I'm not sure about you, but I think a patient who paid taxes (or pay premiums for Part B) to get medical coverage after turning 65 certainly has to pay a lot of money for a hospital stay or outpatient hospital services. Both parts actually have very high deductibles, copays and coinsurances (the 20% described above). As a bonus, Medicare won't pay anything if you stay too long in the hospital. Good luck if you end up in a coma...
Based on what we've seen so far, the payment structure can be illustrated in the following chart:
With the chart, it starts to become clear that we don't have one, but two payers: Medicare and you, the patient. Change the names "Medicare Part A" or "Medicare Part B" above with "Blue Cross Blue Shield" and we have the same characteristics as my medical plan (paid for by myself and my employer). I have yet to hear anybody referring to BCBS as a single-payer system.
I'm sure some of you may dispute this point, but I suggest that you perform a keyword search with the terms "single-payer" or "single payer" on the Medicare website. Looking at the results, you'll notice that not once does Medicare refer to itself as a single-payer. In fact, the keyword results show that Medicare is characterized as a multi-payer system! For instance, the results indicate that the payment structure is characterized as a system of "primary" and "secondary" payers.
Don't believe me? Check out this Medicare document.
We know that Medicare doesn't cover all medical expenses. In fact, the program provides a service to U.S. citizens to help cover their entire medical costs by referring them to private medical insurance companies. This plan is known as Medigap.
Here are two examples of "supplemental Medicare insurance":
- "Blue Cross Blue Shield: We offer a choice of seven Medicare Supplement Insurance plans: Plan F, Plan F High Deductible, and Plan G pay the Medicare Part A hospital deductible and coinsurance, the skilled nursing facility coinsurance and foreign travel emergency care. Plan K and Plan L are low-cost, cost-sharing Medicare Supplement Insurance plans that require you to pay a higher percentage of the costs in return for reduced premiums."
- "Medicare Supplemental Insurance: Welcome to MedicareSupplementalInsurance.com where we strive to offer information, helping you receive the best Medicare supplemental insurance policy possible. While every person has different needs we try to outline policies that fit you best. Medicare Supplemental Insurance is a policy provided by private insurance companies that fill the gaps in coverage that your basic Medicare Part A and Medicare Part B do not cover. Parts A and B, while covering close to 80% of your medical bills and expenses certainly do not cover them all."
Given this additional piece of information, we can now define the payment structure of the Medicare program as follows:
I'm sure you'll agree with me that we're getting steadily further away from a single-payer entity.
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