Shard

I can understand the status quo argument, and distrust of a particular government or even government in general. My point was more that Europeans and Canadians see universal healthcare as a right, whereas there are some in American that not only turn a blind eye to those who are denied healthcare, but believe such a (unsympathetic) system fosters productivity and striving for success. And that's probably true. But it is a trade off that society must undertake.

Anian

It's more like the opposite. Giving up my job to start my own business means I can't afford healthcare until the business takes off. Even the safety net is expensive, so I'd be risking my health on top of any money I invest in the business. It's not fostering any entrepreneurialism or trying new things, it's making people stick at their current job for as long as possible.

robin1234

I’m glad you asked.

Differences are many, but can be put into two major categories. (a) Choice, (b) Comprehensiveness.

(a) Choice. Is having a choice good or bad? I just received my annual “Medicare & You” book in the mail, from Medicare. It’s 130 pages long. It purports to explain all my different choices for getting Medicare services next year. (Folks get to choose each year what plan they want for next year.) I have literally hundreds of different plans that are available to me in my county, and each county in the country will have a different menu of plans. The first choice is, Original Medicare or Medicare Advantage? Then within each of those, are a myriad different plans with different levels of monthly premiums and copays.

(b) Comprehensiveness. When I worked, my employer provided a “gold-plated” health plan for a premium of $40 a month, and quite low copays etc. Now I’m on Medicare, my premiums (including the basic Medicare Part B premium that everybody pays) are hundreds every month, and my annual out of pocket amount is about $8,000. So I won’t be bankrupted by medical expenses, but they can add up.

robin1234

I think this is overly cynical and pessimistic. Most voters voted for the government (obviously.) Most Americans want healthcare to be available to all.

Shard

So you still have to pay / co-pay for Medicare post 65 ? How is that different from normal health insurance ?

Shard

But don't they want some to have more healthcare than others ? (Paraphrasing George O.)

SanDiegogirl

Yes, you continue to pay monthly premiums and (if no supplementary insurance) co-pays and deductibles. The amount you pay per month is dependent on your income - i.e the more income you have the more you pay, although the majority of Seniors appear to pay the basic rate which, currently, is around $140 dollars per month. On top of this you pay for a prescription plan, around $40 a month. As said, you can buy supplementary plans which, depending on how they work can give you additional coverage for no extra charge or for an additional fee. Sounds complicated but it is not really.
Medicare coverage is controlled by the Feds and is the same throughout the US..
Medicare is accepted by health systems throughout the US, but not all doctors within the health systems themselves accept them. - personally, I have never found a doctor that does not take Medicare I must admit.
How it differs mainly from 'normal' health insurance (private individual plans) is that it is less complicated as per the payment process. Bills go to Medicare that's it. Co-pays deductibles come to you. Medicare states pretty clearly what is covers, so no argy bargy about gettng a procedure and then finding its not covered.
I've found it works really well compared to either individual plans or group plans.

ddsrph

I think Medicare works very well. When I was needing neuro surgery for a pituitary tumor two years ago, I found the two best places to get this surgery in the US and in a matter days had appointments at the Mayo Clinic and Emory University in Atlanta. I chose Emory. How does this compare with the NHS? Due to me also having a free Medicare (thru the military) supplement which includes drugs I paid zero for the whole treatment which was superb. Does the NHS offer choice between several world class institutions for specialized treatment in a timely manner?

Shard

Thanks, that's a really good explanation.

Shard

It seems a lot faster than the NHS. Would every US citizen on Medicare be able access such timely and low cost care?

ddsrph

Not all at once. As for cost Medicare supplements are reasonable in price and no restrictions on pre existing conditions. We need something similar to NHS but probably never happen. Our politicians have people focused on Jesus, Guns , Abortion, and socialist takeover to have time to consider healthcare. I have often wondered how much money is spent on administrative costs by all our health Insurance companies especially sales and advertising.

robin1234

The only quibble I have with the above is that you are focusing on Original Medicare. Medicare Advantage is a different beast, I’m not sure what proportion of people have Medicare Advantage as opposed to original Medicare.

https://www.kff.org/medicare/issue-b...nd-key-trends/

Apparently, 42% of Medicare recipients have Medicare Advantage.

SanDiegogirl

Some areas have longer 'waiting times' than others. In SD there are a lot of seniors so, for example, I have just waited 3 months for a knee replacement (it's an elected surgery after all) . Hubby is waiting for cataract surgery and the first appointment he can get for an evaluation is January 2022 ! Swings and roundabouts I guess.
Nothing to stop any US citizen who has paid in their 40 quarters payroll tax (10 years working usually) getting Medicare.

SanDiegogirl

As I stated above there are supplementary plans to 'top up' original Medicare. Some are Advantage plans, others are true supplementary plans. Even if you don't go for any type of 'top up' plan I think Medicare is still better in terms of costs and complexity than individual plans.

robin1234

Last year, I counted how many pieces of mail I got during Medicare season, advertising Medicare plans (Sept - Nov, mostly.) It was over fifty. A lot of it was borderline dishonest, especially since a high proportion of Medicare recipients may have issues with memory, judgment etc. Some of the envelopes are disguised so they look like they come from the government, and other such ploys. The sales and advertising budgets must be significant.