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Inadequate Coverage for Basic Needs

The Myth of Medicare for All

by MARY LYNN CRAMER

When Senator Chris Dodd (D-CT) announced to the media last week that he has been diagnosed with prostrate cancer, he also commented on the importance of getting annual physical examinations. Good thing Dodd is not on Medicare. Medicare does not provide coverage for annual physical exams. As the leading Democrat on the Senate Health, Education, Labor and Pensions Committee, Dodd is a key player in the plan to overhaul the US health care system. So one would assume he knows that today’s Medicare has no dental coverage; no coverage for eye exams or eyeglasses; no coverage for hearing aids, no coverage for annual physical exams, or foot care.

For mental health services, Medicare participants must pay 50% of an outpatient therapist’s charge. Medicare will cover a “one-time ‘Welcome to Medicare’ physical exam.” However, there is a deductible that must be paid first, as well as a charge equal to 20% of the cost of each and every doctor’s visit or service. Other services and supplies not provided by Medicare include acupuncture, chiropractic services, several laboratory tests, long-term care, orthopedic shoes, prescription drugs, shots to prevent illness, and some surgical procedures given in ambulatory surgical centers (you can see the entire list of “What’s NOT Covered by Part A and Part B” on page 38 of the 2009 edition of the aforementioned “Medicare & You.”) For those items that are covered, there is a charge of at least 20% of the medical provider’s costs, and a deductible that must be met.

Given the reality of Medicare’s inadequate coverage for basic medical needs, why is it that “progressive” Democrats, as well as the “experts” interviewed daily by the liberal media like NPR and Democracy Now, keep saying “what we need is ‘Medicare for all’.” They repeatedly identify Medicare as the successful US “single-payer” program preferred by all its participants.

Possibly these spokespersons for Medicare-for-all, are not intentionally misleading the public. It could be that they don’t know anyone personally who depends upon Medicare for their health problems. Or, maybe they have never read US Department of Health and Human Services booklet entitled “Medicare & You” that sets out all the costs and coverage for participants. However, ignorance is no excuse for perpetuating the myth that Medicare is the model for single-payer health insurance. As a Medicare participant who is FOR single-payer health insurance, let me share a few facts with those who might not be familiar with the current Medicare program.

Most of the senior citizens I know cannot afford to have Medicare alone. To get the medical services the elderly need, at an affordable price, they must purchase—besides paying monthly premiums to Medicare (for Parts A/B)— an additional private health insurance policy for Part C. This private Part C insurance covers all those things that Medicare will not cover, and there is no deductible and no payment for a % of the doctor’s costs. There is a co-pay for most medical services; as well as a monthly premium. Everyone in my state of Massachusetts (often acclaimed to be the model for national health care reform) is also required by law to purchase prescription drug coverage (Part D) from a private insurance company.

There is no way anyone could say that Medicare by itself is adequate coverage for all. It is not even adequate for the seniors who rely on it. I would like to see the Obamas and members of Congress try to cover their medical expenses with this so-called “single-payer” program. They would never trade the comprehensive coverage they have for Medicare. Medicare needs to be expanded to cover all basic medical needs (set out above). However, that is not in the President’s plan for health care reform.

You have to listen closely to those trying to sell “Medicare-for-all” to hear the underlying message. Listen to what politicians, medical experts and the President say about “cutting waste.” Where do they plan to cut it? From those very supplemental program payments to subsidized private insurance plans that make Medicare workable and affordable for low-income seniors. ABC News reported that there is bipartisan support to “squeeze an additional $35 billion out of Medicare over the next decade and larger sums in the years beyond…a step toward fulfilling President Barack Obama’s goal of curbing the growth of healthcare spending.” (7/28/09 “AP Source: Bipartisan Group Eyes Medicare Savings”)

Yes, Medicare is to be stripped of even more benefits. And the private insurance companies that now provide the supplemental programs, are ready to go along with this. Why? Because the trade off is so much more profitable: mandatory health insurance for all those millions of US citizens not yet insured. Just look at what US Representative Dennis Kucinich, the fearless champion for single-payer health insurance, had to say in a recent interview about private industry’s support for Obama’s proposed health insurance plan:

REP. DENNIS KUCINICH: “Right now what I see is a public plan that gives the insurance companies the option to pick the people’s pockets. As long as you have a public plan, which now is going to be supported by what? Cuts in Medicaid, on the other hand? And undermining benefits to the elderly? Are you kidding me? …Now, I will vote for it, if we can keep the single payer in, because I think it would be worth the price. But without the single-payer provision in it, I don’t know what’s in the bill that would really be worthy of supporting.”

However, there is no “single-payer provision” in the proposed bill, and Obama has repeatedly insisted that his so-called “public option provision” is not a “trojan horse” for single-payer. Kuchinich knows what is coming regarding “undermining benefits to the elderly,” and “cuts in Medicaid.” Will he and other “progressives” nevertheless vote for the proposal supported by Obama and the private insurance companies, if it includes a worthless “public plan?” For a discussion of the difference between “public option” and “single-payer,” and the “progressives” attempts to confuse the two, see the 7/24/09 article by Cook County Hospital clinician Helen Redmond, “The Selling of Single-payer Features.”

Conservatives point out that Dodd, Obama and the House Speaker Pelosi (D-CA), are very critical of the Congressional Budget Office report showing that the proposed health care reform proposals drafted in June would cost at least $1.6 trillion. Dodd called the CBO report “unfair” because, among other things, it failed to take into account “a reduction in funding for elderly care.” (See 7/31/09 article by Joe Emanual, “Obama Disputes Studies Saying Overhaul Will Cost Trillions”). Although there seems to be much confusion and not a little mystery about what exactly is in the 1000 page health care bill proposal, it does appear that most in congress–whether on the “left” or “right” of the issue–believe (1) it will contain no Single-Payer plan worthy of that name, and (2) cost savings for this national health care overhaul will come from cuts in Medicare and medical services for the elderly.

Congress and the insurance companies are not going to fight to improve or protect Medicare coverage for the elderly. It isn’t profitable. We, the citizens in need of adequate and good health care coverage, will have to fight for it ourselves. We need to educate ourselves, each other, and our members of Congress on the immediate need to adequately fund, expand, and protect Medicare for the elderly. Call them, and drop by the home office while congressional representatives are home during the August recess.. See what they actually know about existing Medicare coverage, and what they think of “Medicare for all?” Let them know what you know.

MARY LYNN CRAMER, MA, MSW, LICSW, Senior Citizen, has a background in economics and clinical social work, and considerable personal experience with Medicare. She can be reached at mllynn2@yahoo.com