Letters: NYTimes, Sunday Reveiw: July 11, 2015
Readers discuss the impact of Medicare and Medicaid at 50 and offer their suggestions.
To the Editor: In “Medicare and Medicaid at 50” (editorial, July 3), you referred to polls between 1999 and 2009 that showed “consistent majorities in favor of expanding Medicare to people between the ages of 55 to 64 to cover more of the uninsured.” The next day, “Insurers Seek Steep Increases in Plans’ Rates,” a front-page news article, reported on likely double-digit rate increases — something the Affordable Care Act can discourage but not prevent.
Isn’t it time to accede to the wishes of the “consistent majorities” and begin dropping the qualifying age for Medicare one decade at a time? It would probably be less costly for consumers, since any increase in payroll taxes would be more than offset by lower premiums and out-of-pocket costs, it would provide truly universal care to those in the covered age groups and it would certainly be less inflationary.
MARCIA ANGELL, Cambridge, Mass.
The writer is a senior lecturer in social medicine at Harvard Medical School and a former editor in chief of The New England Journal of Medicine.
To the Editor: Medicare provides better care at lower cost than private health insurance can achieve. But it is woefully underfunded and may become insolvent. Many argue for privatization. However, every health care system in the world, especially our private insurance industry, faces increasing costs and a decreasing willingness of patients (and taxpayers) to pay for them.
Remarkably, Medicare costs are rising slower than those of private insurance — despite caring for older, sicker patients. Privately administered Medicare Advantage costs more than traditional Medicare; that’s not because patients receive care they don’t need, but because private insurance companies receive extra federal payments they don’t earn. Clearly Medicare needs less private interference, not more.
Medicare delivers high value. Its critical features — prepayment during high earning periods, reduced cost-sharing at time of need, inclusion of the broadest possible population, comprehensive benefits — should be reinforced. Then these features should extend to the rest of us. Medicare for some is good. Medicare for all is better.
SAMUEL METZ, Portland, Ore.
The writer is an anesthesiologist and a member of Physicians for a National Health Program.