In the midst of Bernie Sanders' push for Medicare for All and in the wake of President Trump's Oct. 3 Executive order on Medicare, there is undeniable agreement between the two indicating that health care for NEEDED medical expenses is going to be more out of reach and unattainable to consumers resulting in sacrificing the physical and financial health of consumers facing illness or accident.
Both Donald Trump and Bernie Sanders preserve the most problematic barriers to consumer needed health care, including the disparity between health care access based on wealth, the gross disparity between lawmakers' creation of government payer provision of health care services for consumers and those they make for themselves, unaffordable drugs, and catering to the insurance lobby.
This isn't about "getting" insurance, it's about policies and provisions designed to save payers money, whether private insurers or government that continue the trend of jeopardizing consumer financial and physical survival in the event of illness or accident.
The documents discussed here are President Trump's Oct. 3, 2019 "Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors" https://www.whitehouse.gov/presidential-actions/executive-order-protecting-improving-medicare-nations-seniors/ and Bernie Sanders' Medicare for All Act of 2019, https://www.congress.gov/bill/116th-congress/senate-bill/1129/text.
1. Disparity Between Rich and Poor Health Care PRESERVED:
Yes, if you're rich you get better access to and quality of health care services and both Sanders and Trump preserve and promote that disparity.
Trump's Executive Order and its push for Medicare Advantage plans makes this crystal clear, singing the praises of those plans as if consumers aren't aware of and-or haven't experienced the well-publicized failures of such plans.
Trump ignores the facts of Medicare Advantage plans, as Investopedia explains: "You will find that most have unexpected out-of-pocket expenses when you get sick and only want you as a customer when you’re healthy." And, "Since Medicare Advantage plans can’t cherry-pick their customers (they must accept any Medicare-eligible enrollee), they discourage people who are sick by the way they structure their co-pays and deductibles." https://www.investopedia.com/articles/personal-finance/010816/pitfalls-medicare-advantage-plans.asp.
By design, Medicare for All penalizes those in NEED of medical care and therefore health insurance with higher and likely unaffordable out-of-pocket expenses as well as higher copays and deductibles.
Bernie Sanders' supports this disparity in rich and poor health care in his bill. Sanders' bill provides under Sec. 303, USE OF PRIVATE CONTRACTS:
"Subject to the provisions of this subsection, nothing in this Act shall prohibit an institutional or individual provider from entering into a private contract with an enrolled individual for any item or service—
(1) for which no claim for payment is to be submitted under this Act; and
(2) for which the provider receives—
(A) no reimbursement under this Act directly or on a capitated basis; and
(B) receives no amount for such item or service from an organization which receives reimbursement for such items or service under this Act directly or on a capitated basis."
That's right, any individual can enter a contract with any provider for care, as long as the provider AND patient agree not to seek reimbursement from the government. Rich people can buy better care through contract.
2. Taxpayer Funded Superior Benefits to Federal Public Employees PRESERVED:
Lawmakers exempt themselves from having skin in the game when it comes to the risks the rest of us face from bad health insurance and Democrat or Republican, they're committed to preserving their own superior benefits.
President Trump and Bernie Sanders again agree on this taxpayer funded gift and entitlement to public federal employees.
President Trump doesn't even address reducing taxpayer funding of superior benefits for public employees including Congress including retirement benefits in his Executive Order. Those public employees won't be stuck with Trump's ideas for Medicare.
Bernie Sanders agrees. If you go to Sec. 701, Universal Medicare Trust Fund, (b) Appropriations into Trust Fund, (2) Current Program Receipts you'll find:
"There are hereby appropriated to the Trust Fund for each fiscal year, beginning with the first fiscal year beginning on or after the effective date of benefits under section 106, the amounts that would otherwise have been appropriated to carry out the following programs:
(C) The Federal employees health benefit program, under chapter 89 of title 5, United States Code."
Sounds like it's all going into the Medicare Trust Fund four years after the passage of the Act which would be OK if we didn't already know the game of calling the federal government an "employer" opening the opportunity for public employees to spend taxpayer dollars on their superior benefits effectively exempting them from the law applied to the rest of us. Here, too, recall the health contract provisions allowing sky's the limit coverage as long as you say the benefits don't duplicate Medicare for All and that you'll pay for them, again, we're the ones who will pay for Congress.
3. Prescription Drug UNAFFORDABILITY Preserved
Again, in his Executive Order, President Trump does not address big pharma and its prices.
Bernie Sanders uses more words to also preserve big pharma's chokehold on us: Under Section 614: Payments for Prescription Drugs and approved devices and equipment: (a) Negotiated prices.—The prices to be paid for covered pharmaceuticals, medical supplies, and medically necessary assistive equipment shall be negotiated annually by the Secretary."
NOTE "Prices paid for COVERED pharmaceuticals…" That's right, the ever -shrinking formulary game whereby drugs covered are often omitted from insurance company lists leaving patients in the catastrophic position of being unable to afford whatever-the-market-will-bear drug prices is preserved by Sanders.
4. Insurance Company Leverage Preserved
President Trump really missed the mark on this one, showing the Republican and Democratic alignment in catering to the insurance lobby. This includes the President's push "…to provide beneficiaries with more diverse and affordable plan choices," including "(i) encourage innovative MA benefit structures and plan designs, including through changes in regulations and guidance that reduce barriers to obtaining Medicare Medical Savings Accounts and that promote innovations in supplemental benefits and telehealth services."
These are insurance industry gimmicks designed to get more money from consumers while providing less. Consider each. Medicare Medical Savings Accounts are the Medicare twist on Health Savings Accounts, the atrocity that forced consumers unable to pay for high premiums to settle for high deductible health plans with the lure of being able to put a few thousand pre-tax dollars into a "savings account."
"Atrocity" because they've always been known as healthy-wealthy plans, only valuable if you aren't in medical need or you're rich enough to use the pre-tax savings as a tax shelter or use your wealth to pay for your needed medical services.
Further, these high deductible health insurance plans with savings accounts save administrative costs for insurance companies which pay less in administrative costs as insureds use up their "savings" for authorized medical expenses.
Next, the President's push for supplemental benefits, is another nod to insurance companies that exploit their ability to cover less and then create and sell supplemental plans and charge consumers to cover stuff that they didn't cover to begin with.
You'll see this with specialty supplemental plans like cancer insurance or in Medicare Part whatever to cover services. Medicare Part C, the Medicare Advantage plans often combine Part A and Part B coverage, but for drugs, Part D, again patients find that such coverage is an additional purchase.
Finally the push for telehealth services. I'll leave room for people who like such services for counseling or maybe a prescription call in, but in my experience telehealth is simply a means of insurance companies charging people to get the advice to go to an emergency room, a provider in person or some other brick and mortar service that they'll also pay for and amounts to a double-dip system for providers.
Bernie Sanders IS NOT getting rid of private insurance companies. That one should be repeated, private insurance companies will be fine under Medicare For All. Sanders has the supplemental insurance carve-out for insurers and like Trump, he's pushing the supplemental insurance market big-time.
Basic Medicare for All and its "minimum" coverage is going to increase the opportunities for the insurance industry to create and sell all kinds of supplemental plans. Similar to Obamacare, as Medicare for All covers low-cost preventive checkup style stuff, while NOT covering needed health care in an effective way, supplemental policies and the unregulated, unlimited charges for such policies is an insurance lobby friendly anti-consumer Sanders inclusion.
Sanders' bill states in Sec. 107, "Prohibition against duplicating coverage.
(a) In general.—Beginning on the effective date described in section 106(a), it shall be unlawful for—
(1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or
(2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act."
In case you are still confused, Sanders clarifies: "Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, including additional benefits that an employer may provide to employees or their dependents, or to former employees or their dependents."
Sanders' "employer" language also protects the superior public employee taxpayer funded benefits, just like Congress exempted itself from the Obamacare the rest of us had to live with by characterizing the federal government as their employer and therefore their employer, the federal government provided superior benefits, ignoring the obvious that they're creating the benefits for themselves using OUR money.
If you're tired of politicians fighting, just read the health policies of both parties and sadly, you'll realize that sometimes agreement is more dangerous to the populace than disagreement and the health industrial complex is one example of those times.
