Lowering the age for Medicare

[Car-Guy]

If you would have told me 20-30 years ago that Medicare would be considered a "good standard" for health insurance, I would have laughed in your face. I'm not laughing any more.

I wouldn't have said that 20-30 years ago either. I never thought I'd say a US government program was better than anything offered by private enterprise. IMO, private medical insurance (including drugs) is very likely the most &%^$#* and *&$)%up industry in the US today.

I can't believe we so easily pay outrageous premiums for years and years (sometimes decades) only to beg/fight for coverage when we have a claim. Between the ever changing in-network doctors and facilities, the use of generic drugs that are often less effective that the "originals" and that are rationed, pre-approvals for more and more procedures, and the continuing change of covered services, the customer/subscriber doesn't stand much of a chance.

IMO, the main value of having any health insurance, is getting the benefit of their negotiated discount rates with the doctors, hospitals and drug providers under their plans. And then only if you follow all their rules, use their doctors/facilities, etc. Maybe.


I seriously considered self insuring before I was covered by Medicare.

 

[jimbee]

These are answers to a question I didn’t ask.

Now you’re talking about what’s wrong with US healthcare system, where I clearly agree.

What I challenged, now clearly highlighted in red was your statement “Many health economists would say that the money to pay for universal healthcare in the United States is already in the system.” You said “many” - share one that credibly shows that. It’s not a simple as replace the US system with Canada’s (or any other country)...

Your're previous links show the money is there. 6miths stated "It's just a matter of figuring out a way to modify the system.", not that modifying the system would be simple.

You either throw more money at the system, make the system more efficient, or some variation in between. Take your pick.

 

[harllee]

ACA is a bargain compared to Medicare if you are RE and can "manage" your MAGI for the maximum premium subsidies & cost-sharing reductions (i.e. stay just over 100% of FPL, 138% in Medicaid expansion states)

Not so much if you're over the "cliff" (MAGI over 400% FPL)

I doubt Medicare will be so generous once I get there (~15 years)

Most likely every supplement plan with be some form of Advantage, with only a fixed amount (capitation) allowed annually based on one's age & health (e.g. is the patient compliant with doctor's orders?)

ACA may be cheaper than Medicare for some people BUT in my experience ACA is not better then Medicare. In my state the best ACA policy I could get had a $6000 per person annual deductible and a limited network. Now that I am on Medicare with a Medigap policy G my deductible is $185 and I have a very large network of Medicare providers. To me Medicare is superior to ACA. Most people I know are glad to hit age 65 and finally get on Medicare.

 

[ncbill]

ACA may be cheaper than Medicare for some people BUT in my experience ACA is not better then Medicare. In my state the best ACA policy I could get had a $6000 per person annual deductible and a limited network. Now that I am on Medicare with a Medigap policy G my deductible is $185 and I have a very large network of Medicare providers. To me Medicare is superior to ACA. Most people I know are glad to hit age 65 and finally get on Medicare.

So you were over the cliff?

If I plug in our 2018 household income and family size into KFF's 2020 calculator, here's what I get:

Estimated financial help: $1,710 per month ($20,517 per year)
as a premium tax credit.

This covers 97% of the monthly costs. Your cost for a silver plan: $46 per month ($556 per year) in premiums (which equals 2.06% of your household income).

Maximum out of pocket for the above family plan: $5400.

And if the government goes to all Advantage plans (no more F, G, etc. supplements) as I suspect to save costs there will be networks for that as well so not every doctor/hospital will take your particular Advantage plan.

 

[aja8888]

And if the government goes to all Advantage plans (no more F, G, etc. supplements) as I suspect to save costs there will be networks for that as well so not every doctor/hospital will take your particular Advantage plan.

Supplemental plans (F, G, N, etc) are paid by insurance companies, not the government. If the Gov eliminates Medicare as we know it and goes to MA plans, you can bet that many specialists and hospitals won't take it. Right now, MD Anderson Cancer Centers in Texas won't take MA plan patients.

 

[Dtail]

ACA may be cheaper than Medicare for some people BUT in my experience ACA is not better then Medicare. In my state the best ACA policy I could get had a $6000 per person annual deductible and a limited network. Now that I am on Medicare with a Medigap policy G my deductible is $185 and I have a very large network of Medicare providers. To me Medicare is superior to ACA. Most people I know are glad to hit age 65 and finally get on Medicare.

Again it depends which state/county one lives in.
In Florida in most counties, the ACA plans if MAGI is managed properly is a superior choice to Medicare in terms of costs, while coverage would be similar.

 

[6miths]

These are answers to a question I didn’t ask.

Now you’re talking about what’s wrong with US healthcare system, where I clearly agree.

What I challenged, now clearly highlighted in red was your statement “Many health economists would say that the money to pay for universal healthcare in the United States is already in the system.” You said “many” - share one that credibly shows that. It’s not a simple as replace the US system with Canada’s (or any other country)...

I think that the book 'An American Sickness' is an excellent place to start and that is why I have cited it. It is well referenced and written by an American physician who has much greater insight than I. As I said, I am not going to reference academic papers on a retirement forum (although I am retired, I still have lots to do). I have been to several symposium where this is the topic and there have been no shortage of expert opinions from both the economics and medical side that say this as do the statistics you show. Most (all?) OECD countries spend less per capita and most have better health indicators so it can be done with many different style health care systems. At no point did I, or would I, suggest that the US should adopt Canadian style healthcare. IMHO, Canadians and Americans, for all their shared heritage and similarities, are quite different in many of their core values. I know there are many who would like to go that route but I have no idea whether it would work. I doubt that it would be nearly the disaster that vested interests say it would be but we will never know. Please know that everyone I know would like to see it fixed, you deserve much better.