Judith Armatta

Judith Armatta is a lawyer, journalist, and human-rights activist

Why I Don't Support Medicare for All

I’m not sure what is meant by “Medicare for All.” Is it a more popularly accepted name for Single Payer? Or is it really an expansion of Medicare. If it’s an expansion of Medicare, then let’s be clear. Medicare was partially privatized in 2003 by the Medicare Modernization Act (MMA). As a result, private insurance companies are heavily into the Medicare market.

The MMA created a prescription drug program (Part D) – and handed it to private insurers to offer policies and set premiums and reimbursements. If you don’t want to pay the entire cost of prescriptions out of pocket, you have to buy a Part D plan from a private insurer. Reimbursements and premiums vary from company to company.

In the same legislation, Congress opened the door wider for private insurance companies, allowing them to compete with each other and with “Original Medicare” (Parts A – hospitalization - and B – outpatient services, which are managed by the government for a set premium (currently about $104 a month) by offering “Medicare Advantage” plans. These, too, vary in coverage, deductibles, and premiums, so you will have to shop around, an unpleasant task that faces you each year as premiums and coverage change.

It is also possible to buy a Medicare Supplement Plan (aka Medigap), which, for an additional premium, will cover most copays and deductibles. Again, premiums and benefits vary, so one needs to set aside a couple weeks and forego making the grandchildren Halloween costumes and taking walks in the brilliantly colored fall to compare coverage and try to understand it all, i.e. “Should I stick with Original Medicare Parts A & B or choose a Medicare Advantage Plan?” “If the latter, which one among those offered in the private sector is best for me in coverage and cost?” “Do I need a prescription drug plan, as well, and, if so, which company offers the best deal?” “Does it cover my medications and, if so, how much will it pay?” Are we having fun yet?

Well, you’re not done because even if you have all the coverage discussed above, it won’t cover eye exams and glasses, hearing aids, or dental work. You either have to pay for more policies or pay out of pocket, if you can afford it. For those who haven’t faced the need for hearing aids, you will pay $3,000 to $6,000 -- or less if you’re a Costco member (it’s worth the $55 annual fee). It appears that eyes, ears, and teeth are not part of the human body. Who knew?

It has taken me five years to manage a basic understanding of partially privatized Medicare, law degree notwithstanding. And I am probably wrong.

Does the campaign Medicare for All (that requests my signature daily) mean the Medicare we have now? If it does, I’m not signing any petitions.

Caveat: this is not legal advice. It is cri de coeur and a caution.

An interesting article on the subject is Joshua Holland’s “Medicare-for-All Isn’t the Solution for Universal Health Care.” Holland is a contributor to The Nation, a fellow at the Nation Institute, and hosts “Politics and Reality Radio.” https://www.thenation.com/article/medicare-for-all-isnt-the-solution-for-universal-health-care/