Bernie Sanders in the 2020 Iowa Democratic Party debate said, “Let us be clear what Medicare for all does. It ends all premiums. It ends all co-payments. It ends the absurdity of deductibles. It ends out-of-pocket expenses.”
The facts? Hardly.
There are currently two Medicare pathways: 1) Medicare Advantage insurance, and 2) Original Medicare, which is a government run program.
Medicare Advantage insurance has networks and preferred providers, but appeals to poor people because of the lower and sometimes zero premiums advertised by the insurance companies. Many of these insurance products also include some dental, hearing, prescription drug, and vision coverage within their networks.
However, currently, you still have to pay $144.60/month per person to the government in addition to the insurance company premiums. For a family of four, that would be $578.40/month, which is not the same as, “It ends all premiums.” Depending on the insurance plan, there are currently co-payments and deductibles. There are networks such that if you go outside the network, coverage is limited, leading to out-of-pocket expenses. Therefore, Medicare Advantage does not match his description of ‘Medicare for all’.
The second pathway, Original Medicare, has no network. It covers doctors, hospitals, and other medical providers anywhere in the United States that ‘accept Medicare assignment’, but it only covers 80% of most costs. If you go to a provider who doesn’t ‘accept Medicare assignment’, you could be paying for a substantial amount of the services yourself (out-of-pocket expenses). Since the government stopped allowing Plan F, which had no deductible, most of the Original Medicare Supplement insurance plans have deductibles and/or co-pays.
Original Medicare comes with a government premium of $144.60/month per person. Those with Original Medicare typically get a Medicare Supplement insurance plan that closes the 20% gap at a cost to senior citizens of $225-450/month per person of premium. Presumably younger people without disabilities would be quoted lower costs by these insurance companies. In addition, they are wise to look into Medicare D prescription drug insurance that costs $20/month per person and up. These plans, particularly the low premium ones, come with deductibles and co-pays. All in, Medicare can cost $389/month per person to well over $600/month per person. For a family of four, this would be $1,556-2400/month.
In addition, Original Medicare doesn’t cover certain costs such as annual physicals. Instead of a true physical, Original Medicare allows a doctor to ask you a dozen or so questions, but not actually examine you. If you want a true physical, that would be an out-of-pocket expense. Therefore, Original Medicare does not match his description of ‘Medicare for all’.
The only Medicare option that is not currently an insurance product is Original Medicare, that has a premium of $144.60/month per person. This covers doctors, hospitals, and other medical providers in the United States that ‘accept Medicare assignment’, but only pays 80% of most costs, and no prescription drug coverage. All other Medicare is provided by private insurance.
Thus, what Senator Sanders describes as ‘Medicare for all’ doesn’t look anything like Medicare. It probably looks more like the platinum Senate plan that he has. Converting Medicare over to the Senate plan would greatly increase the cost of providing his ‘Medicare for all’.
Why doesn’t the press or anyone else call him on this???
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