What Are The Pros And Cons Of Medicare For All

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Medicare Advantage plans, also called Medicare Part C, operate as private health plans within the Medicare program, serving as coverage alternatives to Original Medicare.

In many cases, Medicare Advantage plans provide more services at a cost that is the same or cheaper than the Original Medicare program. But at the same time, Medicare Advantage plans place more restrictions than Original Medicare on which doctors and medical facilities you can use. The plans also impose copays, deductibles and other out-of-pocket costs that can make it complicated to predict the actual cost of your health care.

How Medicare Advantage Plans Work

First, it will help to review a few basics. Medicare comes in four parts, with Part A covering inpatient hospital care, and skilled nursing. Theres no premium if you or your spouse have earned at least 40 Social Security credits.

Part B covers doctor services and outpatient hospital care. You have to pay a monthly premium for this coverage, which is $170.10 in 2022, with a deductible of $233. High earners pay more.

The other parts of MedicarePart C, aka Medicare Advantage, and Part D, prescription drug coverageare optional and offered by private insurers.

Medicare Advantage is an all-in-one managed care plan, typically an HMO or PPO. Advantage plans provide the benefits of Part A and B, and most also include Part D, or prescription drug coverage. Some offer extra benefits not available through Original Medicare, such as fitness classes or vision and dental care.

If you opt for Medicare Advantage, you typically continue to pay your Part B premium as usual, but you will pay little or no additional premiums for your coverage. You generally have copays or coinsurance, but once you reach your out-of-pocket limit, the plan will pay 100 percent of your medical costs covered under Medicare for the rest of the year. The out-of-pocket limit does not apply to prescription drugs or extra benefits.

With Medigap, youll pay more in monthly premiums compared with Advantage plans . Youll also have a bit more work choosing your Part D plan.

Government Sponsored Healthcare Would Put A Significant Burden On The Taxpayers

• Medicare for All is estimated to cost $32 trillion over 10 years. Even if the federal corporate and income tax were doubled, it would not cover this cost.

• The benefits of Medicare for All are are far more extensive than anything offered by other national-health-care plans around the world, creating a high risk of overuse and runaway costs.

• Taxing the rich, corporations and the financial sector could cover only one-third of the total cost of the program on its own. Taxes on all Americans, including the middle class and businesses, would likely need to increase to pay for the costly program.

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Pros And Cons Of Medicare For All

The most significant benefit to Medicare for All is that the government covers healthcare costs while ensuring doctors provide reasonably affordable quality care. In theory, universal healthcare leads to a healthier society and workforce. But, the biggest downside is that healthy people pay for the medical care of less healthy people.

Pros of Medicare for All:

• Coverage for all
• Medicare and Medicaid are single-payer systems.

Cons of Medicare for All:

• Providers can choose only private pay options unless mandated differently.
• Doesnt solve the shortage of doctors
• Health insurance costs may not disappear.
• Requires a tax increase
• Shifts costs of employer coverage

Canada: Public Funding Private Care

The single-payer health care system in Canada is probably closer to Medicare for All than any other national system. Under this system, the government provides health insurance coverage, but most of the actual care comes from private doctors and hospitals.

As in Britain, patients pay nothing at the time they receive care they simply show their national insurance cards. That creates much less paperwork for both patients and providers.

However, Canadas single-payer system doesnt cover all forms of health care. Many Canadians receive private insurance through their jobs to help cover the costs of dental care, vision care, and prescription drugs. All in all, the government pays for about 70% of Canadians health care costs, according to The New York Times. The total cost of the system is similar to Britains about 10% of GDP.

To keep costs down, Canada puts hospitals on strict budgets and limits the number of specialists who can receive training. Both these rules can result in long wait times for care. A 2019 report from Health Quality Ontario on the provinces health care system says that emergency room patients wait an average of 9.7 hours to be admitted to the hospital. Also, 30% of patients said they had to wait either somewhat too long or much too long for an appointment with their primary care doctor.

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Universal Health Care In The Us

If you are acquainted with our healthcare system, you know that it is highly reliant on private enterprise. Even Obamacare, or the Affordable Care Act, relies on private health insurance firms to provide government-regulated plans through one marketplace. However, government-funded healthcare programs such as Medicaid, CHIP, and Medicare continue to provide discounted or free health care to individuals who qualify. Bernie aims to make these federal programs open to all, not only those currently eligible.

The terms Medicare for All and Single-Payer are interchangeable. Both want the governments healthcare business to be administered and regulated, with private health insurance firms removed from the equation. America would accomplish this by entirely funding all medical costs in the United States with taxpayer money, ensuring everyone accesses to health care. Although it is a contentious issue in the United States, most developed countries have already embraced a single-payer healthcare system. So, why is the United States so hesitant to implement a single-payer healthcare system when so many other industrialized countries have done so?

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What Are The Pros Of Medicare Advantage

• Access to the same benefits as Medicare Parts A and B, plus more
• Coverage for services such as dental, vision, hearing, and discounts for gym memberships
• Lower front-end costs with monthly premiums that are lower than those associated with Medigap
• Limit on annual out-of-pocket costs, so if you access healthcare, your maximum costs are more predictable
• Because benefits are bundled together, you do not need to purchase separate drug coverage.
• Women have the right to go directly to an in-network womens specialist without a referral for routine and preventive services.
• There are a variety of types of Medicare Advantage Plans to choose from.
• As your healthcare needs change, or if your Medicare Advantage Plan changes, you have the opportunity to choose a different plan.

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Pros Of Universal Health Care

The greatest benefit of universal health care, of course, is that it gives each legal citizen of a country the ability to access health care services regardless of their ability to pay. The World Health Organization, who.int, argues that health care is a vital basic need, and from a humanistic standpoint, providing citizens with access to health care is one of the most important roles of a government. Other advantages of a universal health care system include:

How Medicare For All Could Affect The Economy

Because the health care system currently makes up about one-sixth of the U.S. economy, anything that affects it is bound to affect the economy as a whole. Some of these changes would be beneficial, others would be harmful, and some are hard to predict.

Heres how the plan could affect different parts of the economy:

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Definition And Examples Of Universal Health Care

Universal health care comes in several different forms, but the basic idea is the same across the board: The government steps in with taxpayer money to ensure that every citizen has access to the medical care they need. With universal health care, no citizen is denied coverage based on their ability to pay.

The sheer cost of providing quality health care makes universal health care a large expense for governments. Medical coverage must be paid for by taxpayer-funded programs.

A substantial portion of countries around the world have UHC, including Canada, much of Europe, Asian countries such as Hong Kong and Japan, along with Australia, and New Zealand. The U.S. has the distinction of being the only wealthy, industrialized nation without universal health care.

• Acronymn: UHC

Although the U.S. does not have a UHC system, its health delivery system does have specific components, such as Medicare, Medicaid, and the Department of Veterans Affairs, that provide universal health care to specific populations .

Health Insurance Coverage For People Who Need It

Medicare is the single largest health insurance program in the U.S., providing hospital insurance and medical insurance coverage to more than 60 million Americans.

If Medicare didnt exist, tens of millions of seniors and people with disabilities would have to rely on some form of private health insurance in order to have suitable coverage, something that might not be affordable for many people.

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Americas Current Health Insurance System

Medicare for All looks very different from the way we pay for health care in the United States today. Under the current system, people get health insurance from a patchwork of different providers.

Most workers buy into health care plans sponsored by their employers. Other people get insurance through various government programs such as Medicare, Medicaid, and the Veterans Health Administration that provide care for specific groups. People who dont fit into any of these categories, such as freelancers, must buy their own insurance on the private market or go without.

This hodgepodge of a system creates a lot of problems. Many Americans have no coverage, and even those who do pay more for care than people in most developed countries. Yet our expensive care doesnt make us healthier. In fact, by most measures, Americans have worse health outcomes than people in other developed nations.

The Pros And Cons Of Medicare Advantage

These popular plans may carry hidden risks. Heres what to know.

If youre one of the 63 million Americans enrolled in Medicare, youre probably being deluged by marketing pitches for Medicare Advantage plans, which offer managed care with low or zero premiums.

Medicares fall open enrollment season starts Oct. 15 and runs through Dec. 7, when you can switch your coverage between Original Medicare and Medicare Advantage, change Medicare Advantage plans, or make changes to your prescription drug plan.

All that marketing seems to be working. Recently, 42 percent of Medicare beneficiaries were enrolled in Advantage plans, up from 31 percent in 2016, according to data from the Kaiser Family Foundation. Those numbers include 50 percent of Black and 54 percent of Hispanic enrollees vs. 36 percent of whites in 2018. By 2025, half of Americans are expected to be in Advantage plans.

Its easy to see the appeal of Advantage. Original Medicare doesnt cover all your medical expenses, while Advantage plans have cost-sharing requirements but then cap your out-of-pocket costs. Plus, you have low premiums and the simplicity of all-in-one coverage.

But there can be hidden risks to Advantage plans, especially for those with major health issues.

Some people in Medicare Advantage end up paying unexpectedly high costs when they become ill or find their network lacks the providers they need, says Tricia Neuman, senior vice president at Kaiser.

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Pros And Cons Of Medicare Advantage

Wondering if Medicare Advantage is right for you? Find out what is good about MA.

Like most everything in life there are both pros and cons to Medicare Advantage .

Finding the right Medicare insurance can be rather confusing for seniors, specially when parsing through the 150-page Medicare and You booklet that the government sends out as you approach age 65. We have made a list of the advantages and disadvantages of choosing a MA plan that should help you understand if this product is right for you.

Not included below but also worth mentioning is the fact that Medicare Advantage plans cover the COVID-19 vaccine.

Cons Of Universal Health Care

From an individualistic perspective, the greatest con of universal health care is that each individual must pay the same amount for medical care, regardless of their actual health. This effectively leaves healthy people paying for the care of sick people. Other disadvantages of universal health care include:

• More government control in individual health care. A universal health care system may limit costly services that have a low probability of success. This may eliminate access to care that could potentially save a persons life, because of the large possibility that it could fail and the associated cost.
• Longer wait times to access elective procedures, and funds are focused on essential health care services for the population.
• The substantial cost for the government. Universal health care can take up an enormous portion of a governments yearly budget, in some cases totaling 40% of the total.

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List Of Cons Of Canadian Medicare

1. Long Waiting PeriodsCanada has one of the best healthcare systems in the world and there isnt a dearth of doctors, medical facilities, practitioners or resources. However, there can never be a scenario when there would be more infrastructure, resources and doctors than patients and their needs. Owing to the universal accessibility of the healthcare system, there are always more people needing care and attention than people attending to the same. Hence, there are wait times.

Emergency situations are attended to with immediacy, which could be severe injuries needing emergency care or emergency surgeries. The need to attend to such emergencies makes people with non-emergency health conditions wait for a really long time. It is quite possible that some people will end up waiting for months to get the necessary treatment or medical attention. Whenever there are some emergency cases, they get priority and that naturally shifts other cases. This delay is unavoidable at this stage and some less fortunate people may keep having their cases delayed or postponed due to more pressing matters.

This can be frustrating and can actually make a non-emergency situation life threatening due to delay and negligence. There is room for improvement and the policymakers need to look at the ways to do away with such long waiting periods. The management of wait times is also not very efficient.

Single Payer Vs Universal Healthcare

The terms universal health care and single-payer system are frequently used in the debate. Even though theyre sometimes used interchangeably, theyre not the same thing. While single-payer systems are more likely to offer universal coverage, numerous countries have achieved universal or near-universal coverage without one.

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Limited Coverage Of Some Key Needs

Original Medicare doesnt typically cover prescription drugs or routine dental, vision or hearing care, all of which are important to the health of many older adults. Beneficiaries who are only enrolled in the public portion of Medicare must find other means of coverage for these services, or they must pay out of pocket.

Most privately sold Medicare Advantage plans cover prescription drugs, and many plans also cover things like dental care, hearing care, hearing aids, vision care, glasses, memberships to fitness programs, non-emergency transportation and more. Medicare Part D plans cover most commercially available prescription drugs, and many plans work with participating pharmacies such as CVS, Walmart, Walgreens and more in order to serve beneficiaries in their community.

How Do I Sign Up For A Medicare Advantage Plan

A licensed insurance agent can help you compare Medicare Advantage plans that are available in your area.

You can review information such as plan costs, prescription drugs that might be covered by the plan and whether your doctor is part of the plans provider network.

Find Medicare Advantage plans in your area

Or call 1-800-557-6059TTY Users: 711 24/7 to speak with a licensed insurance agent.

1 Centers for Medicare and Medicaid Services. Medicare Enrollment Dashboard. Retrieved Dec. 2020, from www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/Medicare-Enrollment/Enrollment%20Dashboard.html.

2 Kaiser Family Foundation . . Retrieved Dec. 2020 from https://www.kff.org/health-reform/state-indicator/average-marketplace-premiums-by-metal-tier.

3 Boccuti, Cristina Fields, Christa Casillas, Giselle Hamel, Liz. Primary Care Physicians Accepting Medicare: A Snapshot. KFF. . Retrieved from www.kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot.

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Where you’ve seen coverage of Christian’s research and reports:

• Medicare Enrollment Guide

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The Basics Of Medicare For All:

• Will all Americans be covered? Yes

• Are there any significant costs of care for patients ? No

• Will Americans have an option to keep their private or employer insurance? No

• Will the plan require increased taxes? Yes

• Will the prices of medical care and pharmaceuticals be regulated by the government? Yes

How Would Medicare For All Affect Original Medicare

Medicare for All would be an expansion and overhaul of original Medicare, meaning that Medicare as we currently know it, Medicare Part A, Part B, Part C, Part D, and Medigap, would no longer exist.

Thesingle biggest change to the current state of Medicare would be the eliminationof MedicarePart C, or Medicare Advantage. Medicare Advantage plans are Medicare plansthat are sold by private insurance companies contracted with Medicare. Withoutprivate insurance under Medicare for All, Medicare Part C would no longer be anoption.

In 2019, 34 percent, or nearly one third of all Medicare recipients, were enrolled in a Medicare Advantage plan. The elimination of this type of plan would impact a huge portion of beneficiaries, some of whom enjoy Medicare Advantage simply because it is a private option. There are also some additional benefits to Medicare Part C, including increased medical coverage and savings on medical costs.

However, according to Bernie Sanders, Medicare for All would have even more benefits than what is offered now. Health coverage under Medicare for All would include all the services under current Medicare Advantage plans, plus more. All of this would be offered with no premiums, deductibles, or up-front costs, and it would be available for all Americans, regardless of age, income, or health status.

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