July 16, 2021

Week of Action: Expand Medicare!

29 minutes

Congress has an opportunity to make real steps towards Medicare for All this week. We go over the 4 proposed reforms that would expand Medicare, what’s at play and what’s at stake, the opposition to Medicare Expansion – if you can believe it – there IS opposition to giving seniors dental care – and what you can do to help pressure our legislators to fight!

Show Notes

Ben in Boston and international correspondent Stephanie in Denmark discuss the proposal to substantially expand and improve Medicare that’s moving through Congress right now.

As part of the negotiations around the American Families Plan, there are four demands:

Lower the eligibility age for Medicare from 65 to 60, which would add 23 million people to Medicare coverage. (Lowering to 50 would add 60 million people, and lowering it to zero would be even better, but reducing it by just five years would be a huge victory, lowering overall healthcare spending in the U.S. and lowering employer healthcare spending by almost 15%. This will be the hardest of the four demands to achieve, but the one that would affect the most Americans.

Add hearing, dental, and vision to Medicare, improving the program for existing Medicare beneficiaries, a huge number of whom are going without needed care. Of Medicare recipients, 75% who need a hearing aid don’t have one, 70% haven’t gone to the dentist in the last year, and 50% didn’t get an eye exam.

Create a cap on out-of-pocket costs. Most health insurance has a cap on out-of-pocket expenses, but traditional Medicare doesn’t. This is wonky and less exciting for politicians because while it will save a lot of people a lot of money, it’s not as tangible a benefit as adding hearing, dental, and vision.

Allow Medicare to negotiate drug prices. Medicare has been prohibited by law from negotiating drug prices for decades, forcing Americans to pay up to triple what other nations pay for the same pharmaceuticals. Negotiating with the pharmaceutical industry would save Medicare up to $450 billion over ten years, paying for all of the above expansions.

Calls for expansion are building not just from the grassroots from within Congress. Letters from members of the House and the Senate (signed by many Democrats including centrists who aren’t traditional Medicare for All supporters) have already been sent to President Biden, pressuring him to include expansion in the American Families Plan.

Calls for expansion are coming from inside Congress! (Image description: surprised looking cat, with caption “the call is coming from inside the house!!!”)

We have some (very cynical) theories about these odd bedfellows:

The centrist Democrats who signed on aren’t deeply in the pocket of the healthcare industry, but they are avoiding Medicare for All because they perceive it as a liability in their district.

They are in the pocket of one particular branch of the healthcare industry (but not pharma); they think it could help hospitals or insurance companies.

They are signing the letter but don’t think it will pass, and are happy to throw these provisions under the bus behind closed doors.

All of the Above

These expansion reforms both bring us closer to Medicare for All, and help us divide and conquer the healthcare industry; this proposal takes on Big Pharma, but mostly leaves the insurance and hospital industries alone. But is it working?

Currently the opposition to expanding and improving Medicare is coming from the usual suspects, under the umbrella of the Partnership for America’s Health Care Future, the evil transformer of insurers, pharma giants, and hospitals. They’ve even managed to find (some really bad) ways to argue against giving dental care to seniors.

Dental coverage wasn’t even a thing in 1965 when Medicare was passed, so seniors don’t need it!

38% of Medicare beneficiaries already receive dental coverage through (privately administered, for-profit) Medicare Advantage, so the rest don’t really need it! (Turns out that coverage isn’t very good; according to a New York Times article 43% of those with Medicare Advantage dental plans have annual caps on coverage of only around $1,000.)

Call to Action: Most of the fight for these proposals will be in the Senate. There are only 50 Democrats in the Senate, so all the opposition has to do is knock off one Democrat who is in the pocket of Big Pharma. So the call to action is to contact your Senators.

Call your U.S. Senators: 202-224-3121 (Capitol switchboard will be put you through to your Senators)

If you are between the ages of 50 and 65, write a letter to the editor or OpEd of your local paper about what it would mean to you to have these benefits, and asking your Senators to sign on. Those closest to Medicare age are the most affected and the most in need of these reforms. Your voice is particularly powerful if you’re in this age range.

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By Benjamin Day and Gillian Mason - Healthcare-NOW

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