The Advisor Asks:

The Advisor Asks:

Can Healthcare Costs Be Improved By Expanding Medicare?

By Mary Johnson, editor, with Carol Bingaman, retired public health and business professional

What would you say if you had the opportunity to sit down with 11 other retirees to debate the future of healthcare in the U.S.?  Last fall I had the opportunity to do just that in a six - week course held by the Osher Lifelong Learning Institute at the University of Virginia.  Working together, the group studied and debated the issues facing our current healthcare system and further debated a proposal for universal healthcare.

There I met Carol Bingaman, a retired professional who worked for the state of Pennsylvania, as well as in the private sector.  At a recent town hall in Staunton, Virginia, Carol, who is now a Virginia resident, presented a copy of the group’s ideas to Senator Tim Kaine (VA) for consideration.  Recently, I asked Carol to share some of her ideas for Medicare and Medicaid.

Mary:  In our debate on the future of healthcare in the U.S. you said that you favor “an evolving universal healthcare system that would leverage systems and services already in place.”  Could you explain?

Carol:  There’s already a considerable investment in government programs that manage and oversee U.S. healthcare.  Both Medicare and Medicaid are proven programs.  Over time and going forward it may be possible to make improvements by possibly combining these two systems where it makes sense.  To save money, our government should look for economies of scale and opportunities to negotiate for better prices.  For example, preventive care, better nutrition, and coordination of care all have the potential to save money and improve health outcomes.

Mary:  Do you believe expanding Medicare to people 55 to 64 would provide better coverage than what most people already have?  How would healthcare change for that group?

Carol:  People who are 55-64 are at the age when they start experiencing serious chronic health conditions like heart disease, diabetes, arthritis, and other expensive illnesses.  Those who are unemployed or “under” employed, and not able to buy adequate coverage, will likely wait until they are really sick or beyond help to seek medical care.  Let’s allow this group to buy into Medicare at a rate that’s affordable without placing an undue burden on Medicare financing.  Removing these “heavy health care users” from the “Obamacare” risk pool should allow health insurance companies to develop more affordable plans geared to the 18-54 age group of healthier people.

Mary:  Would expanding Medicare to the 55 – to - 64 age group save money?  How would you envision paying for this expansion of Medicare?

Carol:  Those allowed to enroll in Medicare early would have to pay premiums, possibly at a higher rate than the 65 and up group.  For example, younger enrollees might pay a 10% premium surcharge until they reach the typical Medicare eligibility age.  Getting this population in early with comprehensive medical care could keep this group healthier longer.  Getting quality medical care early before the major chronic illnesses occur could yield savings and better outcomes down the road.

Mary:  What is the status of the healthcare proposal that your class is working on?

Carol:  My hope is that we find a receptive audience for our proposal.  We know there are better systems in place around the world.  It is shameful that our lawmakers accept a life expectancy that is declining while we have examples of systems that work quite effectively in many other countries.  Using these success stories as a model, we can surely develop an approach that will serve us well.