Paying for a Doctor’s Visit Could Look Very Different in the Future

Medicare-X Choice This legislation was drafted by Michael Bennett and Brian Higgins. Essentially, this plan would allow access to Medicare to patients of any age through… Trista - October 18, 2019

Medicare-X Choice

This legislation was drafted by Michael Bennett and Brian Higgins. Essentially, this plan would allow access to Medicare to patients of any age through the Obamacare marketplace.

The main difference in this plan is that the enactment of this system would not be nationwide. In fact, it would only benefit very few people. It would first offer Medicare options in areas with few hospitals and doctors, or in areas where there were limited options in coverage.


State Public Option Act

This bill was created by Brian Schatz and Ray Lujan. This option takes a whole new spin on things: it would give consumers the opportunity to buy into Medicaid, not Medicare.

What exactly is covered under each plan would inevitably vary from state to state; however, no program can offer less than what has already been established by the Affordable Care Act.


Choice Act

Introduced by Schakowsky and Whitehouse, this bill would create an entirely new public health insurance option that would be offered on health care exchanges.

Each health insurance option would include different levels, such as gold, silver, and bronze, and all plans would have subsidies. Small employers will have the opportunity of providing their own health insurance coverage, but large employers will not have this option.


Kamala Harris’ Health Plan

Harris differs significantly from what we have seen before; although she still proposes a government-run system, she does not want to eliminate private insurance; however, they will be operating under a tightly regulated system. This system would ensure lower costs and extensive benefits. Basically, her plan would expand on the costs and benefits already adhered to by Medicare Advantage. Additionally, it would lengthen the transition time from the old system to the new- from four years to ten years. To help ease the transition phase, the plan would automatically enroll newborns and uninsured persons, while also allowing for any of those interested in the option of buying into Medicare right away to do so immediately.

Harris also supports creating a higher capital gains tax, which would impose taxes on households making $100,000 or more. This tax would be exempt from those households making less than $100,000. She also wants to impose a higher income threshold for middle-class families that live in high-cost areas.To make up for this loss in revenue, Harris wants to add an additional tax on Wall Street stock, bond, and derivatives transactions. The fees would be 0.2 percent, 0.1 percent, and 0.002 percent, respectively.

There are some similarities to other proposed plans too. The end goal is to make sure that every citizen has insurance coverage; however, Harris does require a co-payment with her plan. Despite this, costs will remain low; her annual cap for co-payments is set at $200.


Pete Buttigieg’s Healthcare Ideas

His overall plan looks like this: expand coverage, lower costs, and offer Medicare for all who want it. How does he plan on accomplishing this? By introducing a public option and more subsidies for private insurance. In a nutshell, Buttigieg would allow for employer-sponsored and individual private insurance to remain intact while leaving the option open for consumers to join a government health program.

What exactly would the government program look like? Buttigieg wants to create an optional government insurance program that would automatically enroll uninsured persons while also allowing employer-sponsored insurance holders to join. The first to be enrolled will be those who qualify for Medicaid expansion but who live in states that refused to expand eligibility under Obamacare. The government plan would cover the same benefits as private plans sold under Obamacare.

Buttigieg also wants to expand federal subsidies for private insurance that is purchased through Obamacare marketplaces; the grants would be more generous and would even lift the eligibility cap that currently cuts off many middle-class families from receiving federal assistance.


Joe Biden’s Healthcare Plan

His plan is unlike anything we have seen before. Biden wants to build in a public option to Obamacare. His plan also calls for smaller tax increases as compared to other policies discussed previously, which means that participants in his program would be responsible for co-pays, premiums, and deductibles.

Biden claims he will also tackle drug prices by allowing the government to negotiate prices and permitting people to buy FDA-approved drugs from overseas. Biden’s plan would also retain private insurance.   


John Delaney’s Idea for Healthcare

Delaney brings a unique proposal to the table. He wants to enroll every person under 65 into a public program that covers necessary medical services while leaving Medicare for those over 65 the same as it is today.

Delaney would still allow for supplemental insurance to be purchased. He plans on paying for this public program by maintaining the shared state-federal payments for Medicaid and by eliminating tax breaks for employer health benefits.   


Britain: The National Health Service

Now let’s take a look at how Medicare For All compares to other health care systems around the globe. First up, Britain. Here, the government not only provides health insurance, but it also pays for it. It is like Medicare For All in that it allows for medical care for all, regardless of income.

However, Britain’s plan is funded through a payroll tax, which would differ from most of the plans previously discussed. Another similarity: patients in both America and Britain do not pay out-of-pocket when visiting a doctor (only if Medicare For All passes). People in Britain do pay for prescriptions, but it is capped at less than twenty dollars. This health system is not without its flaws; there are often long waiting periods for treatment. Citizens also have the option to buy private insurance, but this is often pricey.  


Canada’s Healthcare System

This country has the system most like Medicare For All. This system is set up with government-run health insurance that covers everyone, but most of the care is provided by private doctors and hospitals. As with both Britain and Medicare For All, patients pay nothing at the time services are rendered.

The difference between Medicare For All and Canada’s system is that the latter does not provide an extensive amount of coverage. Many people have to purchase private health insurance to cover vision, dental and prescriptions. Like Britain, Canadians sometimes have to wait a significant amount of time to receive specialized care.


Healthcare In Switzerland

Switzerland is often discussed for its health care system, among other laws and policies. So, what makes this country so talked about and unique.

In Switzerland, all insurance is private, but they sell most of their plans on a  nonprofit basis. All programs have a premium that is dependent upon the choice of doctor, the deductible, and how easy it is to see the specialist. In some cases, subsidies are based on income.


France’s Healthcare

Health insurance is provided by a small selection of nonprofit health insurance companies. These companies are funded by tax dollars. Most of the health care expenses are being paid by public insurance. Most individuals must purchase private insurance to be covered entirely.

Private insurance is provided either through an employer or a voucher. In this country, the government is responsible for setting prices for health services and drugs and can even control the number of new doctors and equipment available in hospitals.


Germany’s Healthcare

Germany has two types of health insurance: a national public system and a private system. The national system charges a monthly premium based on income, which is paid in part by employees and employers.

Private insurance works just like it does here; most people get it as an add on to another insurance. The government also sets limits here: specifically on how much doctors can earn and how much they can charge for their services.


What Does That Mean For Your Health Insurance Currently?

How will this affect the health insurance world as we know it? Good news for those who are currently uninsured: you would be covered (rather quickly), although you would have to pay for your services through taxes. If your income is low enough, there would be no cost to you at all. If you are insured through your work, you would no longer have to pay for health insurance through your employer, but you would still be responsible for a premium based on income.

For those who are already on Medicare, the new Medicare For All would simply expand your coverage to include dental, vision, hearing aids, some long-term care costs, and all prescription drug costs over $200 annually. You would no longer have premiums or co-pays for care, but you would pay taxes if you are still working. If you are on the Medicare Advantage plan, you would have to drop it and switch to the government based program.

In the case you are currently on Medicaid, your choice of doctors and hospitals will increase, and your out-of-pocket costs would remain low. The bad part here is if you are still working, you could potentially pay more in taxes.

If you are self-insured, you would now pay for your health insurance through taxes. Your out-of-pocket costs could go either way; either somewhat higher or significantly lower. It is also possible you could gain a broader range of doctors and hospitals. Veteran care will not change at all under Medicare For All for at least the next ten years. Individuals would use the same health care system and would pay nothing out of pocket.