by Aldebra Schroll, MD
At a recent staff meeting, a colleague mentioned her client was at an “awkward age”.
I thought she was referring to a teenager, but she quickly clarified herself. She was referring to the age before someone is old enough for Medicare at sixty five, an awkward time indeed. Many people between the ages of fifty to sixty four find that relatively minor health problems make health insurance unaffordable. For those with more serious diagnoses such as a history of cancer, they may play a dangerous waiting game until they can enroll in Medicare.
Medicare is the single payer system that covers the elderly and disabled, approximately forty seven million people. July 30th marked its forty fifth anniversary. Unlike the private insurers who typically average administrative costs up to thirty percent, Medicare has an administrative expense of three percent. As concern grows over the increasing cost of private insurance, support for a single payer model such as Medicare, is growing among physicians and the public.
Over the past few years, as people lost their jobs, I have seen many of my patients in their fifties and sixties who were unable to afford private insurance, often due to common conditions such as cataracts, arthritis, allergies and hemorrhoids. I was particularly disturbed to find that the insurers used my detailed chart notes to exclude patients from their plans. It was not uncommon for new patients to decline to provide a medical history, fearful they would be labeled with a pre-existing condition that might cause their policy to be rescinded. This was never the case for my patients on Medicare. They were assured of insurance despite the presence of chronic medical conditions.
I have also watched several patients struggle with the news of a cancer diagnosis, facing surgery, radiation and chemotherapy; while trying to work because it is the only way they can hang onto their employer sponsored health insurance.
Approximately, forty million Americans are uninsured; another twenty five million are underinsured. In the event of a serious diagnosis, they face the high cost of out of pocket expenses. A study in the American Journal of Medicine found that over sixty percent of bankruptcies in the US resulted from medical bills. An estimated forty five thousand deaths a year are attributed to the lack of health insurance.
A study from the journal Health Affairs found that Medicare enrollees had fewer problems obtaining needed medical care, less financial hardship and higher satisfaction scores than those in private plans. Medicare patients are less likely to file bankruptcy due to medical expenses. There are also less socioeconomic disparities in health for the population on Medicare. Overall, Medicare patients report greater satisfaction and security than those enrolled in private plans.
Medicare is by no means perfect. There is a serious risk of waning access if Congress does not move quickly to find a permanent fix to the sustainable growth rate which has caused a yearly threat to physicians’ reimbursement. However, Medicare offers guaranteed coverage and security that cannot be found in the private insurance market place. Dr. Marcia Angell, the former editor in chief at the New England Journal of Medicine has stated “Medicare is by far the most efficient part of our health care system.”
The Commonwealth Fund, an independent research foundation, summarized the results of their work with the statement “providing a Medicare option to the nonelderly could increase continuity of coverage and bolster confidence that people will be able to get and afford healthcare when they need it.” Isn’t it time to put an end to this awkward age?
Aldebra Schroll is a family physician who blogs An Apple a Day at NorCal Blogs.
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