Sunday, February 5, 2017

You think you are going to touch my MOTHER'S Original Medicare? Have you met my Mom? Didn't think so. . . .

Original Medicare, as I introduced it in my post Turning Alternative Facts to Actual Facts, was rolled out in 1965.  We have Part A for hospital coverage, Part B for outpatient and doctor care.  Most Medicare participants also choose to enroll in either a supplement plan or a Medicare Advantage Plan.  that will pay for some costs that Original Medicare does not cover. Supplement coverage (sometimes called MediGap) has no insurance carrier network, but the doctors/hospitals have to accept Original Medicare.  The supplement will cover the gaps in coinsurance (percentage of coverage by Medicare versus what you would be responsible for) and deductibles (first dollar costs that you are responsible for. Under a Medicare Advantage Plan, the insurance carrier will take on the risk and you are normally going to navigate within a local or regional network, sometimes with coverage for doctors who do not participate in the network.  You would normally have copays if you are staying within the network.

Paul Ryan (R-WI), the Speaker of the House, has put forth a plan to privatize Original Medicare.  Speaker Ryan would replace the current program with vouchers.  It's interesting to see how so many people are talking about 'vouchers' to replace what we have today.  The healthcare industry, as you can tell from my previous posts, is not easy to navigate.  It takes someone with the time and background to really figure out how to make the system work for them.  So, instead of providing more ease of use, the voucher system would make seniors, in this case, more entangled in their healthcare payment process.  Why do you need to upend a system that has worked for seniors and replace it with a privatized program?  

The answer that we are given is that Medicare is on its last legs.  It is on life-support and we have to do something before it collapses and leaves Granny Nan & PePa out in the cold.   

Quick reality check:  Medicare' has IMPROVED in the last couple of years, not gotten worse.  As a matter of fact, it is funded through 2029 and 79% funded through 2040, which can be made up without privatization.    Medicare Trustees Report (page 29).  

Medicare is one of the programs that will find a hard time getting approval to change it, under the current Administration.  It is also NOT tied to the ACA issues.  Remember, Medicare has been around since 1965.  The current Administration ran on a platform promising not to touch Medicare.  

One might argue that Medicare is an entitlement, but I disagree.  An entitlement is having a right to something or the belief that one is inherently deserving of privileges or special treatment.  We all pay into Medicare while we work, and once we retire we have to pay into Part B Premiums.    2017 Part B Premiums

Seniors have a very strong voice and membership association in AARP (American Association of Retired Persons).  They are 38 million members strong and they have the resources to fire up their base.  And let me tell you, don't screw around with their healthcare, golf tee time or cruise ship schedule.  Trust me, my mom would be the first to tell me that!  So let's not pull Part A & B away from our loved ones, let's find ways to enhance the program to make it easier to gain access to incentives for better outcomes within the healthcare delivery system.  


  1. I have had the original Medicare and a Unitedhealthcare supplement through AARP since I was 65 and have been pleased with it.I don't think it should be changed,as at least in my case,it has worked very well.

    1. Thank you for your comment. I agree, the supplement programs work well for many Americans.