Medicare Advantage’s Popularity Shows Americans Won’t Like Single-Payer

Democrats hope their advocacy of single-payer health care will help them in the upcoming midterm elections. More than half the Democrats running for seats in the House back Medicare for All.

It remains to be seen if their embrace of government-run health care, where private coverage is banned for anything considered medically necessary, will prove a winner. Historically, Americans have favored privately-administered health plans, when they’ve had the choice. That’s even true for progressives’ favorite government program, Medicare itself.

Seniors are flocking to Medicare Advantage, or Medicare Part C, wherein private insurers deliver health benefits under contract with Medicare. Advantage plans may feature different deductibles, co-insurance, and out-of-pocket costs. Since 2010, the number of Medicare Advantage beneficiaries has doubled, to more than 20 million. That’s more than one-third of total Medicare enrollees.

It’s no mystery why Medicare Advantage is so popular. The private plans, which are similar to HMO or PPO plans, offer more comprehensive, higher-quality care. Most include prescription drug, vision, and dental benefits — which traditional Medicare doesn’t cover.

Insurers who offer Medicare Advantage plans also have a strong financial incentive to keep the quality of care they provide high — and the cost of that care low.

In traditional Medicare, the legacy federal program for seniors established in 1965, the government pays doctors and hospitals directly for the services they provide to enrollees. In Medicare Advantage, on the other hand, the government pays insurers a flat fee per member. Insurers use that fee, plus premiums from enrollees, to pay for care. If insurers spend less on medical services and overhead costs than they are paid, they keep the difference. So they have every reason to find more efficient ways to treat patients.

Consider patients with diabetes. More than twice as many traditional Medicare enrollees with diabetes face lower extremity complications compared to those with Medicare Advantage, according to an analysis from Avalere Health.

Or look at patients who need hip surgery. An analysis of over 286,000 patients revealed that Medicare Advantage enrollees were less likely to be readmitted to a hospital after the operation than Medicare enrollees. They also spent, on average, five fewer days in skilled nursing facilities after surgery.

Additionally, Medicare Advantage insurers promote the use of preventive services that can catch costly, devastating health problems in their early stages. More than 76 percent of Medicare Advantage enrollees with chronic conditions get screened for breast cancer, compared to 67 percent of traditional Medicare enrollees. A greater share of Medicare Advantage enrollees undergo testing for LDL, or “bad cholesterol.”

Medicare Advantage insurers also tend to experiment with innovative care models, according to researchers from Duke’s Margolis Center for Health Policy. They found that several Advantage plans rely heavily on comprehensive health assessments and home health services — which provide convenient, quality care without the need for a hospital visit — to boost care and reduce costs.

All told, Medicare Advantage enrollees with common chronic conditions have 23 percent fewer inpatient stays and 33 percent fewer emergency room visits than those on traditional Medicare.

Unsurprisingly, seniors love Medicare Advantage. Over 90 percent of Medicare Advantage enrollees are satisfied with their plan. Almost 60 percent of seniors who switched from traditional Medicare believe their Medicare Advantage coverage is better; just 2 percent think their original, traditional coverage is better.

Medicare Advantage proves that private insurers provide higher-quality care than a single government-run entity. As CMS Administrator Seema Verma recently said, “The lesson here is a basic law of economics: choice increases competition, and competition drives up value.”

Insurers are now offering more Medicare Advantage plans than ever before. In 2019, nationwide, there will be more than 2,700 Medicare Advantage plans — an increase of more than 400 compared to 2018. The average patient will be able to choose from 24 health insurance plans, three more than 2018. Fourteen insurers will begin offering Medicare Advantage plans for the first time.

Medicare’s own beneficiaries are increasingly opting for privately administered coverage. And yet, Democrats propose abolishing private insurance — for seniors and non-seniors alike — and forcing everyone into a single government-run plan.

The seven in 10 voters who say they support Medicare for All, per a recent Reuters/Ipsos poll, must not realize what they’re supporting. Indeed, other polling shows that a majority of voters opposes the idea when they learn that it’ll require higher taxes or give the government control over their care. Nearly half of Americans erroneously think they’d be able to keep their current health coverage under single-payer.

Medicare Advantage shows that private-sector competition works. Private insurers have an incentive to provide high-quality care at low prices — and to continuously improve service to attract customers. Ordinary people, meanwhile, like having choices. Once voters realize all what they’d give up with Medicare for All, they’ll turn their backs on the politicians supporting it.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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