TOM PURCELL: Here's hoping Medicare is around in five years - Insurance News | InsuranceNewsNet

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April 11, 2023 Newswires
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TOM PURCELL: Here's hoping Medicare is around in five years

Rockdale Citizen, The (Conyers, GA)

I will qualify for Medicare coverage in five years and, much to my surprise, I can't wait to get government health coverage — because my current coverage is pricey. I recently finished a consulting assignment, which provided me full health benefits. To maintain my health insurance policy through Cobra, I must pay $750 a month.

I also have to cover the first $3,300 of costs before full coverage kicks in. That means that if I go to the hospital with a bad flu — which I did for the first time in my life recently — I'll receive a giant bill to pay for my deductible.

My total health care costs for the year, give or take, would be $13,000 — almost $1,100 per month. Considering my current costs, Medicare coverage is a bargain.

Medicare became law in 1965 and is now offered in four parts to Americans over the age of 65:

— Medicare Part A covers inpatient hospital care, skilled nursing facility care, hospice care and some home health care. Most people do not pay a premium for Part A, as they paid into the program for years as taxpayers.

— Medicare Part B covers doctor visits, outpatient services, preventive care and some medical equipment. The standard monthly premium for Part B in 2021 was $148.50, but higher-income earners may pay more.

— Medicare Part C, also known as Medicare Advantage, is an alternative offered by private insurers to supplement A and B with additional benefits.

— Medicare Part D helps pay for the cost of prescription drugs. Its average cost in 2021 was about $33 a month.

Medicare sounds almost too good to be true, which brings us to its greatest challenge: How do we pay for it as America ages and millions more begin receiving benefits?

Initially, there were many more people paying into the fund than using it — five people paid in versus one person who received benefits — but with baby boomers retiring in big numbers, that is no longer the case.

When Medicare began in 1965, Americans 65 and older made up only 10% of the population. Today, Americans over the age of 65 account for about 17% of the U.S. population.

Here's another worrisome detail: Medicare payroll taxes are only paying for about 62% of the program's annual $800 billion-plus cost. The balance is paid for from the general U.S. cash register — which is running a trillion and a half short every year. The way things are going, the Medicare fund is on track to run a $1 trillion annual shortfall in only 10 years.

The Biden administration is mostly offering a typical non-solution to Medicare's financial challenges: tax the rich. But taxes alone will not solve this challenge. Comprehensive reform is the only solution.

The solution requires a thoughtful, bipartisan approach and will likely include some pain, such as cutting some benefits and extending the age of eligibility from 65 to 67 or so.

Will our politicians summon the courage to deal with this very real challenge — or will they chase cheap votes by telling elderly Americans the other party is trying to take their health coverage away? I have my worries.

I'm in no hurry to become 65, but the only saving grace I hope 65 will bring is for Medicare to relieve me of the 1,100 bucks a month I currently pay for basic health care.

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