Woman Goes Bonkers over Medicare; Wants To Put One-Size-Fits-All Straightjacket on Seniors

Someone named Carol went off on Medicare the other day on a web site for which I can no longer find the link. Don't matter; basically she was saying that Medicare was all too confusing and what the United States needs is one-size-fits-all healthcare insurance for senior citizens. Whowever she is and wherever I saw the comment, she was specifically talking about the "needy" and people in nursing homes, which only tangentially touches Medicare anyways. It got me thinking that a lot of people mix up we seniors and the needy. And do not seem to understand that Americans -- especially we senior Americans -- like choice.

 

In particular, when it comes to Medicare:

1. It is true that about 20% of we seniors are "needy." Most of the seniors in the "needy" group get some kind of completely free or partially free health care¹. Those of us in this sort-of (see footnote) "needy" group are almost all eligible for free or almost free drugs no matter how much they cost (there is no such thing as the donut hole for us).
2. But a large majority of us are not "needy." The other 80% of us split as follows and like choice (see image above):

• A. About 30% of us who are not needy get health insurance from a former employer or union so  -- except for a few wrinkles -- all our decisions are made for us by the former employer or union. This retiree insurance  is known as "Cadillac health coverage;" it's the best available. Those of us in this group definitely do not want some one-size-fits-all program like the woman is suggesting.
• B. Of the remaining 50% of us (not needy and not getting insurance from a former employer), around 6 in 10 of us like having choices as to what our insurance covers and we sign up for a program called Part C of Medicare where our health is monitored by what is called Managed Medicare, like an HMO and now called an accountable care organization by the Obama administration. We also don't want a one-size-fits-all program like the woman suggests because some of these Part C plans are designed for healthy seniors and others for very sick seniors and some just let those of us who wish assume more of our own costs, betting that we won't have too many.
• C. Conversely about 4 out of 10 of those not needy and not getting insurance from a former employer or union reject the idea of being corralled like cattle by the accountable care organization² like those of us in category B. These folks sign up just for vanilla fee for service (FFS) Medicare A and B and buy  private insurance that is like the Cadillac health plan those in group A get. Obviously those of us in Group C want to be able to keep doing this too.... just like the seniors in groups A and B want to keep doing Medicare their way.

I do agree that the process by which this all gets paid for is confusing. It would be nice to simplify a lot of the money changing while keeping the Medicare choices we seniors all want. Anyone who agrees should take a look at a bipartisan Medicare reform plan called Wyden-Ryan released in December 2011. It simplifies the funding part of Medicare and keeps the choices we want.

¹And many of the needy on Medicare purposely put themselves in that category through what is known as a spend-down, down five years before they "need" government assistance to prevent the government from "clawing back" the seniors assets from heirs.

2Because of the Patient Protection and Affordable Care Act of 2010 as amended. all these people are going to be corralled into accountable care organizations against their will whether they know it or not