I am fed up with the Democrat/socialists who believe “Medicare for All” is the answer to provide health care coverage for everyone, which will cost us trillions of dollars and yet provide us with long waits and inadequate health care.
Medicare is made up of four parts. Part A, which covers payments to hospitals and enacted in the mid 60’s and Part B, which covers payments to physicians. Later Part C Medicare Advantage and Part D Prescription Drug coverage were added.
Your Part A Hospital coverage was funded by a payroll tax which the government placed in a trust fund similar to how Social Security is handled while Medicare Advantages or Supplemental Private Insurance Options and Drug coverage is paid by general government revenues for which you also are required to pay a portion of the medical costs by monthly deductions of premiums through private insurers.
When Senator Bernie Sanders and the radical left of the Democratic Party propose “Medicare for all”, they are stating their position on sheer ignorance of how these programs have been set up. And with Sanders stating we need to be rid of private insurers and the only necessity for private companies, in the future is for “Nose Jobs”, it is obvious he and the others do not realize that the Affordable Care Act, Medicare Advantages, and Medicare (Medigap) Supplements are all administered by Private Insurers and not the Government.
What these Democrats are stating is that it did not matter that all through your working career, you and your employer have funded Medicare, that everyone, including illegal immigrants (If the Democrats have their way) will get “Medicare for all” without ever placing money into a trust fund. And even those in the workforce with untimely deaths have funded Medicare; money which is never returned to the deceased’s family. Yet throughout the years since President Lyndon B. Johnson initiated the programs in 1965, subsequent presidents have used these trust funds to balance the budget, which should not have been done. Medicare Part A is expected to run out of money in 2028, some say 2030, with only some revenue but not enough to cover all the expected expenses.
That is why if we go to a “Socialist Medicare for All Plan”, it will cost each individual (Not just the wealthy) 45-85% in taxes, because the programs will cost trillions and trillions of dollars to implement. Instead of allowing the free market to provide the types of insurance which may be affordable to each individual, these Democrats cite that “Medical Care for All” is a Constitutional Right which it is not. But of course these Radical Democrats wish to tear down the Constitution as well.
By contrast, Obamacare cut $716 billion (Now estimated at $800 billion from Medicare in order to fund $1.9 trillion in new health care spending, through the law’s expansion of Medicaid and its subsidized exchanges. At the same time President Obama added a 0.9 percent tax on earnings above $200,000 for single taxpayers or $250,000 for married couples. This tax was meant to help the Medicare Trust Fund by charging more tax to the larger wage earners and subsequently their employers as a result.
Medicare is currently available to those who are age 65 and older, to those of any age who suffer from chronic kidney disease or to those who are receiving Social Security disability benefits. Government programs are necessary for the aged and those who are disabled but should not be provided for those who have the ability to be retrained and to work.
The Medicaid program is also part of the Social Security program whereby matching federal funds to states funds provide medical public assistance plans to help needy persons regardless of age. If a family’s income is below a specified level, Medicaid benefits are available. Also benefits are provided to individuals who are blind, disabled or under 21 years of age and may include deductibles and coinsurance.
Although the Democratic Socialists believe Medicare for all is the solution to provide competitive healthcare, it is not a solution whatsoever. Not only will your taxes increase to 45-65 percent, only to wait in lines to receive only “adequate” healthcare in months from the time you need it, but you will not be able to choose your doctor and you will be required to receive a referral or acceptance before you are able to schedule an appointment with a doctor.
Currently, If one chooses a Medicare Advantage Plan Part C, you can only get your medical benefits from those providers who participate in the plan’s network with a few offering out of network coverage. These plans may cost nothing up to premiums as low as $100 a month over and above what is paid for Part B. Yet you are only seen by providers in the network, many times nurse practitioners, and I was told, when selling Medicare Advantages, at one time, that the average time seen by a doctor is limited to less than 8 minutes. Therefore, the patient is not allowed, in most cases, the care which they need. The Medicare Advantage also is restricted to the areas and the hospitals under the plan in most cases, so forget travelling unless you purchase a Medigap Supplement.
But let’s look at Original Medicare which the Democrats wish to provide you.
Most of us have worked all of our lives to be provided Medicare Coverage at the age of 65 for Part A Hospital (inpatient) care, Hospice Care if you’re terminally ill with a life expectancy of six months or less, and Skilled nursing facility care (Not long-term care).
For Hospital Inpatient care, you pay a deductible and no coinsurance for days 1-60 for each benefit period. You pay coinsurance from days 61-90 for each benefit period of 20% (Medicare pays 80% of the Medicare-approved amount), you pay 20% coinsurance per lifetime reserve day after 90 of each benefit period (up to 60 days over your lifetime) and you pay all costs for each day after you use all the lifetime reserve days. Skilled nursing requires no payment from you for the first 20 days and 20% coinsurance for days 21-100 which is your benefit period.
Although there are numerous Part B Coverage benefits, you are still required to pay 20% of all Medicare approved amounts with the Part B Deductible for all outpatient services of a doctor or hospital. including Ambulance Services by ground, airplane and helicopter transportation
Currently, the Medicare approved amounts which Medicare will pay to doctors and hospitals is not accepted by all institutions. Plus the 20% coinsurance and the mandated deductibles for hospital and outpatient services can be quite expensive for an individual to pay who is retired and on a fixed income. That doesn’t even consider the 20% that you must pay of the Medicare-approved amount for Chemotherapy.
So the original Medicare Parts A and Parts B will require your participation of a deductible and 20% coinsurance. And for placing this program for everyone, the premiums for Part A, which Seniors and those on Disability who have worked all their lives to not have to pay a premium for inpatient care now will be taxed as a high premium for Part A inpatient as well as Part B outpatient coverage and that does not include Part D Drug Costs. So not only will the individual be fleeced by the high premiums, 20% coinsurance and deductibles but the Taxpayers as a whole will have deducted by the government 45-65% of their paychecks to cover the trillions of dollars required for this program through the Government. Currently you are deducted a premium of a little over $100 for your Medicare Part B Coverage Monthly.
The Medigap supplemental policy pays for the Part A and Part B Coinsurance or copayments plus it provides hospital costs up to an additional 365 days after Medicare Benefits are used up And depending upon the plan chosen, it pays for the Part A and B Deductibles and Part B excess Charges.
These Medigap Plans run in excess of the amount paid for Part B Coverage Dependent upon whether you choose deductibles or the amount of deductibles chosen, your plan will cost you probably $150 to $225 a month. This means that every individual who is provided a Medigap policy may pay up to $325 a month for insurance, including the Medicare Premium Deducted for Part B, and that does not cover drug coverage of $30-50 a month. So to these socialists I say, “Nothing is free and you want us to pay more money for health benefits which are restrictive and inadequate”? We either have to pay higher taxes or premiums of $350-400 a month for each individual covered by buying a Medigap Policy which becomes a dilemma for some who have a small fixed income of $500 a month.
Even if a Veteran is provided benefits through the Veterans Administration, there is a set amount paid for each hospital visit, for drug copayments and necessary supplies, for each outpatient visit and the Veteran still secures Part A and Part B of Medicare.
At least with a Medigap policy, you can choose your primary care doctor and are able to see any doctor who is willing to accept Medicare patients. But not every doctor or hospital is willing to accept Medicare Patients because of the low amount of Medicare approved payments for each visit or procedure. For Instance, In January my blood Lab cost by Quest Diagnostics was $1,179.78 but the Medicare Approved Amount was $161.22. With a Hip Replacement UF Health billed $61.00 for the x-ray. The Medicare Approved Amount was $11.51 and Medicare paid $9.10 and Bankers Colonial Life my private Medigap carrier paid $2.30. You can see why certain Hospitals and Doctors do not wish to see Medicare Patients even with a Medigap policy. Currently the two insurers who settle claims faster are Bankers Colonial Life and United Health Care through AARP, in accordance with Physicians who accept some Medicare Patients.
In order to do what the Socialists wish, it would not only cost everyone more money, but there would be no advantage because one would still have to pay coinsurance and deductibles and be stuck with network doctors who are unhappy because they will not be making enough money to pay their school loans. In turn you will wait months to see a doctor which by that time, you may be deceased before seeing the doctor.
Although the States establish eligibility requirements, the States need to do something regarding Welfare Reform, in my opinion. Drug Tests must be required of any Welfare recipient unless that recipient has a waiver showing the drugs were prescribed by a licensed practitioner.
The Government programs are further abused by illegal immigrants who do not have the ability and willingness to work. Providing illegals with health benefits other than general humanitarian benefits should cease and desist after a six month period and if the illegal immigrant has a job, they can remain in the United States and pay for their medical benefits. If they do not have a job, they and their families can be returned back to their respective countries. Our US Constitution does not provide for “Illegal” aliens only “Citizens” of the United States.
Today the Government is providing more benefits to illegal aliens than that which is provided Senior Citizens and Veterans who have worked all their lives and protected our country here and abroad. The Democrats will never agree to anything because of their dislike of the Trump Administration, so I believe, taking all illegal immigrants and moving them to Sanctuary States and Cities which would be responsible for not only welfare benefits but medical benefits is the only solution instead of placing this burden on all Taxpayers of the United States
President Donald J. Trump, Vice President Pence and the Republicans in the Senate and in the House do not believe in Socialized Health benefits because all it would do is ruin our economy, business opportunities would go elsewhere, the Middle Class would go into poverty, Wealthy people would give less to charities, and people like Bernie Sanders really don’t care because he especially has already fleeced the government and the lobbyists for millions of dollars. In my opinion, Bernie Sanders himself and those who wish Socialized Medicine should take the insurance they are offering others and not be covered under the Government officials and workers specialized health care policies which cover everything for free. By the Way, I also have drafted a health care plan utilizing private insurers, leaving Medicare and Medicaid untouched which I have submitted through Senator Rubio and The Healthcare unit in Washington DC. Whether it will be considered in whole or in part, will be determined but I believe in Capitalism and in the Free Market where we all have opportunities and choices.
Winston Churchill argued that “if you’re not a socialist in your 20s, you have no heart, and if you’re not a capitalist in your 30s, you have no mind” That being said, obviously Bernie Sanders and the radical left who are running for the Presidency in 2020 do not have a mind. No wonder Joe Biden is currently the highest democrat in the poles.
Karin A. Fleischhaker-Griffin CPCU