Measuring Coverage for Seniors in Medicare Part A and Estimating the Cost of Making It Universal
Submitted by seachange on Thu, 2010-02-18 02:16.
Michael Birnbaum & Elizabeth M. Patchias, Journal of Health Politics, Policy & Law, February 2010 That Medicare is universal for seniors is widely accepted by leading analysts. But in the context of developing detailed policies that seek to cover as many people as possible, it is inaccurate to make Medicare eligibility sound so simple and inclusive. To estimate the number of seniors without full federal Medicare Part A coverage, we examined data for uninsured seniors, seniors with Medicaid and no Medicare coverage of any kind, seniors with Medicare Part B but without Part A, and seniors bought into Part A by their state Medicaid programs. We found that in 2005, 1.6 million seniors ... Measuring
Close Enough?
At what level do we say that the rate of coverage under a universal program is "close enough"? For Medicare Part A, we've already answered that question. Covering 95 percent of those over age 65 is "close enough," leaving 1.6 million seniors out of the Part A program (primarily hospital care). We now hear from our politicians that the Senate reform bill awaiting approval in the House is "close enough" to universal coverage, cutting the number of uninsured in half, leaving only 25 million without coverage, according to this new RAND report. Many suggest that we abandon the term "single payer" and use "Medicare for All" instead. Universal coverage under single payer means 100 percent - everyone is included automatically, not 95 percent like Medicare Part A. When we choose to use the Medicare rhetoric because it would resonate better with some audiences, we should refer to it as "improved Medicare for All." That's simply code language for replacing Medicare's numerous flawed policies with a bona fide single payer program - a program that removes financial barriers to health care for absolutely everyone. During the health reform dialogue, when someone says, "close enough," you know that person is supporting flawed policies. Jump in immediately, protesting that "close enough" isn't good enough when we have better policies that will get all of us all the way there. - Don McCann, MD, Physicians for a National Health Program