KHN’s ‘What The Health?’: All About ‘Medicare for All’

July 2, 2019

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We’re doing something a little different this holiday week. Because “Medicare for All” is so much in the news, we’re rerunning an earlier explainer episode.

But first, KHN’s “What the Health?” host Julie Rovner talks with KHN correspondent Shefali Luthra about how health care played in the Democratic presidential candidate debates June 26 and 27.

This replay of KHN’s “What the Health?” podcast from February takes a deep dive into the often-confusing Medicare for All debate, including its history, prospects and terminology.

The panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Paige Winfield Cunningham of The Washington Post and Rebecca Adams of CQ Roll Call.

Among the takeaways from the podcast:

Medicare for All is a new rallying cry for progressives, but the current Medicare program has big limitations. It does not cover most long-term care expenses and includes no coverage of hearing, dental, vision or foot care. Medicare also includes no stop-loss or catastrophic care limit that protects beneficiaries from massive bills.
Though recent comments by Democratic presidential candidates on eliminating private insurance with a move to Medicare for All stirred controversy, private insurance is indeed involved in many aspects of the government program. Private companies provide the Medicare Advantage plans used by more than a third of beneficiaries, the Medicare drug plans and much of the bill processing for the entire program.
Many consumers — and politicians — are confused by the terms being thrown around in the current debate about Medicare for All. The plan offered by Sen. Bernie Sanders (I-Vt.) and some of his supporters would be a “single-payer” system, in which the government would be in charge of paying for all health care — although doctors, hospitals and other health care providers would remain private. Others often use the term Medicare for All to mean a much less drastic change to the U.S. health care system, such as a “public option” that would offer specific groups of people — perhaps those over age 50 or consumers purchasing coverage on the insurance marketplaces — the opportunity to buy into Medicare coverage.
Sanders’ vision of Medicare for All is based on Canada’s system. But even there, hospitals and doctors are private businesses, drugs are not covered everywhere, and benefits vary among the provinces.
The health care industry is nearly united in opposing the talk of moving to a Medicare for All program because of concerns about disruption to the system and less pay. Currently, Medicare reimbursements are about 40% lower than private insurance.