how is Medicare different than the proposed universal health care?

Factual Questions
1

(No politics! … this is GQ )
Please help a foreigner understand what those Yanks are fighting about…and in short simple sentences, please.

Isn’t Medicare a huge government-based universal health care system that covers every citizen (over 65) at taxpayer’s expense ?
How is it different than the coverage which most other countries provide for every citizen (over and under 65) at taxpayer’s expense?
I can (sort of) understand why some Americans like their private insurance system and don’t want to get the government involved. But aren’t those same Americans also expecting to recieve free coverage by Medicare for about one third of their adult life.? So what’s the big philosophical/ethical debate all about? If it’s proper,good and ethical for the goverment to treat 65 year olds, why not 30 year olds?

Please-I don’t want to debate the philosophy --there are enough threads in GD.
I just want learn why the proposed Obamacare is being presented as some radically new and different system. It looks to me like obamacare is just an expansion of the existing Medicare system, to cover all age groups.
That’s a financial issue, but not an ethical one. But most of the debate seems to be about ethics(i.e. the role of government vs the responsibility of individual people for their own lives) .
What am I not understanding?

2

People (working, insured people with coverage they like) don’t believe a gov run plan will only be applied to people who can’t afford coverage. Some folks think their good insurance and medical experiences will be ruined by gov intervention.

People don’t want to pay, via taxation, for covering someone else, for yet another program that they perceive would be misused and poorly run by the admins.

3

It’s not about ethics, it’s about selfishness: “I’ve got mine, screw you.”

4

But is it intended only for people who “can’t afford” other coverage?

I’ve known people who “were not eligible” due to things like “grandparents taking care of child, child is not eligible for state-run coverage due to grandparents making too much money, child is not eligible under grandparents coverage due to not being their child, insurance companies refusing to cover child individually.”

There’s also people who have problems due to preexisiting conditions, for example.

So how would those people be affected?

5

Europeans see healthcare as “public policy” like police and fire protection or education. The taxpayer pays for it whether or not they ever need it.

If you get medicare when you’re 65 how long is it gonna be before you die? A few decades at most.

If you got a similar coverage when you were 18 and working at a low wage job and didn’t have the skills to get a better job, the governement would be paying for your medical insurance for 50 years or better.

Much more.

I’ve worked in H/R and one of the biggest cost is health insurance. Do you really think an employer is going to offer health insurance if he can say, “Use the government.” Of course he won’t

What you’ll get is a two tiered system where, executives and other hard to fill positions will get private insurance, but the average working “Joe,” now getting health insurance will get dumped on to the government plan.

Finally the government is horrible at running things. Look at Social Security, people apply who SHOULD get it. They get denied and hire lawyers who get it for them. Now this show an entire specialty of lawyers has grown up around SS denying legitimate claims.

If they can’t handle SS, how can the government handle massive healthcare.

Now I wouldn’t mind if it were just for uninsured people, but again, employers will simply dump all the low level employees off their insurance and offer it.

I suppose you could pass a law saying all people in a company must be offered the same insurance. But that is easily gotten around.

Last big company I worked for offered two HMO plans (Humana and Unicare) and a third plan that was a basic old fashioned 20/80 plan, where you saw anyone and it covered anything but you paid the first $100, then 20% till $2,000/year then everything was covered at 100%.

It was darn good insuarnce, EXCEPT it was $250.00 a paycheck. This compared to the two HMO plans which were $20.00/paycheck or $15/paycheck.

So what does this mean. It means even if you pass a law saying everyone in a company must be offered the same insurance, the company will simply say, you get the cheapo government plan or the good plan at $250/paycheck.

Thus you’re right back where you started from, companies will bump up salaries of execs and hard to fill positions by $6500/year and this will allow them to purchase the non-government plan at no cost to them.

So this is the issue, businesses will dump their employees except for the hard to fill jobs to the government who will be easily overwelhmed by the numbers

This leaves out the arguments that the voters will be able to dictate, health of people on this insurance, by voting Conservative or Liberal members into office.

Suppose Mr Obama get’s his plan passed and the economy doesn’t pick up. If you can’t get it going in six months, there’s a good chance the Congress make up will change.

Now in Illinois we have a thing where all children under 18 can get healtcare. Many parents are using loopholes to stop coverage on their own policies and get health insurance through the state, as it’s cheaper

This is not suppose to happen but it happens constantly and very easily done because no one is going to say “Don’t give health insurance to children under 18”

You can’t blame them either as it’s not their fault parents would rather buy cell phone or computers than pay for insurance.

Now I don’t have any insurance so I’m for it, as it’s better than nothing, but you have to figure out how you can stop abuses. If you can’t put plans into effect that will prevent this, there’s no point going on.

6

Keep in mind that there’s a big racist element to the opposition. For a large group of Americans, when they think about Medicare, they think of a nice old white lady who needs some pills to keep going. When they think about “Obamacare”, they think about lazy young black men getting gold teeth and illegal Mexicans wasting money on their dirty Mexican diseases. That’s not an opinion or debate, that’s just what these people are thinking. Unfortunately, the large corporations that make billions of dollars under the status quo can easily use some of that money to whip up and amplify these crazies so that their ignorant fears become the conventional wisdom.

Sadly, the answer to any question in the form “why do Americans do X?”, where X is something patently absurd, is “overrepresentation of idiocy and wealth”.

7

These two statements are mutually exclusive.

8

It’s certainly not a fact, either in the manner you’ve presented, as it can’t be proven either way.

I think much better points have been made above, and until I hear a very good argument I’ll lean toward being against it, as any government operation ends up having its rules made by people with no idea of the issues. Try truly understanding California’s gun laws some time. It’s clear that the state legislature just threw together a series of statements and passed them so they could say they did something about gun violence. There’s no coherence or logic to most of them.

I just don’t trust the government to almost anything right.

9

1.) Yes it is.
2.) To the best of my understanding, Medicare is not different than (some of) the European universal systems.

American health insurance is built around an employer provided model. When people retire, they (by definition) no longer have employers. Thus post employment insurance was always in limbo and Medicare filled that gap. Pre retirement, many Americans (most of those who have insurance?) have health insurance through their employer, who in turn purchases from whatever private insurers operate in their area.

There are several ways in which the proposed reforms would alter this system:

1.) A public option would allow employers (and individuals) to buy into a medicare type program at any age, thus competing with private plans in an market where private plans have traditionally operated without government competition.

The scare about the public option is, in my opinion, fundamentally the result of confusion. The government is already managing the health care of children, poor people, and old people to varying degrees and a public option is more a change of extent and degree than kind.

Confounded with this issue in many people’s minds are
2.) A mandate that punishes people who do not buy insurance.
3.) Subsidies for those who, by some criteria, can not afford to buy insurance.

Those point are, conceptually, entirely separate. One could have a public option absent the mandate and subsidies, and one could have a mandate and subsidies absent a public option. Points 2 and 3 are aimed at ensuring universal coverage, point 1 is intended to control costs.

10

Then why are insurance companies afraid they cannot compete with such incompetence? Won’t the market flock to the provider who gives them good service?

11

the government can always fund its incompetence through taxes, a luxury not available to private firms

12

As a health care consultant I see Medicare as the most efficient payer across the board. Yet it is run by the government. Claims are paid in a timely manner, submitted electronically and payment is received electronically directly into the provider’s bank account.

Also, most of the HMO/POS plans are based on a percentage of Medicare and often the percentage isn’t more than 100%. More like 80% or 90%.

I’d take a Medicare like system to that of a privately run HMO any day.

13

Not under Obama’s plan, they can’t. One might as well worry about UPS and FedEx going out of business, because the post office could be funded through taxes.

14

But why would the market keep using a public insurance program if it delays treatment for months, denies coverage of needed care, and conspires to kill old people? Can’t the insurance companies do better than that? And if so, why won’t the market choose better service in the private insurance market, instead of the lousy service we are told is the best we can expect from another incompetent government bureaucracy?

15

First the public program – which doesn’t need to turn a profit – delivers well enough to put the other companies out of business. Then it’s free to suck.

16

Good point. If the public option turns out to be so terrible, people would prefer to choose the private insurers over the public option. Even if this results in the government supporting the public option via extra tax money, they would be still be losing customers due to their lousy service. Then the public option would be flush with money…but it wouldn’t be doling it out to doctors/hospitals if no one is signed up for the public option. So how does the government channeling money to a service no one uses harm the private insurers?

17

Medicare is not free to those who have to use it. It costs me 97 bucks a month. This coming out of a check that now only leaves me with about 1600 bucks to live on per month. (With which I have to pay rent, car insurance, food, utilities, etc.)

Medicare, unlike private insurance, does not pay 100% after the deductible is paid. You always pay 20% of costs of things they cover. There are many things not covered – there is no dental, eye care, and a few other things I can’t think of offhand.

It’s better than no insurance, but certainly not better than private insurance.

You may pay more for private insurance, but you get more. Prescription coverage is almost always part and parcel of your plan – in Medicare, you have to pay extra and there are not that many medications that seem to fall into the list of approved meds. I can’t afford the premium for the prescription coverage as it’s more than what my everyday meds costs (lucky me) but if I get sick, I have to hope that the meds my dr prescribes are on the $4 list from Target.

I’ve been lucky that I’ve been able to get into my doctors when I’ve needed them, but their hands are tied in what they can do for me. There’s a lot of stuff that my old insurance would have covered w/no problem that aren’t covered under Medicare.

I think if more people understood Medicare, they’d not be quite as keen for an expansion. I know before I was on it I didn’t understand how it worked and had a complete misinterpretation of how much it actually covered, etc.

18

But we have been told that government is incapable of anything but suckitude, no matter how much they spend. So what are they afraid of?

19

Yes. Medicare is a single payer system funded by a 2.9% tax split 50/50 between employers and employees. You pay your whole life, and when you turn 65 you can collect medicare. It is no different than the system in a nation like Canada. It is a single payer system funded by payroll taxes. Medicare also has premiums for the elderly, and people also buy supplemental insurance.

Its not different than the systems in other nations, and is in fact more of a socialist program than some nations in Europe have, which involve private plans.

This part makes me sad. I know you don’t want politics, but you honestly have to understand how enamored of stupidity we are in the US. Being poorly informed and hypocritical is not something to be ashamed of here, nor is it something our media will call you out on. The emperor literally has no clothes here, and nobody says anything.

To answer your question (it is actually worse than you know) many of the people screaming the loudest against government run healthcare are already over 65 and are already on medicare. So no, the people protesting ‘government run health care’ are not going to eventually get medicare. Many of them are already on medicare and are so poorly informed that they don’t even understand that medicare is a government program.

If you go on youtube and look at some of the protesters, several are over 65. One man who had his finger bitten off while protesting government healthcare went to the emergency room and got medicare to pay for his treatment. Another 67 year old man gave a long winded speech about the evils of government programs despite him collecting medicare and social security.

I know you don’t want politics, but until you understand that being poorly informed and blatantly hypocritical is not unacceptable in US politics, this stuff is going to be extremely confusing. Many of the people shouting the loudest against government run health care (republican politicians, white voters over age 65) already collect government run health care.

For example, in the US many of the people who share the views that ‘government run health care is evil’ get their news from talk radio and Fox News. The median age of viewership for these 2 programs is 67 and 65 respectively.

Obamacare is not an expansion of medicare.
The bill to expand medicare to everyone is called HR 676, medicare for all.

http://www.healthcare-now.org/hr-676/
What Obama is proposing is this:

Eliminate private insurance lifetime caps (so you can’t only collect 2-5 million in benefits)
Limit annual out of pocket expenses to 5k per person or about 10k per family
End pre-existing condition exclusions (in the US, if you have gotten sick in the past it is hard to buy health insurance on the private market)
Various cost controls

And a health insurance exchange where private and a public plan compete for membership.

20

I go to a clinic for health care. They take Medicare at 100 percent. I have not paid a dime in the 1 1/2 years I have been on it.
The government also runs the V.A., which takes care of veterans .