The Truth About Medicare & the Public Health Care Option

Right now, the Democrats are pushing a "public option" for health care insurance in America.

Seniors, have already had a "public option" for years. It's called Medicare.

The impression that most people have is that Medicare is "free" government-paid health care coverage. Nothing could be farther from the truth.

First, not all care is covered by Medicare. In fact, routine office visits are not covered. Secondly, any unskilled nursing care will not be paid for. Third, for the things it does pay for, the most that the government will pay is 80%; leaving the senior to cough up 20% of the cost (Click to See Full Story). If that senior is living off of Social Security (alone) and they rack up a couple hundred thousand dollars in hospital/surgery billing, they could wind up owing the hospital $40,000 against their meager social security income of less than $18,000 a year.

This is the very reason why many senior advocacy groups like AARP sell supplemental Medicare insurance to pay for the things that Medicare won't cover (Click to See Full Story). But, this is private insurance and it has a cost that many Social Security dependent seniors can't afford. Consequently, it is not uncommon for seniors to lose everything -- their homes and their cars, etc. -- because they can't pay their medical bills under Medicare. Many just become wards of the state that they live in; living their lives out in understaffed, low-quality nursing homes.

The other thing that people don't seem to understand is that Medicare doesn't provide anything that could be literally defined as "extraordinary" care. This precludes seniors from accessing latest surgical and drug regimens because they aren't approved by Medicare. Or, even if the procedure is approved, Medicare's payment for that procedure is so low that Doctors and Surgeons won't even offer it to their patients. The type and amount of care that any senior can expect to get is defined by Medicare's Diagnosis-related Group (DRG) classification system (Click to See Full Story). Medicare DRGs clearly define what methods of care can be given and how much a health care provider will get for that care. Everything from age to sex is defined by the DRGs.

The belief that Medicare is somehow "free" and not "rationed" is simply political bull. Medicare is rationed care and isn't "free". In fact, if you haven't paid at least 40 quarters of FICA payments before becoming Medicare-eligible at age 65, you will have to pay at least $233 per month in insurance premiums. If less than 30 quarters of FICA payments, expect to pay $423/month (Click to See Full Story). And, that's before you buy any supplemental insurance to cover those things Medicare won't pay.

Even with all it's conditions on the amount of care that will be provided, Medicare is in deep financial trouble. It represents $450 billion in Federal spending and that is 16% of all spending by our government. It is now estimated that the unfunded amount of Medicare payouts are about $38 billion dollars per year. Seven percent of Medicare payouts -- about $31 billion in this year alone -- are said to be due to waste and fraudulent billing and in double billing for services.

I find it interesting that, yesterday, Henry Waxman declared that he was able to get his proposal for health care out of his committee. He did so with no Republicans and 2 Blue Dog Democrats voting no. The proposal, itself, needs $1 trillion in additional funding over ten years. To offset part of that additional cost, Medicare benefits will be reduced if the bill passes. Consequently, it appears that what many people think is already free, but hardly isn't, will just get a lot more expensive for Medicare recipients in the future. I suspect that this Waxman bill has even more rationing provisions for Medicare recipients if passed.

And, let's not forget that this Health Care bill will extend coverage to millions of uninsured Americans. I'm sure that everytime you go to the doctor you get in to to see your doctor, almost immediately. Right? My guess is, actually, not! Just think about your "wait times" once your doctor has to serve 20% more patients than he has right now. Believe me, you will be waiting longer and getting less care once the Democrats get through with this "health-care-less" health care bill.