Medicare for All. What does it really mean? How does it change things?

10 mins read
Photo by Hush Naidoo on Unsplash

by Jeff Martins-Sexton

We’ve all heard it before. The term “Medicare for all” being thrown around during election cycles as a promise by progressive presidential hopefuls, competing to attract the attention of voters who are frustrated with the current state of healthcare in America. Despite a mass of supporters applauding at the mention of it, the question remains: 

What does “Medicare for All actually mean? And how would this change the current healthcare system in place?

Before I tell you what it means, let’s review how Medicare for all started.

Where does the term “Medicare” come from?

Medicare, as it’s known today, has its origins in the Social Security Amendments of 1965, signed into law by President Lyndon B. Johnson. Under these amendments, Medicare was enacted, which provided health insurance to Americans over the age of 65. At that time, elderly Americans who required health insurance the most, found it nearly impossible to get private coverage. The Introduction of medicare increased health and longevity, and made health care coverage a universal right for the elderly.

What Does “Medicare For All” mean?

In recent years, the term “Medicare for All” defines  a single-payer health insurance plan administered by the government. The term “single payer” means that the government would be the sole institution paying for the plan, as opposed to the current situation, in which several institutions pay separately. By having the government administer the plan, they would have more control in setting prices for medical costs, including things like surgeries and prescription drugs. 

Medicare for All would also cover every single American. According to a report by the census bureau, the number of uninsured Americans rose from 25.7 million in 2017 to 27.5 million in 2018. Having Medicare for All would ensure that all Americans are covered, regardless of their income or health status, and would no longer need to worry about what would happen to their healthcare coverage if they switch jobs or occupations. 

Although Medicare for All would cover every American citizen, those currently with adequate health insurance wonder what would happen to their existing coverage and how Medicare for All differs from their current coverage.

What would happen to my Private Health Insurance?

In the case of Medicare-for-all, Americans wouldn’t require private insurance, seeing as how everyone would be covered under the single-payer health insurance plan. It’s possible that private insurance companies could still exist in providing extended health insurance for items that are not covered by Medicare for All. However, the national plan would cover standard matters, such as seeing a physician.

What about Pre-Existing Conditions?

Because the plan would be run by the government, pre-existing conditions (as a factor in determining a person’s eligibility) would cease to exist. There would not be a screening process to determine eligibility under Medicare for All because everyone is covered regardless of their personal health status. Currently, pre-existing conditions are covered under the Affordable Care Act, also known as “Obamacare”.

Out of pocket expenses?

The question that arises for many is “How much out of pocket expenses will I incur?”. 

Almost everyone who has dealt with private health insurance has had to pay out of pocket costs, whether it’s in the form of co-pays, deductibles and prescription costs not covered by their insurance. The answer to this is a bit complicated. In the case of Medicare for All, things like co-pays and deductibles would cease to exist for standard visits to the doctor. Due to the fact that the government is implementing the insurance, deductibles wouldn’t exist. Countries which have a single payer system such as Canada, do not pay deductibles and co-pays.

Where it gets complicated is looking  at what would be covered under Medicare for All. Certain procedures and medications may not be covered under Medicare-for-all, but in the case of Canada, these procedures are usually elective and NOT life threatening. So while costs will decrease, there still may be out of pocket expenses for procedures not covered under Medicare for All. In order to determine these costs, we have to look at the plans being proposed by elected officials and presidential candidates.

How is the government going to pay for it? 

This brings us to the most important question. “What’s this going to cost?” and “how are we going to pay for it?” 

In terms of costs, the Committee for a Responsible Federal Budget, a non-profit, bipartisan public policy organization based in Washington, DC estimates that Medicare-for-All will cost between $28-$33 trillion dollars over a decade. Although numbers do fluctuate depending on the association or candidate conducting the estimate, this tends to be the average.

Having established an estimated cost, the question now becomes “how is it going to get paid for?” The simplest answer for this is taxes. Taxes would fund Medicare for All plans.The thinking behind using taxes to pay for Medicare-for-all is that taxpayers would no longer have to pay health insurance costs and therefore could afford a tax increase.. Taxpayers, in turn, wouldn’t notice the tax increase because they would no longer be paying for premiums.This of course, is the proposal being given by a number 2020 presidential candidates. 

It is also being argued that there would be an influx of tax money being brought in by the wealthiest Americans and large corporations, who currently pay little to no federal taxes (Netflix, Amazon). In order for this to happen, Congress would have to close the loopholes in the tax system which in turn would raise taxes on the wealthiest Americans.  This is the proposal that several Democratic candidates are pitching, but implementing this would require tax legislation to be passed in both chambers of congress. This would be extremely challenging if we end up with a divided government, where one party has the majority in one chamber but not the other. Nonetheless, Democratic candidates seem confident  that this can be done, and that the new revenue would pay for a large portion of the plan.

So where do we currently stand?

Although it’s been the ultimate goal for progressives, proposals on how to implement Medicare for All vary depending on the presidential candidate. Some pose minor changes to the current structure in place, while others are proposing a major overhaul. One thing that is for sure is that any plan to tackle healthcare in America, will require dedication and hard work on the part of lawmakers and constituents who wish to see the status quo change. 

And what can we actually do?

No matter where you stand on Medicare-for-all right now, whether you think we should tackle this in one or multiple steps, I think we can agree that healthcare is a human right and we should make it easier for people to get quality medical care and affordable prescriptions. 

Unfortunately, Republicans are currently focused on taking healthcare away from people. They spent most of 2017 doing everything possible to eliminate the Affordable Care Act and replace it with something worse. A plan that would let insurers charge sick people higher premiums and remove essential health benefits. Luckily, this didn’t pass.

So what we need to do is elect legislators who are willing to fight for our healthcare and vote out those who want to make it more difficult for people to find coverage.

Jeff Martins-Sexton

Jeff Martins-Sexton
A graduate of the University of Toronto, Jeff Martins-Sexton is a writer who uses his studies in history and the United States to influence his take on current affairs and the state of American society. He’s also a screenwriter and performer having studied both in Toronto and Los Angeles.Share

Originally posted on Tono Latino. Re-posted with permission.

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