As part of her Excluded Voices series in the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, talks to medicare expert Marilyn Moon about the program’s weaknesses and about proposed reforms to the system. Moon pushes for a simplified deductible system, says supplemental insurance is a major concern for subscribers and calls private vouchers a “hail Mary pass.”
Moon offers a sober assessment of Medicare’s financial status, saying that many reformers operate under the implicit assumption that there are inefficiencies in the system that may not actually be present. In the end, reforms can’t escape the fundamental fact that you can’t lower taxpayers’ costs without increasing those of Medicare users.
“The public also needs to realize that refusing to insure certain tests and treatments that do not work is a good approach, not a bad one as some critics have charged,” Moon said.
Lieberman asked Moon what the “biggest risk faced by people now on Medicare” was.
The gaps in Medicare’s benefit package mean that anyone who can afford to will seek supplemental coverage. That coverage is expensive and often not a very good deal. When people buy what’s called “Medigap” insurance, on average they may be getting back only seventy-five cents worth of health care for every dollar they spend. Administrative costs are also high. But going without such coverage is risky since the basic Medicare package has no catastrophic protection for those with very high expenses.
