After a Democratic debate that straddled two days and four hours last week, few issues seemed to have as much staying power with the candidates’ audience and political opponents as health care. A handful of Democrats in the race support the idea of Medicare for all, a prospect that by most accounts would involve the elimination of private health insurance.
Some of the post-debate criticism from Sen. Lindsey Graham (R-South Carolina) was aimed at Democratic candidates’ support for “taking away private healthcare from American citizens,” an allegation that obscured that Medicare for all would replace that coverage with Medicare-style health insurance.
Former Rep. John Delaney, D-Maryland, also opposes Medicare for all and alleged during the debate that the policy would cause hospitals to close because they would be paid at the Medicare rate for every service. PolitiFact and Kaiser Health News determined this claim was false, largely because his statement lacked evidence to back it up. A factchecker also ruled it was false because it remains uncertain that Medicare for all would require all hospitals to be paid at the Medicare rate, and it’s equally uncertain that doing so would put every hospital out of business.
Would eliminating private health insurance have unintended consequences?
Definitely. Economists are split on whether the current health care system is more or less expensive than a potential switch to Medicare for All.
Getting rid of private health insurance would impact the coverage of about 250 million Americans and the employment of those who work in the industry – about half a million people. Eliminating a one-trillion-dollar industry with publicly-traded corporations would also have after-effects. Some of these issues are addressed by prospective Medicare-for-all plans.
But do Americans like their current health care coverage?
A Gallup poll from last year found that 69 percent of Americans rated their health care coverage excellent or good, but only 34 percent gave national health care coverage the same rating. The report also found that Medicare and Medicaid recipients were more likely to like their coverage, with 9 in 10 senior citizens who qualify for Medicare rating both their health care and coverage positively.
Is the cost of health insurance going up?
Yes. Premiums, the amount individuals and families pay for coverage, and deductibles, the amount health insurance companies require to be paid before they start picking up the bill, have both been growing for years.
According to a study from the Kaiser Family Foundation, by 2018, family premiums for employer-covered health insurance had gone up for seven years in a row and increased 55 percent since 2008. Last year, the average family premium was about $19,600, with workers responsible for about $5,500 of that figure on average.
For individual coverage, the average premium is about $6,900, with workers contributing an average of about $1,200.
Deductibles are more common than they used to be, and they’ve more than doubled during the last decade. In 2008, 59 percent of workers had a plan that required a deductible. Last year, 85 percent of workers had a deductible, which was about $1,600 on average.
Does the health care industry negotiate universal prices for services?
No. The health care industry charges vastly different amounts for identical services, and it’s a common experience to not know what you owe until you receive the bill. Medical providers generally don’t disclose the prices they’ve negotiated with insurance companies, leading to huge price differences for the same services across the country and even in individual markets.
A study from the Health Care Cost Institute pinned down some of these stunning price disparities. For example, the median cost of a C-section in Knoxville, Tennessee is $4,556, but in San Francisco, it’s $20,721.
The study also found that prices can vary widely for the same services in a single metro area. For instance, researchers found some providers charged about $24,000 more than others for C-sections in the San Francisco metro area.
Do health insurance companies cover everything they’re required to?
In some cases, no. For instance, Bloomberg reported last month that although insurance companies are required to cover mental health care services, some insurers deny or limit services during a time when suicide and fatal overdose rates are soaring.
Contact Mollie Bryant at 405-990-0988 or bryant@bigiftrue.org. Follow her on Facebook and Twitter.
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