Going to Medicare for all will be more costly for all


By Doug Gardner

Sunday, August 18, 2019

I hope young Democrats chanting “Medicare for all” understand the program is a premium-based, 80-20 insurance plan.

Diana and I pay Medicare premiums of $266 monthly to cover 80 percent of our medical bills.

Like most prudent seniors, we hedge our risk on the other 20 percent of our medical exposure by spending $366.88 monthly on a Medicare supplement from State Farm Insurance Co.

That still leaves us without drug or dental coverage.

We pay a total of $103 monthly to United Health Care and Silver Script for pharmaceutical coverage mandated under Medicare Part D.

Dental insurance is another $89.58 monthly to Blue Cross Blue Shield.

If you’re keeping track, that’s $825.46 monthly, or $9,905.52 annually, for Medicare and four private supplemental health plans.

And, it’s a bargain compared to the cost when I was employed into late 2015. Our private insurance tallied $21,534 annually, plus a $6,000 deductible.

Four years later, we are actuarially closer to being permanent guests of Twiford Funeral Home, but our out-of-pocket medical insurance tab is $1,468.20 per month less than it was in 2015. How come?

Because any of you under 65 and still in the labor force are picking up that tab.


You’ll pay a lot more if any of the leading Democratic candidates wins election next November and succeeds in imposing a national health care plan. Bernie Sanders was at least honest when he declared that, “Middle class taxes will go up,” during the first debate. There’s a political promise that will be kept.

A lot of people I talk to are pretty happy with the clinical quality of their health care. It’s the cost and complexity that bothers them. Scant attention is being paid to changes that might actually drive down health care costs.

When I was employed by a company with offices nationwide, I could transfer from Elizabeth City to San Francisco and access the same group health plan in California as in North Carolina, for the same price. You can’t do that as an individual.

Any insurance firm wishing to compete for private business nationwide, must offer 50 different plans. They can’t sell a stripped down, major medical plan. North Carolina requires 57 specialty services be included in any health insurance plan. You can thank the lobbyists for chiropractors, optometrists, psychologists, secular counselors and pastoral counselors, among others, for this.

Safeway stores tried a bold experiment 14 years ago when double-digit premium increases butchered the company’s bottom line. Then CEO Steven A. Burd and his Human Resources Department discovered that 75 percent of the company’s health care cost related to four maladies: obesity, diabetes, cancer and cardiovascular disease. The company cut health insurance premiums up to $1,560 per year for employees who got their weight, tobacco use, blood pressure and cholesterol under control.

Burd followed the auto insurance model: driving behavior, such as speeding, tickets and accidents, results in higher premiums. Personal responsibility matters. Getting employee skin in the game cuts costs.

American families spent an average of $36,843 on each new car or truck they bought in April, according to Kelly Blue Book. No politician has suggested a federal role in helping Americans pay for their “vital transportation services.” These families figure out how to save for such purchases, or, more often, finance them over three to seven years.

Therein lies a clue to the proper role of government in providing medical care. When costs exceed $36,000 for any one health event, taxpayers would step in to pick up the rest.

We’d probably find broad agreement across the political spectrum that none of us wishes to see American families driven into bankruptcy by medical costs. But it’s a long way from fending off bankruptcy to forcing taxpayers to underwrite Beto O’Rourke and Pete Buttigieg’s annual prostate exams.

Doug Gardner is a resident of the Weeksville section of Pasquotank County.