Public opinion polls show strong support for efforts to expand health coverage to more Americans.
But the list of proposals is long and the phrases used to describe them are often sloppy sloganeering.
Let us help you cut through the confusion.
Universal coverage means everyone has health insurance. Universal coverage can be provided by the government or a private company or some combination.
In a single-payer system, the government pays all medical bills and sets prices for medical procedures. Canada has a single-payer system.
Single-payer is not the same as socialized medicine, where the government owns the hospitals and clinics and employs the staffs. Great Britain’s National Health Service is an almost fully socialized health system.
A public option is a plan sponsored by the government that individuals may purchase. Private insurance plans would remain and the public option plan would compete with them for customers.
Medicare is the government program that insures 60 million people, most age 65 and older. It’s very popular.
Medicare, however, does not have very generous benefits compared with most private insurance plans. For example, you need separate insurance for prescription drugs and there is no limit on out-of-pocket costs.
Backers of “Medicare for All” proposals want to expand current Medicare to the entire population and enhance the benefits, too.
Medicare for All plans would minimize the current role of private insurance plans and some would eliminate them entirely.
Some people would like to expand Medicare gradually. This is sometimes called “Medicare for More.” It might simply lower the eligibility age to 55 or 50. Or it could begin by adding children and gradually move the eligibility age up until everyone is covered.
Another variation would keep the current Medicare coverage but let people who are not now eligible purchase it. These Medicare buy-in proposals might allow people ages 50 to 64 to opt in. Or Medicare might be available for purchase to those who don’t get insurance at their job.
All these plans will cost the government — that is, taxpayers — more. How much more, well, that’s a whole ‘nother can of worms.
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