This essay was written by Arthur C. Donart, Ph. D.
Most people are aware that medical care is expensive. Health Insurance also is expensive. Health Insurance is “pre-paid” medical care. If you don’t use it this year, you may need it next year. It is risk sharing. No one knows ahead of time who will come down with cancer or some other dreaded disease. So, no one wants to be without some health care protection. Most people rely on some form of employer-provided health insurance. If they are dirt poor, they may be covered by Medicaid.
Left out are the people with too much income to qualify for Medicaid, but who don’t have enough income to afford health insurance. They may be working two or three part-time jobs that provide no benefits.
This is a real dilemma for them. Recently, I took my wife to the Emergency Room, because she was experiencing a lot of pain. We arrived there at 8:00 p.m., and by midnight she was released with some medication and instructions. The Nurses and Doctors were excellent. She had a CAT scan and other tests. The shock came, when I received the bill properly itemized: only $26,996!
Thank God and the brave Democrats who fought for and got Medicare passed back in 1965! I remember what a battle it was. It was labeled “Socialized Medicine,” and it was dubbed a “Communist p[lot],” etc. Now, some 56 years later, many people take Medicare for granted.
But Medicare doesn’t take care of everything, nor does it pay for all Doctor and hospital costs. Medicare pays only 80% of the cost. That leaves $5399 of the wife’s bill to be paid by the insurance company, minus her co-payment of $120. Now, Medicare does not pay what is “charged,” it pays “actual cost plus 10%.” So, there was an INSURANCE adjustment of $25,764. That means the actual cost was $1234. Medicare paid $986 dollars. We paid $120, and the insurance company paid about $130. (The insurance premium is $140 a month.)
What happens if you have no insurance? Then cough up $26,996. Of course, being “not enough poor,” but “too poor” to come up with $26,000 bucks, you have to choose between
• making a payment plan
• having your wages garnished–which gets you fired from a job
• filing for bankruptcy–which you can do only once every seven years.
On top of that, your inability to pay up is reported to Credit Agencies, which means that
• you would have to pay higher interest on a car loan.
• you probably couldn’t get a loan to buy a home;
• even if you could get a loan, it would be at a higher interest rate.
Very few people can work their way out of poverty. The deck is stacked against them. This is not the America we brag about. This describes systemic injustice.
Enacting Enhanced Medicare for All into law would go a long way to leveling the playing field. It would be a great assist for farmers and small businesses.
With Primary Elections coming up, make those seeking their party’s nomination state where they stand on Medicare for All. This is our chance to help level the economic playing field.