Medicare is popular and it's working. Shouldn’t we expand Medicare coverage to all Americans?

in favor

against

Medicare does well for its elderly and disabled beneficiaries – two of the more challenging populations to cover – so expanding it to the general population should be feasible.

Zetema Panelist In Favor

+6 Good Point

As we saw with the rollout of the Affordable Care Act’s national marketplace, the federal government can’t manage enrollment for 10 million Americans at one time. How could a large, consistently underfunded government agency possibly enroll the 150 million or so people currently insured privately, let alone oversee the ongoing program successfully?

Zetema Panelist Against

Good Point +2

Medicare per-capita costs have grown more slowly than those of private insurers for every year since 2009, so an all-Medicare system clearly would be less costly than our current one.

Zetema Panelist In Favor

+3 Good Point

About 70% of Medicare beneficiaries have a second form of payment (such as supplemental insurance or Medicaid) so comparing Medicare’s reported per-capita costs with those of private plans is misleading.

Zetema Panelist Against

Good Point +2

Medicare gets better (lower) prices from doctors and hospitals, so expanding the program would reduce overall costs. The savings would enable us to afford coverage for all Americans.

Zetema Panelist In Favor

+2 Good Point

It’s appealing to say that Medicare is working, but in fact the Medicare Trustees say that the Medicare Trust Fund will exhaust its reserves by 2028, so it’s not a sustainable model. As with education, a top-down government run system might be able to save some cost, but only at the expense of quality, flexibility, innovation, and access to care.

Zetema Panelist Against

Good Point +3

The largest tax break in the entire federal budget is for employer-sponsored health insurance, so moving everyone to Medicare would free up funds from that deduction to provide care for all.

Zetema Panelist In Favor

+3 Good Point

Medicare is funded primarily by tax revenues, and Americans have little appetite for the large tax increases that would be required for expansion. A major Medicare expansion almost certainly would be underfunded, leading to rationing of care.

Zetema Panelist Against

Good Point +2

Expanding Medicare to everyone would greatly reduce complexity and bureaucracy around enrollment, coverage, benefits, provider networks, and many other issues that now are confusing.

Zetema Panelist In Favor

+2 Good Point

Isn’t the IRS complex and bureaucratic? Government is less efficient and less flexible that the private sector in managing large programs, and is more influenced by political forces. If all coverage went through Medicare we’d see less innovation and far more political influence, little of which would benefit patients or taxpayers.

Zetema Panelist Against

Good Point +2

Having all Americans in the same healthcare plan would eliminate concerns about adverse selection, underwriting for pre-existing conditions, non-paying patients, and unequal funding for people with different incomes.

Zetema Panelist In Favor

+2 Good Point

Most employees with employer-sponsored health insurance like their plans, and many would object to being forced to change to a single government program. America is not a one-size-fits-all society.

Zetema Panelist Against

Good Point +2

What do you think?