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Is there a new type of Medicare coming? - (1/8/2019)

By Dr. Ron Gasbarro

Mrs. Chen was new to this pharmacy. She handed the pharmacist several prescriptions and her Medicare card. “Tell me, sir. I heard there was a new type of Medicare that may be coming that will cover everyone no matter what their age.” The pharmacist explained to Mrs. Chen that she was referring to a yet-to-be-launched program called “Medicare-for-All.” Is this proposed system any better than the existing programs of Medicaid and Medicare?

Medicare is a federal system of health insurance for people over 65 years of age and for certain younger people with disabilities. The system is kept afloat via taxes paid for by employees (such as Mrs. Chen), employers (Mrs. Chen’s boss), and self-employed persons (Mrs. Chen’s daughter who runs a cookie shop). Conversely, Medicaid is for those people unable to afford medical services. Medicaid is state-funded with matching funds from the federal government. Medicaid is often thought of as a welfare program because of the essential role it plays in providing health insurance for low-income people. However, Medicaid coverage for the elderly and disabled comprises a greater percentage of overall spending than coverage for low-income adults and children.

Why are not these programs good enough? Many Americans have enjoyed vast gains in life expectancy since the creation of Medicare and Medicaid. Yet, many people are too young, too healthy, or have an income that disqualifies them from these programs. Sadly, many of these people cannot afford the monthly premiums to provide their families with health insurance. The Affordable Care Act (aka Obamacare) has made it possible for an extra 20 million people to obtain life-saving health insurance. Yet, there is another alternative that has been hotly debated: Medicare-for-All.  

Also called “single-payer health insurance,” the plan would not expand the current Medicare program but replace it, along with Medicaid and private insurance. Payroll taxes would cover the costs of healthcare for all American citizens. Compared to private insurance, costs would be minimal. The deduction for Medicare-for-All would be between 0% and 5% of one's income that would pay for wellness services, pre-existing conditions, hospital stays, and medications.  A 2016 New York Times survey found that 20% of working-age Americans with health insurance and 53% of the uninsured cannot pay their medical bills. The plan would keep most from healthcare bankruptcy. Yes, there are disadvantages. Medicare-for-All would automatically turn all healthcare, research universities, and medical equipment manufacturers into employees of the government. This system would also have a strong tendency to reduce creativity since there is no more financial incentive to do research and develop new medicines.

“Isn’t that socialism?” Mrs. Chen asked. “No. You are confusing government programs and services with socialism,” replied the pharmacist. “Socialism is an economic system whereby the workers and the community own the means of production. For example, instead of a wealthy person owning the factory, deciding who is hired and how much they are paid, the workers own the factory together and make those decisions themselves. We do not have that economic system. We embrace capitalism.” Mrs. Chen agreed that she must do more reading on the topic but agreed it was an interesting concept. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com 


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