There's talk and hope in many quarters that the United States will end up with Medicare for all. How would this affect nursing?
I currently pay a lot for my portion of high deductible insurance through work. It's basically mainly useless to me since I'm healthy, don't take meds etc. Even going to the doctor would cost me.
Honestly, the middle class has become the new underserved in America. Frugal, responsible people think twice about going to the doctor because of huge copays that have made basic healthcare a budget buster.
How would Medicare for all affect the middle class, nursing in particular? Employers would no longer have to pay for insurance. Would they pass savings on to us in the form of higher wages? How would we fare economically with higher taxes? Would the poor government compensation to facilities drive down wages?
Specializes in Critical care, tele, Medical-Surgical.
A Heritage Foundation study comparing cost of Medicare and private insurance
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Comparing Medicare and Private Health Insurance Spending
It should be noted that the calculations are confined to spending for hospital and physician services. Those services are common to both private insurance and Medicare, and represent the bulk of health spending. ...
... Spending for hospital and physician services by private insurance grew 18.1 percent faster than comparable Medicare spending between 1970 and 1999.
Spending trends began to diverge in the late 1980s, coincident with Medicare's move to price schedules and crackdowns on fraud and abuse in the traditional fee-for-service program....
... In 1970, private insurance paid for 59.6 percent of total private spending on hospital and physician services. By 1999, insurance paid for 85.4 percent of the total.
The percentage of health spending that was paid directly out of the pockets of beneficiaries declined as insurance financed a growing share of health services...
Over the past 30 years, although private insurance costs rose more quickly than Medicare, cost per unit of private coverage grew more slowly.
The gap between higher Medicare costs and lower unit costs of private insurance first appeared in the late 1970s and has widened in recent years...
Conclusion: Although private insurance spending has risen faster than Medicare spending over the past 30 years, the value of private insurance has grown just as rapidly. These data suggest that Medicare does not have an advantage over the private sector in limiting the growth of health care spending.
Specializes in Critical care, tele, Medical-Surgical.
Another publication:
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Comparing administrative costs for private insurance and Medicare
... Administrative costs are the expenses incurred by medical insurers that are not strictly medical, such as marketing, customer service, billing, claims review, quality assurance, information technology and profits...
First, we’ll break down the numbers.
To measure the administrative costs for Medicare, we turned to the 2017 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds -- the document prepared by Medicare’s fiscal overseers.
The trustees’ summary listed total Medicare expenditures of $678.7 billion for 2016, of which $9.2 billion was characterized as "administrative expenses." That works out to 1.4 percent...
... That covers salaries and expenses, patient outreach, and fraud and abuse control by the Health and Human Services, Justice Department and FBI, among other things.
But because much of Medicare piggybacks off Social Security, other administrative costs such as enrollment, payment and keeping track of patients are left to the Social Security system. That’s one of multiple reasons using the current administrative costs for Medicare wouldn’t translate as cleanly if the entire population were to be covered. (Medicare serves those over age 65 currently... (With Medicare For All everyone would be covered my Medicare, thus adding to administrative costs)
... A February report from the Center for Economic and Policy Research totaled overhead costs for private individual and employer based plans at 12.3 percent in 2015. And America’s Health Insurance Plans found that 17.8 cents of every premium dollar goes to operating costs...
... When the Congressional Budget Office broke those costs down, they put administrative costs in the nongroup market at 20 percent, small-group market at 16 percent and the large-group market at 11 percent...
... The difference is still pretty substantial, though...
But a lot of administrative costs go to marketing, because private health insurers have to compete for clients. That’s something Medicare doesn’t have to deal with, and which wouldn’t be a problem with a similar universal health plan...
I hate using this example..but how is Venezuela coping with all their "universal health care?"
And here we finally have it, I'm surprise it took you this long, this is normally the go to for right wing main stream media libertarians, find the one authoritarian state run system in a less developed country and compare it to the richest country in the world which isn't authoritarian.
Ignore the other democratic socialist states that are more comparable where free at point of care healthcare works because where would the narrative be if we didn't?
You are all over the place, the term parody comes to mind but I actually think you genuinely believe what you're saying and its a sad indictment of American main stream media and the narrative they continue to push that people like yourself can't even grasp the most basic maths. 34-32 = 2.
There seems to be an assumption on some people’s part that Medicare For All would be better than any other insurance and everyone should be happy to switch their premiums over to a payroll tax. Well, I for one don’t pay premiums for my employer provided insurance; it’s part of my compensation package (about 12k per year). To add my spouse is only about $350 a month. I have a $500 deductible, low copays, can see any doctor I choose, very good prescription drug coverage, and a decent out of pocket maximum. So why would I want to cheerfully give this up only to see my take home pay reduced by a Medicare tax because I really don’t think I would get a plan like this for the same money.
There seems to be an assumption on some people’s part that Medicare For All would be better than any other insurance and everyone should be happy to switch their premiums over to a payroll tax. Well, I for one don’t pay premiums for my employer provided insurance; it’s part of my compensation package (about 12k per year). To add my spouse is only about $350 a month. I have a $500 deductible, low copays, can see any doctor I choose, very good prescription drug coverage, and a decent out of pocket maximum. So why would I want to cheerfully give this up only to see my take home pay reduced by a Medicare tax because I really don’t think I would get a plan like this for the same money.
I have great insurance too. Id be more in favor of a hybrid system like Germany and France where there are public and private options (most citizens use both).
There seems to be an assumption on some people’s part that Medicare For All would be better than any other insurance and everyone should be happy to switch their premiums over to a payroll tax. Well, I for one don’t pay premiums for my employer provided insurance; it’s part of my compensation package (about 12k per year). To add my spouse is only about $350 a month. I have a $500 deductible, low copays, can see any doctor I choose, very good prescription drug coverage, and a decent out of pocket maximum. So why would I want to cheerfully give this up only to see my take home pay reduced by a Medicare tax because I really don’t think I would get a plan like this for the same money.
Your employer is free to continue to provide the same coverage without any changes to your take home pay (they could share all of or a portion of their savings if they really wanted to as well). The $22 to $25k they're currently spending on the plan you describe could go towards the combined employer/employee contributions and supplemental coverage to cover the deductibles, copays, etc could be provided with the money saved to give you the same coverage you have now.
There seems to be an assumption on some people’s part that Medicare For All would be better than any other insurance and everyone should be happy to switch their premiums over to a payroll tax. Well, I for one don’t pay premiums for my employer provided insurance; it’s part of my compensation package (about 12k per year). To add my spouse is only about $350 a month. I have a $500 deductible, low copays, can see any doctor I choose, very good prescription drug coverage, and a decent out of pocket maximum. So why would I want to cheerfully give this up only to see my take home pay reduced by a Medicare tax because I really don’t think I would get a plan like this for the same money.
Just a quick question, what happens if you decide you don't want to work there anymore for whatever reason? Or if you were terminated or had to move to another city/state? Is your employer provided insurance any help to you then?
If you are so tied in because of insurance how is that any different than slave labour? Well paid slave labour certainly, but slave labour nonetheless.
3 hours ago, OUxPhys said:
I have great insurance too. Id be more in favor of a hybrid system like Germany and France where there are public and private options (most citizens use both).
Nobody has said that you (group you, not personal you) has to use the UK system. I, and I presume Osceteacher, are using the NHS as examples as that is the system we are familiar with.
This is your countries chance to find the best system for you all.
Just a quick question, what happens if you decide you don't want to work there anymore for whatever reason? Or if you were terminated or had to move to another city/state? Is your employer provided insurance any help to you then?
If you are so tied in because of insurance how is that any different than slave labour? Well paid slave labour certainly, but slave labour nonetheless.
Nobody has said that you (group you, not personal you) has to use the UK system. I, and I presume Osceteacher, are using the NHS as examples as that is the system we are familiar with.
This is your countries chance to find the best system for you all.
Im in favor of a single payer in that we have one payer for insurance, not a government system like the NHS or VA (although I go to a good VA medical center near me as secondary insurance).
Just a quick question, what happens if you decide you don't want to work there anymore for whatever reason? Or if you were terminated or had to move to another city/state? Is your employer provided insurance any help to you then?
If you are so tied in because of insurance how is that any different than slave labour? Well paid slave labour certainly, but slave labour nonetheless.
Nobody has said that you (group you, not personal you) has to use the UK system. I, and I presume Osceteacher, are using the NHS as examples as that is the system we are familiar with.
This is your countries chance to find the best system for you all.
How is it different from slavery? It’s different because I still have a choice whether or not to continue working there or not. I guess I forgot to mention that I passed the “rule of eighty” a long time ago so even if they wanted to fire me or I became disabled I could take retirement and have the CHOICE to keep my current plan and have Medicare as my secondary insurance. Or not. Did no one here listen to Bernie when he said that under his plan employer provided coverage would no longer exist and BCBS and other health care insurance companies would only be there to cover elective procedures like nose jobs. So I still have options. Under the Bernie plan no one has a choice.
How is it different from slavery? It’s different because I still have a choice whether or not to continue working there or not. I guess I forgot to mention that I passed the “rule of eighty” a long time ago so even if they wanted to fire me or I became disabled I could take retirement and have the CHOICE to keep my current plan and have Medicare as my secondary insurance. Or not. Did no one here listen to Bernie when he said that under his plan employer provided coverage would no longer exist and BCBS and other health care insurance companies would only be there to cover elective procedures like nose jobs. So I still have options. Under the Bernie plan no one has a choice.
How is it different from slavery? It’s different because I still have a choice whether or not to continue working there or not. I guess I forgot to mention that I passed the “rule of eighty” a long time ago so even if they wanted to fire me or I became disabled I could take retirement and have the CHOICE to keep my current plan and have Medicare as my secondary insurance. Or not. Did no one here listen to Bernie when he said that under his plan employer provided coverage would no longer exist and BCBS and other health care insurance companies would only be there to cover elective procedures like nose jobs. So I still have options. Under the Bernie plan no one has a choice.
Bernie's proposed plan is not a Medicare-for-all plan, it's a built from scratch single payer plan, and it doesn't outright ban private plans, only those that would duplicate the basic coverage of the single payer plan, since otherwise a two-tiered system develops.
Under Medicare-for-all, private plans would still be common, BCBS for instance already sells more Medicare plans than private plans. You're still free to choose plans to meet your deductible, copay and OOP preferences.
herring_RN, ASN, BSN
3,651 Posts
A Heritage Foundation study comparing cost of Medicare and private insurance