One More Reason for Medicare for All

This morning, I went to my normal clinic for my "Welcome to Medicare" physical. Now, my old health insurance didn't pay for such thing, and the last physical I had cost me over $600 out of pocket. Medicare pays for this initial physical exam completely. My supplemental insurance won't be charged. By the time everything is done, here are the elements of the physical. Items marked with an asterisk (*) were done today. The rest are scheduled for later dates:


*Smoking Cessation Counseling
*A Complete Medical History
*Questionaire designed to spot depression, anxiety, and other issues
*Questionaire about living situation and risks
*Listing of all medications, including OTC products, with counseling where needed
*Typical Complete Manual General Physical Exam
*Electrocardiogram (mainly to establish a baseline, but also to spot any existing problems)
*Manual Prostate Exam (PSA test in the lab tests)
*Instant occult blood check on a fecal sample.
*Basic vision check
*Weight Check and obesity counseling, if needed
*Vaccination review and any needed vaccinations given (I got my tetanus shot, but had had the others earlier)

Also part of the exam, to be done shortly, as needed:

Complete blood analysis, including PSA, Cholesterol Screening, and the usual CBC measurements
Colonorectal screening exam (Ick!)
Any necessary follow-up visits based on these tests.
Ophthalmology Exam to check for cataracts, glaucoma, and other eye problems.

Other Exams, as indicated:

Cardiac Stress Test (not needed for me)
Further testing for anything discovered in lab tests



No co-pay. No additional charges, except for any prescriptions written. I had a rash on my arm, so I got a prescription for some meds. I also got a year's renewal on my blood-pressure medication, and discussed my life-long fungus toenails and associated athlete's foot. We decided to forget that one, since I effectively self-treat as needed.

I spent an hour with the doctor and his assistant during this exam.

This is what medical care should be like. Preventive care is part of the Medicare deal, and they push this initial baseline exam very hard. I hate going to the doctor, but I did this because I could finally afford to do it. My wife's pleased. No problems were found that pose a serious risk. My electrocardiogram was fine, my blood pressure is well-controlled, and heart and lung sounds were normal. A belly palpation turned up nothing unusual and I have the prostate of a 30-year-old, says the doctor. I've been seeing this doctor, when needed, for 6 years. He already knows me, and ended the visit with, "So, welcome to Medicare, George. Don't hesitate to make an appointment for any issues that come up."

I want this for everyone in the United States. I have wanted that for a very long time. Let's try to make it so!

My clinic is a nearby satellite clinic for a major health care system in the Minneapolis St. Paul area. It's a multi-specialty clinic, complete with CAT Scan and MRI equipment, and becomes an Urgent Care facility after hours. Takes me five minutes to get there.

I asked the clinic worker who checked me in about their attitude toward Medicare patients, and she told me that they actively seek Medicare clients, especially those with supplemental policies, and that over 50% of their patients are on Medicare. I've been able, in the past, to get same day appointments when needed, and always next day, any time.

This is a very competitive health care market, so their eagerness to treat Medicare patients may be due to an oversupply of facilities. I don't know. Looks like this will work out well.

As opposed to those who are like, "I've got Medicare, sucks to be you."

I'm counting the years & months until I become eligible.

Or some of them do and the rest will have to in 2013; I forget.

I want this for everyone in the United States. I have wanted that for a very long time. Let's try to make it so!

That would be awesome. But we can afford this for you because you paid into the Medicare trust fund for decades (presumably), and because your doctor can take a loss on seeing Medicare patients and recoup it from patients with private insurance (if he's a GP in his own practice; it's a little less direct with a hospital GP). Expand the people getting Medicare while simultaneously reducing the people using private insurance, and the numbers get a little more hairy :(

age. There's no option. They should be markedly lower than current health insurance premiums, though. Even we Medicare recipients pay a premium, that's taken out of our monthly payments, and most buy supplemental insurance. Right now, my total is just over $200/mo. Shortly, it will go up about $20.

A properly-managed premium system, mostly paid by employers, as they do now with other insurance, along with subsidized premiums for low-income people should handle most of it. And, just as the insurance companies do now, controlling the amount paid for treatment, etc. should help control the cost of medical care.

The savings come with control of payment for services, a larger pool, and a single entity to handle administrative costs, without any profit motivation on the part of the payer. Personally, I believe a universal, Medicare-style system would bring costs down considerably...maybe even dramatically.

I don't understand the resistance to this, and think it will disappear before too long, as costs for private insurance continue to rise. The service providers are going to scream bloody murder, but there it is.

The service providers are going to scream bloody murder, but there it is.

My worry is that forcing the entire medical industry to operate at Medicare-level reimbursements (which are still higher than reimbursement rates in other countries) will have some pretty extreme impacts on the medical field.

comes into the system being a paying patient would help ameliorate the situation, and that's entirely possible with single-payer. Right now, costs for services that are never repaid are a huge drag on the industry. Emergency rooms are a prime source of these, as are various pro-bono programs that are in place in many hospitals.

Right now, in markets like Minneapolis St. Paul, there is high competition for Medicare patients. Part of the reason for that is that they pay a good portion of the overhead costs of clinics and hospitals, and keep revenue flow coming in. That allows more or less proper staffing, etc.

Don't forget that the major insurers have long forced providers to accept the insurer's payments for procedures and services. Same thing, generally.

In my one major hospitalization, the hospital's original bill was over $150,000. Blue Shield, my insurer paid only $50,000, and the hospital had no choice but to accept that amount. I had already gone past my out-of-pocket max for the year in pre-hospitalization services, so I didn't pay the hospital anything.

Making every patient a paying patient would go a very long way toward keeping the providers going. There will be some contraction in some markets, and there may well be fewer providers, but there will also be fewer empty beds for the ones that remain. In other areas, where there are few providers, the situation may be different, of course.

It is a government funded and operated system, like Medicare, that people will have access to in place of for-profit private insurance WHICH THEY WILL NO LONGER BE PAYING FOR. The government system will cost 30% less than private insurance because private insurance sucks 30% of what you pay off the top. So, instead of paying $600/mo for private insurance, you pay $400/mo and have access to a Medicare-like system.

Nobody, and I mean nobody, is suggesting that we put everybody on Medicare and fund it out of our Medicare deductions on our paychecks. That's just silly.

Now, I mean obviously that was a bill written to make a point rather than to pass, but there's not remotely a consensus on the left about how to fund a single-payer system, which is the main reason I don't think it's time to push for one -- we need to figure out what it would be and how to pay for it first.

The government system will cost 30% less than private insurance because private insurance sucks 30% of what you pay off the top.

Except the government system will have to pay for anybody and won't exclude sick people like private insurance does (for the next two years, at least). So unless there's a mandate for everyone to get this insurance and not private insurance, it will be extremely expensive because it will be a bunch of sick people (this is why I'm dead-set against a public "option").

of paying $600 to a private insurer you would be taxed $400 by the government. The overhead for administering Medicare is like 2%, rather than 30% for private insurance.

Everybody wins. Everybody gains. Just like they do it in the grownup countries.

We will be going to the mattress just to protect Medicare for the elderly.

since getting out of the military.

Glad to hear you had a nice experience.

insurance, so I skipped them for many years. That's the difference.