intended to be an alternative to private health insurance; it was to be administered directly by the government and modeled on Medicare. It has taken on every which size and shape since then. A true public option should have provider rate regulation, an unrestricted provider network and very low administrative costs. That does not appear to be the model any state is considering.

    Washington state was first to pass legislation offering residents a “public option.” But, the option is hardly “public.” It works through private insurers, offering state-administered private insurance to people and it does not require hospitals to accept the public insurance. It has enrolled less than 1 percent of the population.

    Washington is now working on a fix, requiring all hospitals that take Medicaid patients to accept people enrolled in its public plan. Will it pass? Will the hospitals accept public option patients?

    A public health insurance option was up for consideration in Colorado. Colorado would have relied on a non-profit it established to administer the public plan, which would make it less likely to focus on profit maximization and more likely to focus on good health outcomes than a for-profit insurer. The state would set provider rates and require all providers to accept them. Standardization of provider rates is needed across the country and could be valuable if the rates are set fairly. An unrestricted provider network is also important, particularly for people with complex conditions. But, again, the insurance industry lobbyists succeeded at keeping it from happening.

    As it was originally designed, Colorado would give insurers two years to voluntarily lower their premiums before implementing its public option. But, Colorado’s “public option” is not going forward. Instead, under proposed legislation, the insurers will have until 2025 to lower their premiums by 15 percent (after adjusting for medical inflation) in the individual and small group markets. If not, Colorado might regulate payment rates for these insurance plans.

    Insurers can make up for lower premiums with higher deductibles. So, it’s not clear to me that the Colorado law accomplished much of anything.

    So long as state mandates for a public option rely on private insurers, and these mandates simply define the benefits to be offered and do not define the care that is medically necessary, insurers can delay and deny care inappropriately and with little accountability. And, if the insurers are paid a capitated rate-a fixed upfront amount regardless of the cost of the care they deliver–as they are in Medicare Advantage, they have every reason to delay and deny care. That’s how they maximize profits.

    In Connecticut, United Healthcare organized its workers to fight a public option. United felt that it was wrong for the state to set lower provider rates for the public option and, in the process, make corporate health insurance less attractive.

    Nearly three in four Connecticut residents support a public option. Of course they do. It sounds like another choice, one that might cost them less. For a huge swath of the US population, even with insurance, critical health care is often unaffordable.

    All the insurers based in Connecticut have also let the governor know that they would leave the state if it passed a public option. That could be the best possible outcome for Connecticut residents needing health care. But, the state would lose jobs and taxes, two mainstays.

    New York seemed to be on the verge of offering universal coverage to residents through a government-administered public plan. The plan would have no copays, deductibles or premiums. It would be paid for through a progressive tax. But, some big unions oppose it–worried about job losses and losing their value to workers–without considering lives lost for lack of comprehensive health insurance.

    California’s legislature refused to hold a vote on single payer, state-administered health care coverage for everyone, in 2017. The Democrats had supermajorities in both houses. And, the governor was also a Democrat.

    It’s on Congress to guarantee everyone in the US affordable health care. Already tens of thousands of Americans die each year for lack of health care. Millions more suffer tremendously or face huge medical debt or bankruptcy. What will it take?

    Here’s more from Just Care:

  • A federal “public option” won’t deliver health security

    A federal “public option” won’t deliver health security

    Merrill Goozner writes that Congress is considering ways to guarantee everyone in the US affordable health care. Senators Tim Kaine and Michael Bennet are proposing to put a “public option” on the state health insurance exchanges, and Representatives Rosa DeLauro and Jan Schakowsky are also proposing to make a “public option” available. For reasons I explain below, their public option proposals will not deliver health security. That said, it is not at all clear that the House or Senate will vote on these proposals any time soon.

    Neither the House nor the Senate bills should go forward as drafted. While they claim to offer a public health insurance option, neither do. Rather, they offer private health insurance options, much like the for-profit insurance options in the state health insurance exchanges today. For this reason and others, they have no chance of reining in costs or guaranteeing Americans the good affordable coverage we need.

    Indeed, calling these options “public” is Orwellian. The public option is supposed to give people the choice of health insurance that is not run by for-profit insurers, that is not private health insurance. The public option is supposed to eliminate the for-profit middleman from the mix.

    That said, even a true public option modeled on traditional Medicare is not likely to deliver health security.  So long as for-profit insurers can compete with this public health insurance option, they will find ways to undermine it, as the Medicare Advantage plans have with traditional Medicare.

    The best approach, working from what we have, is for the government to change the way it pays private insurers in Medicare and Medicaid and then, over time, to open Medicare up to everyone else. The government needs to set the terms of coverage and pay for that coverage and for the insurers to process the claims. We don’t have to do away with private insurers, we have to do away with their control of our health care system, as other wealthy countries have succeeded in doing.

    We need to change the way we pay health insurers so that they don’t have an incentive to delay and deny people care. Handing them money upfront to pay for care they might or might not cover is a recipe for incentivizing them to withhold care.

    We also need to regulate health care prices, so that they are rational and fair. Shifting to this new payment and coverage model would help Americans, bringing down the cost of care and dismantling the barriers to care for-profit insurers impose.

    Goozner suggests that there is some form of national regulation of for-profit insurers that could guarantee everyone in the US continuity of care and affordable care. Regulation of insurers cannot work in practice if insurers are allowed to call the shots. It never has in a way that delivers good affordable care, and there is no evidence either in the US or in any other country that it ever will. There is no way to oversee the insurers effectively.

    What could work, and what does work in other countries, is a health insurance system with private insurers in which the government calls the shots and the insurers’ role is in processing claims.

    Here’s more from Just Care:

  • Health care reform in 2021: What you need to know

    Health care reform in 2021: What you need to know

    Mark Dudcik, National Coordinator of the Labor Campaign for Single Payer, offers ten important facts that will affect health care reform in 2021 and over the long-term. They help to highlight the challenges and opportunities for health care justice with President-elect Joseph Biden at the helm. Here’s what you need to know:

    1. 72% of voters support Medicare for All. Fox News exit polls reveal that 72% of the voters were in favor of a “government run healthcare plan”  
    2. All House candidates who cosponsored the Medicare for All Act were reelected. These advocates for Medicare for All even won in swing states. 
    3. The COVID-19 pandemic has caused 14 million people to lose employer-sponsored health coverage. The 14 million Americans include workers who lost their jobs and their families. Since 2017, when President Trump took office, and pre-novel coronavirus pandemic, an additional 2.3 million people lost their health insurance.
    4. Unions are beginning to see the risk of tying health care to jobs. They are struggling to guarantee health care to their members who have lost their jobs since the pandemic or who are likely to lose them if the economy sinks. With state and local governments in economic distress, union members are likely to face health care benefit cuts. 
    5. President-elect Joe Biden is seeing an outpouring of support from the for-profit health care sector, including the health insurance industry and the pharmaceutical industry.  
    6. President-elect Biden has said that he does not support Medicare for All.  Indeed, he said that he would veto it, if passed. 
    7. President-elect Biden proposes a “public option.” It doesn’t look like people will be able to opt for public health insurance, a “public option” in the next year or two. But, even if Congress were to enact legislation allowing people to buy a version of traditional Medicare with an out-of-pocket cap–the only public option that would give people access to the doctors they want to see at a lower cost than they currently pay–it would not address out-of-control health care costs or eliminate the $600 billion in administrative waste in our health care system.
    8. President-elect Biden proposes lowering the age of Medicare eligibility age to 60. Helping 20 million older people get good coverage is beneficial. But, if Congress were to enact this legislation, which is unlikely in the next two years, it would also need to offer a subsidy to people 60-64, or most people would not be able to afford to enroll inMedicare. Congress would also need to improve traditional Medicare, adding an out-of-pocket cap and drug benefits or it would not be a viable option. People under 65 do not have the right to buy Medicare supplemental insurance, which they would otherwise need to fill gaps in traditional Medicare.  
    9. The Supreme Court could undo some or all of the ACA. Most people do not believe that the Supreme Court will completely undo the ACA, but it still might undo some of it. Democrats in Congress might not have the power to strengthen the ACA.  
    10. Without Congressional action, our people and our economy are likely to suffer tremendously. Congress should pass the Health Care Emergency Guarantee Act, which would help Americans get needed care and stimulate the economy. So, long as Mitch McConnell is Senate Majority Leader, it is unlikely to happen.

    Given the state of our Congress and President-elect Biden’s policy agenda, it’s hard to see a clear path forward to a better health care system in the near future. But, those of us who believe health care is a human right need to continue to make our voices heard and to pressure our political leaders to do right by Americans and guarantee everyone access to affordable care.  

    Here’s more from Just Care:

  • Majority of Americans support a public health insurance option

    Majority of Americans support a public health insurance option

    Vice-President Biden is proposing that the government offer people a public health insurance option, if he is elected President. A new Data for Progress poll finds that a large majority of voters support the government offering a public health insurance option. That said, there’s not yet a clear definition of how a public option would work.

    The concept of a public option was first raised in the last wave of health reform. It was based on the notion that private health insurers were not meeting people’s needs, either in terms of access to care or affordability; they offered restricted provider networks and charged high premiums and out-of-pocket costs. What’s worse, many seem to indiscriminately deny care because they profit when they deny care. But, no one knows when they enroll in a plan, the extent to which that health plan inappropriately denies people care.

    Congress ultimately enacted the Affordable Care Act, which offers government-administered private health insurance. It opted not to offer people the choice of public health insurance, provided directly through the government, like traditional Medicare.

    Unlike private health insurance, which generally is accountable to shareholders, public health insurance, like traditional Medicare, is accountable to the public. It relies on the government’s leverage to control costs and to ensure people access to providers across the nation. It does not profit from denying care, and is designed to “spread risk,” so that people with costly conditions are not burdened with high health care costs.

    As the Biden-Sanders Unity Task Force spells out. Americans who opted for public health insurance would pay the government for their coverage. And, the Data for Progress poll indicates Americans are fine with that. Nearly half of voters, a plurality, say they would be willing to pay the government directly for public health insurance (49 percent).

    Members of Congress are still considering how to design a public option and whether it should be available to everyone. Americans want public health insurance to be available as a choice to everyone (45 percent). It should be. Private insurers, no matter how many there are in a given market, do not engage in meaningful competition–competition that drives value by lowering health care costs and improving quality.

    Americans also support automatic enrollment in public health insurance for people who do not have other coverage. The novel coronavirus pandemic has revealed the fragility of our employer-based health care system. You lose your job and, often, your health insurance as well. People who leave their jobs continue to need protection from health care costs and do not want to worry about having health care coverage.

    What’s most interesting is that two-thirds of Americans say they would get their health insurance through a government-run plan. Fewer than one in five voters say they would not get insurance through the government. Americans increasingly realize that they need an alternative to private health insurance, which is often unreliable and unaffordable.

    Lest there remain any confusion about the definition of a public option–the choice of public health insurance–it is not the same as the choice of private health insurance through the government. Americans already have government-administered private health plan options in the state health exchanges. These health plans do not have the power to rein in costs; they do not offer a broad provider network; and, they answer to their shareholders first and foremost.

    The question becomes whether Democrats in Congress, much less Republicans, are prepared to acknowledge that if they enact a public option it should piggyback off of traditional Medicare with an out-of-pocket cap and prescription drug coverage woven into the benefit. That would put it on a level playing field with private health plans. Only this improved traditional Medicare offers people the guarantees of easy access to care from the doctors they want to see at a price they can afford.

    Here’s more from Just Care:

  • Biden-Sanders Unity Task Force recommends incremental health reforms

    Biden-Sanders Unity Task Force recommends incremental health reforms

    The Biden-Sanders Unity Task Force recently released its recommendations for health care reform. Unfortunately, the three Sanders’ appointees on the health care task force were not able to move the Biden appointees to support reforms that will guarantee health care to all Americans, much less get us meaningfully closer to Medicare for all. Rather, the Task Force’s proposed reforms are small and not likely to help most Americans.

    Vice-President Joe Biden wants to “build upon our bedrock health care programs, including the Affordable Care Act, Medicare, Medicaid, and the Veterans Affairs system.” In his view, building means adding a “public option” and lowering the age of Medicare eligibility to 60. It’s unclear what exactly a public option would mean or how it would help guarantee Americans access to good affordable health care.

    Here’s what we know: Joe Biden believes that if Americans had the choice of enrolling in a “public health plan”–health insurance provided directly by the federal government–in the state health insurance exchanges, private health insurers would engage in “real competition” and have a financial incentive to deliver quality affordable care. But, the evidence suggests otherwise.

    We know that private Medicare Advantage plans do not engage in real competition with the public Medicare plan. Rather, they game the system, market to healthy people, create barriers to care for their members who need it and drive up costs. There is no reason to believe that private health plans would behave any differently for people under 65 if a public option were available.

    What’s more, the Unity Task Force has in mind the possibility of more than one public plan choice, but it does not explain why there would need to be more than one choice. It says that at least one choice would not have a deductible and would be administered by traditional Medicare, not a private health insurance company. For reasons that are not explained, the government administrator of the new public plan would engage in its own negotiations with doctors and hospitals over prices rather than piggyback off of Medicare rates.

    Anyone with employer coverage or coverage through the ACA would be free to enroll in the public plan. One special feature of this public plan is that people who are not eligible for Medicaid but whose incomes are low would automatically be enrolled in the public plan. People living in states that have not expanded Medicaid could also enroll in this public plan. They would not pay a premium for it and could opt out of it if they chose.

    In addition to creating a public plan option, the Unity Task Force recommends that, at age 60, anyone could choose to enroll in Medicare. But, it does not recommend an out-of-pocket cap on traditional Medicare or other reforms that would improve Medicare benefits and make it easy to enroll in traditional Medicare.

    Of course, with many options available, it will be easy for marketers to confuse people about what health plan is best for them. Inevitably, plenty of health plans will not meet people’s needs. For example, they might inappropriately delay and deny care, have narrow networks without high-value health care providers, or high copays. To help people distinguish among plans, the Unity Task Force supports appropriating money to let people know about their options and enroll them. But, assistance is of little help if there are no good options available. And, information that would shed helpful insight into which are better than others–such as which don’t have high denial rates–is not available.

    The Unity Task Force recommends giving states the right to come up with their own health plans. Many advocates and states want that right. Still, the likelihood of success on the part of states to guarantee residents affordable health care is slim given financial constraints and their lack of resources to take on the private health insurance industry. States have never been able to serve Americans well on the health insurance coverage front and there is no evidence that they will do so in the future.

    The Unity Task Force sees its recommendations as meeting the needs of people who are recently unemployed as a result of the pandemic along with people who have been uninsured for a long while. But, it’s unclear why. With health care costs continuing to rise and little focus on reining them in, it’s hard to imagine the public option–the Task Force’s chief way of improving health insurance–will be affordable to most people without substantial federal subsidies.

    If you can’t afford health insurance as a result of these health care reforms, you might want to get care at community health centers, sometimes known as Federally Qualified Health Centers, and rural health centers. The Task Force recommends greater and more predictable funding for these health centers.

    To address shortages of health care providers, particularly primary care nurses and dentists and mental health counselors, the Unity Task Force recommends a larger National Health Service Corps.

    Here’s more from Just Care:

  • Medicare for all would save 68,000 lives a year

    Medicare for all would save 68,000 lives a year

    New research by Yale Professor Alison P. Galvani et al., published in The Lancet, concludes that Medicare for All could guarantee health care for everyone in the US at far less overall cost than we spend today. The research adds to a body of 22 other studies which also conclude that Medicare for All saves money. As important, Galvani’s team finds that Medicare for All would save 68,000 lives a year.

    The researchers project a 13 percent savings in national health expenditures from Medicare for All. Put differently, we would spend about $450 billion a year less on health care each year. The analysis considers the costs associated with extending coverage to 37 million without health insurance and 41 million with inadequate coverage.

    Going from a multi-payer system to a single-payer system would save doctors and hospitals a lot of time and money. They would be relieved of many administrative headaches. And, doctors would be able to spend more time with their patients.

    In an interview with Amy Goodman of Democracy Now, Galvani explains that Medicare’s administrative overhead is nearly 10 percent less than private health insurance overhead, 2.2 percent v. 12 percent respectively. Eliminating private health insurance would therefore save $200 billion a year in insurer overhead alone. In 2019, the private health insurance industry made $100 billion in profits.

    In addition, Galvani explains that a public option, what Pete Buttigieg calls “Medicare for all who want it,” does not save money. The exorbitant administrative overhead costs of the private insurers remain. It is inefficient and expensive, costing $175 billion more a year than what we currently spend. And, it costs $600 billion more a year than Medicare for All.

    Galvani’s team calculated that Medicare for All would save 68,000 lives a year based on data revealing that people without health insurance have 40 times higher mortality rates than people with decent health insurance. The team did not factor in additional lives saved as a result of the fact that 41 million additional people would no longer be underinsured.

    Here’s more from Just Care:

  • What are the major differences between Medicare for all and a public option?

    What are the major differences between Medicare for all and a public option?

    The latest Kaiser Family Foundation health tracking poll reveals substantial public confusion about various health reform proposals. Americans do not understand major differences between Medicare for all and a public option. Here’s a cheat sheet.

    Would both Medicare for All and a public option cover all Americans? Would they both require people to pay monthly premiums? No. Medicare for All is designed to guarantee all Americans health care coverage automatically. It would be paid for much like Social Security, public schools, and police departments. Medicare for All does not require people to pay monthly premiums.

    Rather, with Medicare for All, premium contributions that once went to private health insurers would go to the government in the form of taxes, based largely on income. Everyone would be covered by single-payer, public health insurance. Instead of paying private premiums, you would pay an income-based tax, effectively a public premium. Yet, 44 percent of people surveyed did not understand that they would not need to pay monthly health insurance premiums with Medicare for All.

    In stark contrast, a public option, which could be designed in a variety of ways, would likely work more like private health insurance today, requiring you to pay a monthly premium. Still, 50 percent of people surveyed did not understand that they would have to pay a monthly premium for their coverage. Moreover, 53 percent of people surveyed thought the public option would cover everyone, which is not at all clear.

    A public option would not likely guarantee coverage to all Americans, unless the federal government increased taxes enormously to pay for it. And, no one is proposing a sizable tax increase to cover the cost of the public option; rather, proponents, like Pete Buttigieg, are saying that a public option would not raise taxes significantly. Consequently, people could opt not to pay their premiums. And, it’s more than likely many people would not be able to afford their premiums, since the public option would not rein in health care costs substantially.

    Would both Medicare for All and a public option require people to pay deductibles and copays? No. Medicare for All eliminates deductibles and copays. But, more than six in ten Americans don’t understand that people would not pay deductibles or copays with Medicare for All. And, more than three in ten Americans do not understand that people would continue to pay deductibles and copays with a public option, as the do today.

    How about unrestricted access to doctors and hospitals?  With Medicare for All, you can use whichever doctors and hospitals you would like. But, a public option builds on our current system and likely would allow provider networks, restricting access to doctors and hospitals.

    What about costs? Only Medicare for All reins in health care costs substantially. It is estimated to save middle-income households 9.6 percent of their annual income. Medicare for All creates significant savings because it eliminates private health insurers and, with that, about $600 billion a year in administrative costs. It also cuts prescription drug costs in half. A public option could not save much money. It would cut prescription drug costs, but it keeps all the administrative waste in our health care system.

    And, what happens to private health insurance? With Medicare for All, your primary insurance is public insurance; you could not keep your private health insurance. Still, almost half of Americans do not understand that Medicare for All would not allow them to keep their current health insurance; that’s key to bringing down costs. About 40 percent believe that a public option would not allow them to keep their current health insurance either, though it would.

    Here’s more from Just Care:

  • Can building on the ACA bring down health care costs?

    Can building on the ACA bring down health care costs?

    The Kaiser Family Foundation (KFF) released a new report looking at trends in public opinion on health care reform. Its findings suggest that most Americans don’s know that building on the ACA will neither provide them with access to the care they need nor bring down their health care costs. Among other things, building on the ACA keeps our current system with $600 billion in administrative waste in tact.

    KFF finds that voters who lean Democratic are more inclined to want to build on the ACA than replace the ACA with Medicare for All. Voters appear to be looking for incremental change. They favor an expansion of Medicare. They don’t appear to understand that if you leave private health insurers in place, you do not achieve the savings needed to expand benefits and reduce health care spending.

    Americans also appear to lack a good understanding of how different reform proposals would affect their out-of-pocket health care costs. They do not appreciate that Medicare for All would save middle-income households about 10 percent of their income. A public option would save them far less, if anything; it would continue to impose high premiums, deductibles and co-insurance costs.

    That said support for Medicare for All has grown appreciably over time, according to Kaiser. It was not until February 2016 that a majority of Americans supported national health insurance. Today, more Americans favor Medicare for All than oppose it. Not surprisingly, three in four Democrats support Medicare for All and seven in ten Republicans oppose it.

    Here’s more from Just Care:

  • Would a public option reduce your out-of-pocket health care costs?

    Would a public option reduce your out-of-pocket health care costs?

    Democratic presidential candidates’ health care reform proposals are designed to improve upon your current coverage. But, how? Would a public option reduce out-of-pocket health care costs and guarantee Americans access to affordable health care?

    If you have traditional Medicare or a Medicare Advantage plan, Vice President Joe Biden and Pete Buttigieg‘s public option proposals offer little guarantee of reducing your health care costs. They are largely designed to provide more options to working people and people without insurance today. Health care reforms proposed by Senators Elizabeth Warren and Bernie Sanders, in stark contrast, would reduce your costs substantially, ending Medicare premiums, deductibles and coinsurance and adding important benefits, including vision, hearing, dental coverage as well as home and community-based care.

    If you have employer coverage, Biden and Buttigieg offer you a Medicare-like option. You could get your health insurance through a Medicare-like system rather than a corporate health insurer if you chose. Would that help?

    Biden’s and Buttigieg’s public option proposals could help some people afford insurance coverage they cannot afford today. But, it’s not at all clear their plans would help with out-of-pocket costs. Shefali Luthra reports for Kaiser Health News that a recent Kaiser Family Foundation poll reveals that about four in ten people with employer health coverage have trouble paying medical bills. About 50 percent of them delay or forego care because they can’t afford it. And, about one in six of them have to make “difficult sacrifices” to pay for their care.

    Except at the margins, Biden’s and Buttigieg’s public option proposals appear to be of little help to people with employer coverage who struggle to afford their care. They do not fill gaps in people’s coverage; they still require you to pay a lot for your health care. And, they do not offer people additional benefits that many need, such as dental, vision, hearing and home care.

    In short, the key advantage of their public option proposals is that Americans can choose not to rely on corporate insurers or employer health plans for their coverage; they give people a choice of a public plan. But, public option proposals are not likely to save Americans any money or ensure they can afford their care. Only Medicare for All proposals significantly reduce the cost of care for working people and guarantee its affordability.

    People say they prefer the public option to Medicare for All. But, most do not know that their health care costs will continue to rise under public option proposals. Once people understand that the public option does little to make health care affordable, Medicare for All should garner their support.

    Here’s more from Just Care: