A Senior on Medicare Responds to President Trump
Medicare is a decent program with a lot of room for improvement—which is exactly what Medicare For All does.
The Hudsons

This week President Trump put out an op-ed calling Medicare for All a “threat to seniors” that would “end Medicare as we know it and take away benefits that seniors have paid for their entire lives.” I’ve been watching conservatives try to scare seniors into opposing good reforms my whole adult life, and now that I am a senior (a year older than Mr. Trump), I find the tactic even more offensive. The truth is that Medicare is a decent program, but it has a lot of room for improvement—which is exactly what Medicare For All does.

I have been on Medicare for eight years. In addition to Part A, which everyone is automatically enrolled in at age 65, I am enrolled in Part B (which is also automatic unless you intentionally opt out). Part B requires that I pay a premium, which is deducted from my Social Security benefits. Beyond this coverage, I also purchase supplemental insurance through a private insurance company to help with costs not covered by Parts A and B, as well as separate prescription drug coverage (Medicare Part D), also through a private insurance company.

This hybrid system is complicated, and my wife and I struggled to decide what private coverages to choose and what company, or companies, to get them from. But for the most part I now go to a medical provider and everything is paid for, with the exception of occasional co-pays for prescriptions.

Did I say “everything is paid for?” Sorry about that. If I want to go to the dentist, I have to pay out of pocket or choose to pay a premium for dental insurance (my wife does this, I don’t) to mitigate some of the cost. In my case, I haven’t been to a dentist in at least five years. Under Medicare For All dental work would be covered, and I could get my teeth checked without worrying about the cost of exams, x-rays, and any necessary work.

I also wear glasses. Medicare will pay for one eye exam per year, but not for glasses. My wife went to a commercial eyewear place and got her exam there. If the provider had accepted Medicare, the exam would have been free, but they didn’t. Instead she submitted paperwork to get reimbursed, and Medicare sent her a check for an approved amount. However this amount was far less than what she paid for the exam, so the difference between what she paid the eyewear place and what she was reimbursed by Medicare became, in essence, a significant co-pay. We’re certainly glad to not pay full price, but Medicare For All would have let us pay nothing.

What does all this cost us? In addition to whatever portion of our federal taxes that goes to support Medicare, here’s a breakdown of the premiums we pay in 2018 for the things mentioned so far:

  • Medicare Part A -- $0 out of pocket for either of us
  • Medicare Part B -- $134.00/month for me
  • Medicare Part B -- $108.00/month for my wife
  • Private supplemental medical coverage -- $274.25/per month for me
  • Private supplemental medical coverage -- $215.64/month for my wife
  • Prescription coverage -- $20.40/month for me
  • Prescription coverage -- $74.80/month for my wife

Do the math. That’s $827.09 per month or $9,925.08 total in 2018, not counting prescription and dental co-pays, the non-reimbursable portion of the eye exam, and any other out of pocket expenses, such as the cost of glasses.

People who have different private supplemental insurance plans might have lower premiums than we do, but might incur expenses for deductibles and co-pays that we don’t because of the plans we chose.

In spite of this, Medicare is far superior to any private insurance I ever had. At least I know I cannot be denied coverage for anything, which was a major concern before the Affordable Care Act, and is becoming a concern again as Republicans try to undo aspects of the law. It is also less expensive than the cost of insurance in the five to 10 years that preceded my eligibility for Medicare.

But what I really wish is that I didn’t have to think or worry about any of this. I wish I could just pay my taxes and then go to the doctor, the dentist, the optometrist, the pharmacy and leave having been taken care of without paying anything out of pocket. Well, okay, if I want some fancy frames for my glasses I guess I should be willing to pay extra. Maybe if I want to have the dentist do a whitening treatment on my teeth, I should pay extra for that, too. You get the idea.

And every study shows that I could get my wish for far less in taxes than the $9,925.08/year (plus uncovered expenses) it costs us now. So count me in as a supporter of Medicare for All.

Rob Hudson is retired and lives in St. Louis, Missouri.