By Jeff Belle
The value Americans place on having choices, extending life and ensuring quality of care are critical considerations in how the U. S. health care delivery system meets the needs of its citizens. Failure on part of policymakers to recognize this will result in lack of support for “radical changes” in the health care system—even if its intent is noble. In order to discover new oceans, one has to leave the shore. In 2010, we boarded a new voyage-“ Affordable Care Act” (ACA) with the intent of improving health care for all U. S. citizens. The ship has left shore and headed into deep waters beginning next year (2014). Medicare and Medicaid as we know it today will never look the same beginning 2014. Are we on the right course? Is the U.S. health care system treading into dangerous waters? Have we gone too far to turn the ship around? Is our health care system headed into uncharted territories?
Let’s go on board and look at Medicare-the nation’s health insurance program for Americans 65 and older, and for young adults with permanent disabilities. As the U.S. population grows older, 52 million people currently relying on Medicare will increase drastically. Medicare has four parts, each covering different benefits. Part A-Hospital Insurance (HI) program covers inpatient hospital services, skilled nursing facilities, home health, and hospice care. Part A is funded by a tax of 2.9 percent of earnings paid by employers and workers (1.45 percent each). Obamacare increased the Medicare HI payroll tax from 1.45% to 2.35% for higher-income taxpayers ($200,000/individual and $250,000/couple) and businesses. This tax went into effect last January. Most individuals do not pay a monthly premium for Part A services, but are subject to a deductible before Medicare coverage begins.
Beneficiaries are generally subject to a coinsurance for benefits covered under Part A. Although Medicare Part A imposes tax increases on those earning $200,000 or more and businesses, there is no such thing as a free lunch. In fact, BIG, BIG changes occur in Medicare Parts B, C, & D.
Unlike Part A, Part B deals with outpatient hospital care, physician visits, and other medical services. There are significant changes in Medicare Part B. I will devote next month’s entire column on Medicare Part B. If you think that Medicare changes are confusing, we dare not open the door to Medicaid changes! Now that you have boarded the voyage-ACA, you are well on your way to a new destiny. Today, skies are sunny and blue; however, forecast indicates thunderstorms are ahead and some are even predicting a tsunami over the horizon. One thing that’s certain– you will never see the shores of yesterday’s health care system again.
Source: Center for Medicare and Medicaid Services (CMS).
Jeff Belle is a senior fellow at Institute for Public Policy and Leadership Development. He researches, writes and lectures on health policy and leadership development issues.