By Rob Stone, M.D.
The Herald-Times (Bloomington, Ind.), July 30, 2013
Who is the most popular health insurer in America? Not Anthem Blue Cross. It’s Medicare. And what insurer is the most efficient? Medicare again, operating at only 1.4 percent overhead, while the private insurers strain to meet the Affordable Care Act maximum overhead of 20 percent.
While the Affordable Care Act struggles to be born, it’s worth looking again at how well Medicare works. Last year the respected journal Health Affairs published a study showing how Medicare performs better than private health insurance plans.
According to the report, “Medicare beneficiaries are less likely to have cost-related access problems, high premium and out-of-pocket health care expenses as a share of income, and financial problems because of medical bills. And compared to non-elderly adults with employer-based coverage, Medicare beneficiaries are more likely to have access to a medical home – a primary care provider who knows their medical history well, is accessible, and helps coordinate their care,” and are “far more likely to report excellent quality of care.”
Medicare is not perfect and needs improvement, but it performs far better than the best of the private plans – the employer-sponsored health plans. Individual and small group plans have even worse performance. The Health Affairs article concluded, “Medicare is doing a better job than employer-sponsored plans at fulfilling the two main purposes of health insurance: ensuring access to care and providing financial protection.”
In my work as a physician I see it every day – patients under the Medicare eligibility age of 65 struggling to find affordable insurance, or fighting with their insurance company when they try to make a claim, or driven to bankruptcy by impossibly high deductible payments. But if they can hang on until they reach Medicare age, then they can finally get the care they need, without the hassles. “Pre-existing conditions” are not an issue. You can pick the hospital and doctor of your choice.
We need to celebrate and protect Medicare, a uniquely American approach to health care. Somehow Congress in their infinite wisdom decided 48 years ago that we should have a universal health care system for everyone over 65, but that the rest of us were on our own.
Don’t let the politicians privatize Medicare or raise the eligibility age. Some want to turn Medicare into a voucher program and shift more costs to seniors, a terrible idea. Medicare is the victim of skyrocketing health care costs, not the cause.
Medicare may not be perfect, but Americans with Medicare are far happier than those with private insurance. Medicare has been a leader in keeping costs down. Medicare already insures the people with the greatest health care needs: people over 65 and the disabled.
Happy Birthday, Medicare! It’s time for everyone to be able to see a doctor when they are sick, to have access to preventative care, and to not face financial ruin when they have to go to the hospital. We should improve and expand Medicare to cover everyone. Everybody In – Nobody Out. We all deserve health care.
Dr. Rob Stone is director of Hoosiers for a Commonsense Health Plan. He lives in Bloomington.
http://www.heraldtimesonline.com/news/opinion/medicare-has-proved-itself-after-years/article_0289bbec-3b3f-5e03-a45f-d47d60a88fc0.html
