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Real Medicare Doesn’t Match Political Promises

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We had been on Medicare exactly two days when our first premium increase notice arrived, a nice healthy 5% jump.

This isn’t the Medicare Heaven that I keep hearing about from the presidential contenders. I want that Medicare, the idyllic one described by Sens. Bernie Sanders and Elizabeth Warren. Surely their “Medicare for All” wouldn’t raise my premiums on Day Two.

Technically, the price increase is for the Medicare supplemental policy provided by Anthem, not the government-run Part B. But those price increases will come, as well. The transition process from the family coverage provided by my wife’s former employer to Medicare has been highly instructive. It is a transition we are going through simultaneously because we share a birthday.

The “Medicare for All” I’ve heard discussed in recent Democratic presidential debates shows little relationship to what we’ve observed so far. Clearly the promises they are making are for an entirely different health care payment process, simply using the Medicare brand name because of its popularity.

The real Medicare is not free, not at all. The real Medicare has plenty of deductibles and co-pays, unless you go out and spend even more money for a supplemental policy to cover most (but not all) of those. In fact, you pay for three things in most cases — Part B medical coverage, Part D prescription coverage plus that supplemental.

And while we’ve had no claims yet, we understand there are plenty of quirks and some things that are not covered, often making Medicare just as frustrating as the private insurance world.

There was another rude shock of reality. My primary care physician is moving to a high-cost concierge practice, so I’m considering options. My wife’s current provider was quick to say “no” to taking me on, because that practice is not taking any new Medicare patients. Other insurance plans are welcome, however.

Providers are rejecting Medicare? Again, that flies in the face of claims that once all Americans move to that same government-directed system, all will be well. It will not.
Not long after somebody said, “You can keep your plan, you can keep your doctor,” my wife learned she would not be keeping her plan. Suddenly we faced a $5,600 annual deductible and needed to start a health savings account. Health “insurance” only kicked in for the big things. Even a trip to the emergency room was suddenly “out of pocket.”
The problem is not how we pay for health care. The problem is how much we pay, and how much gets siphoned off in nonproductive ways. The Democratic complaints about the drug and insurance company profits, protected by top-gun lobbyists and compromised politicians, hit a chord with me. President Donald Trump, sensing the same public anger, is pushing back hard on prescription prices.

Unlike with private insurance, Medicare is means-tested, and a higher retirement income triggers a higher premium for the same coverage. This follows years of paying taxes into the system based on income level, more than 40 years of taxes for most of us.

In my case, the Medicare taxes paid by me or my employers total $88,618, according to Social Security’s accounting. Imagine the balance had it been invested starting in the 1970s. What did that quarter-million in present value dollars pay for? The answer, of course, is for previous beneficiaries, which included (to be honest) our own parents. But it doesn’t appear we were paying in for our own future needs, as the underlying trust fund won’t be fully solvent after 2026.

The big advantage for Medicare for us is that annual spending hurdle of a $2,800 deductible each is now gone. Maybe “Medicare for All” would end the annoying robocalls.
But it still is going to cost us hundreds of dollars per months, with three monthly payments each to keep track of, three payment sources to coordinate, and no human resources department to call when things get dicey. We already have made three trips in person to a Social Security office, taking our number and waiting our turn, to get our current lower incomes recognized to avoid those higher-income premium levels. One visit was wasted after the paperwork submitted was lost.

Those crowded offices will need to be as big as Walmarts when “Medicare for All” covers all Americans cradle to grave.

A single-choice, government-managed “Medicare for All” is no answer. Those candidates promising it, most of them members of Congress, are confusing the health care coverage they enjoy on Capitol Hill — and the obsequious service they receive if they have any problem — with the real world all the rest of us face.

This Commentary originally appeared in the August 12 issue of The Richmond Times-Dispatch. Reprinted with permission.

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