My opinion on Medicare for all

Medicare for all

This is my opinion based on what I know about Medicare.

Medicare is not free. You pay into Medicare for 40 quarters before you qualify. If you qualify you receive Part A at no cost. If you did not pay into Medicare for 40 quarters you will have a monthly premium of $437 if you didn’t work at all and $240 if you worked at least 75% of the needed qualifying hours. And you do not access the benefit until you are 65 – if you start working at 20 that is 45 years of paying into the system and not even using the benefit.

Let’s say there is no cost to Medicare Part A in the new Medicare for all. There are a lot of rules for being an inpatient in a hospital. Remember a quick ER visit, DR visit, lab or drug is not covered by Part A.

Part B costs a chunk of money. For the average Medicare recipient this will be $135 in 2019. You will have a 20% coinsurance. Without a supplement or Med Advantage plan you will pay 20% no matter the service. Go to the DR’s office and its not a screening visit you pay 20% of the cost of the visit.

Your Drug benefits will be another $35 for the middle of the road plan, plus you will have copays for certain drugs.

So average joe making under $85k is already looking at $170 a month for insurance plus a 20% out of pocket with regular Medicare.

Last month I paid about $40 into Medicare through payroll withholdings.

Here is my opinion – Medicare for all will cost us all a flat rate of $250 a month to pay into if you make under $85,000 a year in 2019 dollars. And you will have a 20% coinsurance, out of pocket, when you see the doctor for anything outside of the annual things. Why $250 over the $170, because now you are paying for people who can’t pay and you are paying for a service you are using from age 20 to 65 instead of the money sitting there and being used to generate more money to cover the costs later on.

They will probably create a lower rate for those under $42,000

If you make under $16,000 a year it will cost you nothing.

If you made $161K will mean at least $500, but I could see this going to $750 a month.

So how can they say it will save billions from the American pockets if we go to Medicare for all – I think that has nothing to do with Medicare but has more to do with contracted rates.

When I call a Medi-Share insurance to verify benefits they will tell me that they will pay 140% the Medicare rate.

Right now if you ask for a self-pay quote on a procedure you are going to get told a couple of really confusing things. One is the self-pay cost, another the prompt pay discount and if you have insurance the contracted rate.

A service costs $2000 for the self-pay cost. The prompt pay self-pay discount is around 25%. With the self-pay prompt pay discount the costs drops to $1500. Medicare is usually 50% or contracted at $1000. That Medi share program is saying they will pay 140% of the Medicare rate or $1400.

If we had Medicare for all, the contracted rates would drop to Medicare rates.

If your out of pocket is a 20% coinsurance with the Medi share is $280 and $200 with Medicare, and everyone paid the Medicare contracted rate – then everyone would save $80 in out of pocket cost plus another $400 to $1000 on this $2000 service because of the contracted rate difference.

There is your billions. They cut the cost in half, because the contracted rates are half.

I am for Medicare for all. Its going to happen. But it aint going to be free. And it aint going to prevent wealthy people from buying a Supplement of $300 a month to hedge against the co-insurance. Nor will it stop ways of people buying their way to the head of the line.

What is missing from the Medicare for all story is how we pay this premium. Medicare withholding are still a premium of sorts. Are there going to be deductibles, coinsurances, copays on top of the Medicare withholding premiums?

Ask these questions, look for these specifics and make an informed choice about Medicare for all. The people in these forums are looking for a better life through real estate, business or better financial choices. This means you are not going to be the person in the rally where this will be free, because for them it will be. That rally 20 something kid drinking the free Kool-aide has not even started to earn enough income to really understand what they are setting themselves up for in 15 years when their education has paid off and they start making $85k a year. But they do see their parents, grandparents and family struggling with the cost of healthcare. They want to make the world a better place, and I can support that ideal.