There’s been a lot of talk about Medicare for All in the news lately. But what is it, specifically? Is it a law yet? Will it become law soon? And what does it mean for you and your family? Get the facts about Medicare for All, the pros and the cons, right here in this article.

What is Medicare For All?

The Medicare for All Act was proposed by Senator Bernie Sanders in 2017. The 2020 Democratic Presidential candidate wants to provide one source of health insurance for all Americans so that they can all be provided with care. Millions of Americans are currently not insured which has caused many fatalities that may have been prevented otherwise. Medicare for All has become one of the hottest topics on the news lately, especially with the election drawing near. After much controversy about the Affordable Care Act, also known as Obamacare, politicians, and citizens of America have been searching for a better alternative for health care nationally. This decision will indeed affect everyone, as it will change the way we view health care in this country – and will ultimately change the kind of care we will receive, too.

The coverage that will likely be provided includes:

  1. Hospital services, inpatient and outpatient hospital care, 24/7 emergency services, and inpatient prescription drugs
  2. Ambulatory patient services
  3. Primary and preventive services, including chronic disease management
  4. Prescription drugs, medical devices, and biological products
  5. Mental health and substance abuse treatment services
  6. Laboratory and diagnostic services
  7. Comprehensive reproductive, maternity, and newborn care, including abortion
  8. Pediatrics
  9. Dental health, audiology, and vision services

Medicare For All – Who Want It (The Public Option)

There are two proposals for Medicare for All: a public option, and a single-payer system. The public option includes automatically enrolling all eligible American citizens in health care. Citizens will only be able to opt-out of it if they have private, government-approved health care replacement coverage. Another aspect is the cost of the public option. If you fall below 200% of the poverty line, you will not have to pay additional health care taxes. If you fall above, there will be an income-based annual health care tax. The idea here is to tax those that are in a better financial state because they will be more likely to afford it. Those who are fully funded will be covered by both the Federal government and other taxpayers.

The public option gives citizens the opportunity to choose whether they want universal health care or not instead of forcing it on them. According to current legislation proposals, the public option would function similarly to the way the ACA works now. But critics of the public option point out that letting private, for-profit health insurance companies continue to play such a large role in the healthcare system will likely keep medical costs higher than they need to be.

Medicare For All – Mandated (Single-Payer System)

The latter option for Medicaid for All is the single-payer system. This mandated system would be funded by corporate taxes, marginal taxes from wealthy citizens, and income tax from both state and federal health insurance companies pre-existing. Most out-of-pocket costs are subject to be eliminated with the single-payer system. This proposal will attract many Americans because that means the majority of them will not have to pay directly. Therefore, instead of paying your health care, the federal government will pay the cost to your providers instead.

The Pros of Medicare For All

So why is the topic of Medicare for All controversial? Won’t it benefit everybody? Not necessarily. There are plenty of good reasons to support legislation like Medicare for All – but at the same time, it’s not without its caveats.

Pro #1: More Americans Will Receive Medical Care

The age eligibility for Medicare for All will gradually go from 55 to 0 within a 4-year transition. This transition plan will allow all members to have full coverage. In year two it will go to 45, year three will be 45 years old, and year four everyone residing in America will be eligible for Medicare for All. Yet, during year one, resident children from newborn to eighteen years old can apply to the Universal Medicare Program. This allows for all children to still have access to health care before the transition period is over. The Original Medicare program did not include aid for children and families, unlike Medicaid. So, including people of all ages would be a step in the right direction for the country.

Pro #2: No More Restrictive Medical Networks

Patients get to choose their doctor/hospital providing they are participating in Medicare for All. Similar to indemnity plans, members will be able to have more say in their health care. Having the choice of doctor and hospital can make all the difference in choosing a health plan. For example, someone who has been diagnosed with cancer would want their primary physician to specialize in patients with cancer to ensure they will receive the best care. Medicare for All will include hearing, dental, and vision care (which is not the case currently). This plan will cause fewer issues with insurers, less paperwork, and less time spent on administrative tasks – thereby freeing up more time to treat patients.

Pro #3: Alleviates Health Insurance Burdens for Companies

Medicaid for All will take most of the onus off of employers to provide health insurance for their employees. By doing this, employers will not have to worry about providing their staff with health care and instead focus on bettering their business. Not only that, but many Americans have also admitted to staying at a job they do not like simply for the health benefits in may entail. This causes many working adults to be overstressed and underwhelmed with their careers, leading to unhappy workers. With that being said, it will still be an option for employees to have private health care if they choose to purchase qualifying coverage instead. Additionally, private insurance would only be used as a supplement for services and treatment that are not offered through Medicare for All.

The Cons of Medicare For All

Yes, there are some less-than-positive sides to a Medicare for All system. And all American citizens should educate themselves as to what they are before this proposed legislation comes up for a vote in Congress.

Con #1: Some Out-of-Pocket Costs Will Remain

The Medicare Single-Payer System proposed by Senator Bernie Sanders still includes co-pays for things like brand-name prescription drugs. Although it may be an improvement from ACA, any kind of co-payment tends to deter customers away from a plan. Depending on a patient’s condition, co-payments can start to add up in the long run. Increasing access will most likely increase costs and it will not be the same for everyone.

Con #2: Some New/Increased Taxes Will Be Necessary to Pay for Medicare for All

Another negative aspect of this plan is that the public will pay for this health care through taxes. Taxpayers in higher income brackets will feel the cost of this plan the most as they will be paying for it alongside the government. In 2018, health care costs in the U.S. were nearly $3.6 trillion. The projected amount of money likely to be spent throughout the next decade is $45 trillion. The common misconception is that the single-payer system will eliminate the costs of healthcare; but in reality, it shifts the financial burden away from those who can’t afford it and more toward those who can.

Current local, state, and federal tax revenue programs for Medicare and Medicaid will be redirected into the general fund for Medicare for All. Those funds – along with increased corporate taxes and a nominal annual tax on those in upper-middle-class tax brackets and above – will all contribute towards covering the costs of Medicare for All.

Con #3: The Healthcare System May Be Overburdened (at First)

Automatically enrolling all American citizens into health with the public option may seem like a good idea at first, but some may not want to use this. Some say that putting health care at such a low cost and giving access to everyone will put many providers out of business. It will be more difficult for them to care for very sick patients without immediate funding for it. There has been research done with other nations who participate in the single-payer system in regards to the need for co-payments and it has been found to not negatively affect cost control.

How do I learn more about Medicare For All?

With 27 million (almost 1/10th) of Americans uninsured, it is essential that we find a solution to this problem. It is important that all residents have access to health care. Countries that participate in single-payer health care include Canada, Denmark, Norway, Australia, Taiwan, and Sweden. It might be a good idea to research the different ways they were able to make it work and implement these ideas for ourselves. At the moment, Medicare for All is still just an idea and nothing has been confirmed. To stay updated on the status of Medicare for All and other health care decisions, you should follow the financial state and budget of the government, read/watch the news often, and make sure to keep yourself informed on the government officials who are these decisions.