Q&A: Should We All Have Medicare?

Robert Hayes runs the Medicare Rights Center, an advocacy group for people on Medicare.

We asked him five questions about expanding Medicare to all Americans.

1. You believe in Medicare for All. What exactly does that mean?

We work to ensure that all Americans have access to good, affordable health care coverage. Under our plan, people could keep the private insurance they have if they like. Alternatively, they could buy affordable coverage through a public purchaser, like Medicare, that allows them to use doctors and hospitals anywhere in America. As we know from Medicare, a large public purchaser can use its market leverage to offer a standard set of benefits at an affordable cost to all Americans. If everyone had this choice, the cost of coverage would come down for everyone.

2. Why do you believe Medicare is a good model for providing health insurance to all Americans?

First, only a large public purchaser can guarantee that all Americans have health care coverage. History shows that private insurers cannot do this. Second, a large public purchaser can negotiate far lower prices for health care services than any single insurer. Since a public purchaser is not profit driven, it can also deliver more services for the money it spends on health care. Medicare is a good example of how public purchasing guarantees people health security and gives them the choice of the private doctors and private hospitals they want. Any worry about Medicare's financial viability evaporates if everyone is contributing to health care coverage.

3. Isn't Medicare for All a backdoor way to socialized medicine?

No. A health care option like Medicare is a public-private solution. Health care is delivered by private doctors, hospitals and other providers across America. We know that collectively, individuals will always do better at purchasing, no matter what the product, than individuals on their own. Giving people the choice of health insurance through for-profit companies or through a public-private solution should bring out the best of both options.

4. We hear doctors routinely complain that Medicare simply doesn't pay enough and that private insurance basically subsidizes Medicare patients. Wouldn't payments have to increase substantially for a Medicare for All scheme to work?

No. Medicare is the nation's most effective and efficient payer of health care -- that's why 99 percent of doctors in the country accept it for delivering health care. Payment denials and delays by private health insurers today have forced health care providers to spend an ever-increasing amount of money on administrative staff to collect reimbursements.

5. You would basically be putting health insurance companies out of business. Is that realistic?

Our plan would offer the American people a public-private option for health care coverage, but it would not put insurance companies out of business. People should have the choice of private insurance or a public-private solution like Medicare. It is true that a public-private model would force private insurers to offer better coverage at lower prices; the companies would face more competition. But more choices for the American people serve the public interest.

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