Expanding Medicare to Cover Eye, Dental and Hearing is Essential Care and Must Pass

This huge rise in Medicare Advantage enrollees suggests the cost of healthcare is becoming increasingly unaffordable to risk keeping only original or traditional Medicare. But when people turn of eligible age, 65, and analyze their enrollment options and cost, seniors quickly realize basic or traditional Medicare is not the trustworthy safety net they had hoped for.

Workers have put into the Medicare system for most of their working lives then are faced with the shocking reality that Medicare is not free. That’s the big news workers should know, unless politicians finally have the political will to make changes.

No limit on charges
Under original or traditional Medicare, there is actually no limit on what a person may have to pay out of pocket to receive medical care. When Medicare was created in 1965 as national health insurance, the purpose was to protect the elderly from exorbitant health care costs and to provide a means to get medical treatment they can afford. The problem is over time, as medical inflation skyrocketed, Medicare hasn’t been updated to keep up with the price of modern medicine.“Medicare is one of the few health plans or programs out there today that doesn’t have a limit on out-of-pocket spending,” said Tricia Neuman, senior vice president at the Kaiser Family Foundation.

To ensure both specific medical needs are met and to cap costs, many seniors enroll in a Medicare Advantage Plan, which is actually private insurance. Or another alternative is for seniors to keep basic Medicare and supplement coverage by purchasing additional insurance called Medigap. Some seniors are fortunate to have both Medicare and health care insurance from a previous employer.

Again, the very purpose of why Medicare was created is undermined as many seniors are not able to afford either a Medicare Advantage Plan, Medigap option or the additional costs of treatment not covered by insurance, or out-of-pocket costs.

Currently, an estimated 6 million Medicare beneficiaries do not have any supplemental or alternative coverage, meaning they in theory have no cap on their out-of-pocket costs if they require a lot of or lengthy medical services.

What happens then is often seniors go without preventative or urgent treatment to avoid care they cannot afford.

Original Medicare does not include many services from long-term care at private facilities to lengthy home care for chronically sick seniors. Vision, dental or hearing – care that a majority of seniors need – are not covered under the basic plan.

Earning too much or too little equals not having sound options available
Basically, if you are a senior with compromised health or suffer a debilitating health crisis such as a stroke or heart attack, you have no choice but to purchase supplemental private insurance or potentially go bankrupt. Medicare Advantage now accounts for 42 percent of enrollment, up from 25 percent a decade ago.

Lower middle-incomed Americans and sickly middle-incomed Americans who do not qualify for Medicaid find themselves in a bind of making too much to receive assistance or too little to afford insurance and/or other fees, copayments, cost-sharing.

This leap in Medicare Advantage suggests the cost of healthcare is becoming increasingly unaffordable to risk keeping only original or traditional Medicare. It also suggests that updating Medicare to at least cover additional medical services (not currently offered with extra insurance) is sorely needed.

Pass the Reconciliation Bill
Included in the current reconciliation bill that Democrats are pushing for is a part to expand Medicare to include dental, vision and hearing.

A majority of Americans support these expanded services proposed. Given that lowering the cost of health insurance was a major issue in the last two national elections, politicians must at the very least, deliver on these most basic services.  Congressional and Senate leaders owe it to Americans, and to seniors in particular, to offer some relief in medical services.

The original reforms that American voters had been demanding – Medicare for All, lowering cost of prescription drugs – are far more extensive. Expanding services in these three areas is a compromise.

Lower Medicare eligibility age
The other proposal in the reconciliation bill is to lower the Medicare eligibility age from 65 to 60. The original proposal tossed around was to go from 65 to 55.

Lowering the eligibility age is also a major compromise from what many voters had been calling for, Medicare for All. Waiting an additional five years to qualify for Medicare could be the difference that could help the uninsured to get medical preventative care before serious illness kicks in. The likelihood of getting seriously ill increases in age.

Lowering the eligibility age would also benefit many businesses by shifting the burden of providing health insurance from employers to the federal government. This helps businesses’ financial strength and stability. It enables some businesses that do not offer medical insurance to their employees to consider offering it as the period of coverage is reduced.

Look at the Big Picture
It’s clear that any major reform to the nation’s health care system is not politically feasible with the current composition of Congress-Senate. This, even as health care, becomes increasingly unaffordable. It’s also evident that the health insurance lobby is against expanding Medicare coverage because they have been making handsome profits by providing supplemental insurance or a complete private insurance alternative.

If politicians lack the courage or political will to make major reforms, they could do the minimum by expanding Medicare to cover eye, dental and hearing care. This is very basic and not asking much. After all, working Americans have been putting into the system for most if not all their working lives. It’s not workers fault that the cost of medical care is rising much faster than inflation or wage contributions to Medicare.