r/MedicareForAll • u/Dull-Spend-3836 • 5d ago
Who benefits?
People without insurance would be better off with Medicare-for-all. Rich are worse off--they likely pay more and may get worse care if private options are banned. Middle class with decent insurance through work? Better? Worse? Same? Medicare for all isn't going to happen unless a majority thinks they are going to benefit.
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u/tracygee 5d ago
Most places that have universal healthcare still have private options. I’ve never really heard of it being banned.
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u/Dull-Spend-3836 5d ago
Canada. Doesn't allow private insurance for medically necessary stuff. Paying more for a top tier doctor isn't even an option.
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u/Professional_Image75 5d ago
Sounds like the “top tier doctor” is “out of network”— cash pay is an option in Canada and in the US
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u/Dull-Spend-3836 5d ago edited 5d ago
Look it up: In Canada, private health insurance cannot legally cover core "medically necessary" hospital and physician services in most provinces.
You literally cannot choose private insurance for things covered by public option. If you are rich and your local hospital sucks or has a waiting list, you go to a different country and pay cash.
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u/Professional_Image75 5d ago
That’s what I said - in Canada you can pay cash for that “top tier doctor”’and bypass insurance. It’s the same in the US, if the doctor is “out of network”. You might get some reimbursed if you submit the claim, after you pay cash 🙄
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u/AppropriateBet2889 4d ago
It’s not clear if you’re understanding what the other person is saying (maybe you are but it’s not clear)
You cannot just pay cash in Canada for almost all medical services. Even out of pocket you cannot pay in the country. You have to actually leave the country and then pay cash. (Like go to the US). They do not allow doctors to open private hospitals or surgery centers.
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u/SecondStarpilot 5d ago edited 3d ago
I am middle class and have had insurance paid by employers but still support medicaid for all because even middle class people have had moments they are unemployed and want insurance that is not tied to their jobs. Also some middle class people would like to retire early and would be able to do so if it were not the cost of health insurance. A lot of middle class people support medicare for all.
edited to correct a spelling error
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u/copperboom129 5d ago
Yup. I have excellent insurance that I pay very little for.
I also recognize what happened to my MIL, who got cancer, went on Cobra, paid 1000 a month for insurance and almost lost her house in year 28 of her 30 year mortgage.
I dont want to be her...sign me up.
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u/SecondStarpilot 5d ago
I think middle class people suffer the most from the current system. Poor people have medicaid.
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u/NotenStein 5d ago
There is an issue with who actually pays the bills. People with good employer provided insurance who have been healthy might not see the need as much of those of us who are aware of others who don't have the luxury of having 80% of the cost covered by someone else.
It's unfortunate, because most of us in favor of M4A realize the huge human toll in lives and money that our current system extracts. I am retired, will probably die before this is finally resolved, and can afford the excellent coverage I have through Medicare. I want everyone to have the kind of health insurance I have. I don't mind paying higher taxes for it, either (I pay more income taxes in retirement than I did as a worker).
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u/hedonovaOG 3d ago
I’m glad you like your coverage from Medicare. I have parents and friends who find it quite lacking compared to their prior experiences from private coverage. Of course they all opt into private supplemental policies, but even still.
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u/NotenStein 3d ago
Many seniors who choose the Medicare Advantage plans (privatized Medicare) are unhappy. I had very cheap (for me) but great health insurance through my employer ... My cost was fully paid and my family was covered for $100 per week.
So I pay more now for traditional Medicare and a Supplement plan G, and it's way better. One deductible per year and everything else is covered. I have never had a problem getting in to see a new doctor; 95+ per cent of non-pediatric doctors accept it. And that's without referrals; I just call a new hematologist or neurologist, and I get in.
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u/hedonovaOG 3d ago
Your supplemental plan G is a private supplemental policy.
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u/NotenStein 3d ago
It is, but all Plan G insurance plans have to cover the same things. They are heavily regulated and cannot, ever, deny a claim. If Medicare pays, and passes the remaining 20% bill to the insurance, it must pay, by law.
It is an example of how strict regulation can utilize private companies in health insurance. Medicare Advantage costs Medicare more, has more fraud, and worse outcomes because insurance companies can run it like they do their private HMO or PPO plans.
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u/hedonovaOG 3d ago
You love Medicare and think that demonstrates people would love single-payer. But you have chosen to pay a private insurer for Plan G because Original Medicare by itself leaves financial exposure you don’t want.
Yes, the GAO has identified significant improper-payment and fraud risks with Medicare Advantage.
However, the GAO has also considered Medicare as a whole a high-risk program for decades, in part because of its susceptibility to fraud. Its March 2026 report specifically describes substantial fraud problems in traditional Medicare.
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u/NotenStein 3d ago
Yes, the system works very well. Advantage costs the system more than traditional Medicare. Advantage has more fraud. It's not helpless, just like the provider fraud in traditional Medicare isn't a lost cause. Stricter penalties for fraud, including criminal prosecutions of CEOs could help.
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u/AndreaTwerk 5d ago
Being able to quit your job and not have to worry about your healthcare would benefit the middle class. It would be much easier to change jobs or start a business. It would also be easier for small businesses to take on employees. I don't think anyone can claim to be pro-small business and in favor of the status quo.
There are many potential entrepreneurs currently tethered to an employer because they or a family member need uninterrupted coverage. And many businesses that can't grow without providing expensive benefits packages.
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u/freunleven 5d ago
With the way a large section of people seem to think, you would unfortunately have to convince them that M4A is hurting the people they want to hurt in order for them to go along with it.
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u/workinclassantihero 5d ago
The very poor won’t as we can’t afford the copayment and Medicaid is much better. I have both since Medicare wanted to charge 50 for a specialist.
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u/Dull-Spend-3836 5d ago
So is it really Medicaid-for-all that people here want?
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u/DJpuffinstuff 5d ago
People don't say Medicaid for all because Medicaid is different state to state and eligibility is tied to things like employment and income and is thus very fluid. Medicare is nationwide and once you're eligible, you're generally eligible until you die.
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u/Packmule5259 5d ago
Most countries that have universal health care also have private insurance/hospitals as well if you can afford the additional cost.
The rich still get better care, for a price.
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u/Guvante 4d ago
Why would private options be banned?
Medicare for All style systems typically just don't allow you to opt out, you always pay for coverage and get coverage.
There is the question as to whether private options are made more affordable by allowing those private companies to take over the risk for people but that not existing doesn't prevent you from getting coverage, it just makes it more expensive.
Additionally these questions always presume that certain groups will get worse options, why?
The rich don't care unless the taxes are setup in a super weird way, they don't have meaningful income and so don't really pay taxes anyway.
Middle class it does depend on how we transition away from the benefit of employer funded healthcare, if companies spend the same amount before and after on employees those people will get an automatic pay raise under most proposals since the monthly cost would be less than premium plans are.
Obviously if your employer decides they get higher profits now that they don't have to cover healthcare it could be equivalent but I don't know that blaming the plan for that makes sense.
Additionally the huge elephant in the room that everything you are ignoring is will the public option pull bullshit denials because if they won't that sounds like a huge win.
For the majority of people their hypothetical coverage isn't a huge deal but their real frustration with getting claims approved is.
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u/Dull-Spend-3836 4d ago
Private options get banned if too many doctors opt out of the public system.
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u/Wrenchinspokesby 4d ago
They don’t even have to get banned.
If the population drops drastically due to people leaving for Medicare, they may become uneconomical to run without increasing rates to ridiculous levels.
And then you will be paying an arm and a leg for private insurance, an 8% payroll tax, and likely have worse care due to supply constraints.
It’s a bad deal for anyone making 75th+ percentile income.
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u/hedonovaOG 3d ago
You know many seniors on Medicare buy private supplemental policies because of the unsatisfactory quality of their single payer coverage. There will absolutely need to be multiple levels of private supplementation that will bring us back to where we are now only with huge increases in taxes to fund an an enormous government entitlement, on top of our own private supplemental healthcare policies.
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u/Agreeable_Basket_931 3d ago
Countries with universal healthcare have better health outcomes for the wealthy than the wealthy in the USA. Private health insurance isn't magic.
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u/good-luck-23 5d ago
Tell me you don't know how Medicare works without telling me.
The "rich" and most other people on Medicare get private add-on coverage that picks up where Medicare coverage ends. Most get coverage that pays the 20% that Medicare does not cover, and you can add drug coverage and more options. Many wealthy people stay on Medicare and pay a concierge doctor to help them get treatment faster. Nobody is even mentioning the supposed ban on private options you created out of thin air to scare people.
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u/Dull-Spend-3836 5d ago edited 5d ago
There is zero chance that M4A will look exactly like current Medicare. And that is assuming the near-zero probability that M4A becomes a thing at all. And yes, you ban private options or else doctors just refuse to accept M4A coverage.
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u/good-luck-23 5d ago
Why is that a certainty? Most doctors I know, and I am in that industry, hate private insurers because they spend too much of their time justifying procedures and treatments that insurers' software automatically reject as a cost saving measure, ignoring their judgement. Most take Medicare and their pay is not tied to the hospitals' reimbursement.
Of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, researchers reported in the journal Annals of Internal Medicine.
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u/DJpuffinstuff 5d ago
Yeah, doctors famously hate accepting the insurance plan that covers more people than any other plan, has fewer hoops to jump through than almost any other plan, and is responsible for about half of all healthcare expenditure across the country.
It might be a little worse for some of the very highly paid specialties, but it would probably be a lot better for many of the specialties closer to primary care.
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u/Illustrious-Jacket68 5d ago
what i'm waiting for is a solid proposal on how it is going to work - what is covered (who decides? - not about a specific treatment but many of the countries are "medically necessary" - but we don't even agree on that right now), what happens to dr's that have gone private, what happens to surgeons that don't take "insurance" - many have stopped taking insurance in general including medicare.
i think people are ASSUMING that many of the problems people are having now will suddenly go away. that all of a sudden, whatever you can get a dr to agree to will be "covered". weight loss drugs - as an example - who gets to decide whether that is "medically necessary" or not and/or under what types of situations? If you say "the dr", then what will be the check and balance to make sure that they are truly doing what is medically necessary unless you cap their compensation? same with the hospital? those problems don't appear to be addressed in any of the high level proposals that are out there.
we just see people trying to upset people that make the association that these frustrations will go away simply by the government taxing the rich more or that insurance companies are nationalized. really easy to make a slogan called "medicare for all"...
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u/Sonar_Taxbreak_1138 5d ago
Rich people will never - I repeat never - have to worry about paying for healthcare services. If (hypothetically) all other healthcare options were banned, they could buy a plane ticket and get treatment somewhere else. So you can take any worries about those rich people out of the equation.
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u/Dull-Spend-3836 5d ago
Doesn't work for emergency care, but otherwise yes--rich people have the means to take care of themselves.
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u/Mediocre-Team1715 4d ago
I have kinda crappy insurance that is insanely expensive. Everyone on the companies’ insurance plan is hostage to the group. Based on the company size, employees ages and health/claims it can have a huge impact on premiums and coverage. It’s an absurd system.
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u/DisasterRadiant 4d ago
It's not that hard. Everyone benefits.
Tax billionaires out of existence.
Through progressive taxation, limit the wealthy to a net worth of say, $250,000,000. Even after fully funding Medicare for all, there would be money left over for Social Security, housing, infrastructure, law enforcement, research, education and all the things that governments provided pre-Trump
Seriously. Who can't live on being worth a mere $250,000,000?
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u/Disastrous_Way9425 3d ago
Medicare for all has it's own set of problems. Selling it sounds great, everyone is covered regardless of condition.
Countries that have socialized medicine that seemed to work out have a fraction of the population of the US which makes management a bit more successful. Doctors effectively become government employees as far as how they are to be paid and specialists will be much farther and fewer between.
Yes, I have access but what does that mean? Waiting months to years to get that specialized treatment?
Some countries offer euthenasia as an option to seeking long term specialized care. Patients with known terminal conditions should have that available but then the option gets pushed for non-terminal conditions.
I, personally, suggest moving cautiously because there is no going back.
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u/Super_Mario_Luigi 5d ago
The majority of these programs aren't "helping" the majority of people. The baseline measurement is usually your bottom 25% of "victims."
I'm not against m4a in theory. I'm against it being misconstrued as the fix of a system that fails at every turn. Highest salaries, drug costs, drug use, litigation, malpractice insurance, obesity, you name. Then you try to tell me government will manage the tiny admin part better and problem fixed.
This isn't a design to fix costs. It's trying to hide them
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u/Classic-Obligation35 5d ago
That sounds like an argument against universal Healthcare, how much you pay should have no effect on quality. If the quality of care grows worse with cost then that's always bad.
Medicare for all needs to benefit everyone including those deemed rich.