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As a person who is about to go on Medicare, I am learning that I don't like it very much. My family and I have participated in group health insurance plans provided the my employer(s) for forty years. In the 1980s the company I worked for paid 100% of the health insurance premiums for its employees. Most of the time the companies I have worked for paid 85% of premiums.
Medicare bills itself as covering 80% of the cost of medical care. Individuals are responsible for the remaining 20%. Some individuals can afford medigap plans that are provided by private health insurance companies, and others cannot. For me, the 20% for a medigap plan will cost more than twice what I pay for similar coverage at my current job, so although I will have Medicare in my "golden years" when I suspect I will need health care more than any time in my life, I may or may not be able to afford the kind of coverage I have had for forty years.
There is a better way. This has been my problem with promoting Medicare for all. The current Medicare program does not provide sufficient health care, especially for retired people on fixed incomes. My proposal for health care in the USA is a program similar to the one used in Taiwan. The key to Taiwan's health care system is this attitude.
“When they set up the program, they said, ‘We should feel sorry for those who are sick ― on top of that pain and suffering, it’s an awesome financial burden. We should take care of that.”
We can do anything we want to do. The question always is what do we want to do.
What The System Looks Like Today
More than 99 percent of people living in Taiwan now have insurance through the NHI. They pay premiums based on a sliding scale, with employers contributing additional premiums, and they have to pay modest out-of-pocket costs for everything from prescriptions to hospitalization.
That last part might surprise people who think that single payer necessarily means “free” health care. It doesn’t, though the NHI waives copayments and deductibles for several key populations: the poor, pregnant women, children younger than three and people with serious, long-term conditions like diabetes or cancer.
“It protects the disadvantaged, it protects the sick, really well,” Cheng said. “When they set up the program, they said, ‘We should feel sorry for those who are sick ― on top of that pain and suffering, it’s an awesome financial burden. We should take care of that.’”