Myths and reality about Medicare and Medicaid

A pair of recent studies use evidence to challenge two widely held beliefs, namely that undocumented immigrants are draining the Medicare trust fund and Medicaid provides poor quality medical care.

In the first instance, a study conducted by investigators from Harvard Medical School and the City University of New York and published online in mid-June by the Journal of General Internal Medicine, found that undocumented immigrants pay more into the Medicare Hospital Insurance Trust Fund than they take out.

The second study, released June 25 and conducted by researchers at The Commonwealth Fund, found that in 2014, 95% of Medicaid patients who were covered all year had a regular doctor, and 55% said they received excellent or very good care.

“I think this underscores the need for evidence-based policymaking,” Sara Collins, PhD…a co-author of the organization’s study told MedPage Today. “It’s important that everyone look at the data that’s available.”

Between 2000 and 2011, unauthorized immigrants generated a substantial surplus for the Medicare Trust Fund — $35 billion, according to the Harvard study. That ranges to between $2.2 billion and $3.8 billion per year, or $316 per capita for that population, compared with $106 per capita for the rest of the American population…

On the Medicaid side of the equation, according to the Commonwealth Fund report…Medicaid patients ages 19-64 had similar experiences to people with private insurance and were in far better circumstances than those who lacked insurance altogether. Among the uninsured, the survey found, 77% of people reported having a regular doctor, with only 40% saying they received good care.

“There’s some conventional wisdom that Medicaid is not very good coverage, but this shows how well Medicaid does in enabling people to protect themselves,” Collins said. “It may be a surprise to many, but these figures do demonstrate that it’s certainly better to have Medicaid than to have no coverage at all.”…

Perhaps most telling, 19% of Medicaid beneficiaries reported having some kind of issue related to paying medical bills. About one-third of people with private insurance – and 47% of uninsured – reported the similar struggles.

Given the still-controversial Medicaid expansion called for by the Affordable Care Act, and the beating Medicaid coverage has taken in some quarters as a result, the survey findings call for a fresh look at what Medicaid really delivers, Collins said…

I hope you’re not surprised that evidence and data-driven analysis reveals a more positive outlook than conventional wisdom or conservative ideology. Now, let’s make it even better!

Expansion of Medicare to all citizens within a single-payer system reduces costs by cutting out the insurance industry slice of the pie. Congress isn’t likely to have the courage for that. But, the experience of Social Security – with operating costs about 80% cheaper than anything the insurance industry offers – proves the possibility.

The same holds true for Medicaid. And I may as well throw in my favorite criticism of the provisions as designed by Congress. There is no legitimate reason preventing taxpayers in general from enjoying the same fixed, government-negotiated rates for prescription drugs that are offered members of the armed services.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.