Medicare For All: What It Really Means & Thoughts on Alternatives

It is December.  Hard to believe that we will be voting in less than a year.  So here are some thoughts. I am not in favor of Medicare for All, at least not in the way several political candidates have proposed it. Medicare, as I know it, has copays, deductibles, maximums, and premiums based on income.  In many cases, it also requires a Supplement to cover the deductibles, copays, and amounts above the maximums. I have it and I love it.

Medicare for All has no copays, no deductibles, no premiums, no maximums and covers medical inpatient and outpatient, drugs with no copay, dental, and vision.  See the problem? Have any trouble getting in to see a doctor recently; or even getting a doctor to accept you as a patient? Imagine what it will be like when everyone knows they can go to see a physician or dentist and it won’t cost them anything. There is already a problem with people using the emergency room because it is more convenient than waiting two weeks for an appointment or going during the day when the evening is more to their liking.  If the cost of such a program doesn’t scare you (and I have heard the rich will pay for it) then the lack of resources should and the millions of people involved in the health insurance industry that will be looking for jobs should.

But just knocking a problem and not offering any solutions is counterproductive.  So here is what I am in favor of:

• Outlawing advertising of drugs except for medical professionals.  The drug companies say they spend more on R&D than advertising but it is not true.  Those billions of advertising dollars could be used to look for cures.   Congress outlawed alcohol advertisements they can do it with drugs.

• Universal Coverage:  Medicare, expanded Affordable Care Act (ACA) or some other vehicle.   These plans should have no annual maximums; deductibles and premiums should be based on income.  Insurance companies could sell supplements to those that wanted them as they do now for Medicare.

• Dental:  Free cleanings and fillings done at clinics staffed by senior dental students or by your favorite dentist for a fee.  We actually had this system in Hawaii for a while.  If you want veneers or some of the other things that make you look beautiful, like whitening, then I’m with you.  I want them too but we should pay for them from our own pocket.

Next issue:   what I think of  Koa furniture in the waiting room.

Be Your Best Self in your Career

For More information we recommed reading How We Work: Live Your Purpose, Reclaim Your Sanity, and Embrace the Daily Grind by Leah Weiss, PhD which inspired this post.

Mindful Minute: Find Your Connection to Nature

"Look deep into nature and then you will understand everything."

- Albert Einstein

Yoshifuki Miyazaki wrote Shinrin Yoku or "Forest Bathing" explaining how 15 minutes of being in nature regulates blood pressure and decreases stress; 1 full day regulates blood pressure and stress for 5 days! Miyazaki's studies also proved that being around nature elements for people that didn't have access to forests like city-dwellers, receive similar results from being in a city park, having a bonsai or fresh cut flowers, or even smelling and feeling wood.

The next time you're feeling stressed, anxious, or imbalanced; spend time connecting to nature and its elements.


For more information about Forest Bathing, check out Yoshifuki Miyazaki's book Shinrin Yoku: The Japanese Art of Forest Bathing

Hawaii is also fortunate to host one of the top Forest Bathing centers. Forbes called Forest Bathing Hawai‘i’s walk in a rain forest one of the top five travel experiences in the world "that should be on every intrepid traveler's bucket list."

Be Your Best : Practice the Pause

Social psychology researchers found that slowing down and allowing for less automatic responding goes a long way in creating a positive environment at work and in life. Pausing gives us the ability to view our emotional reactions from a more objective viewpoint to determine if our response will be constructive or destructive.

This post was inspired by Leah Weiss, PhD and her book, How We Work: Live Your Purpose, Reclaim Your Sanity, and Embrace the Daily Grind.

Leah Weiss is a researcher, professor, consultant, and author. She teaches courses on compassionate leadership at the Stanford Graduate School of Business and is principal teacher and founding faculty for Stanford’s Compassion Cultivation Program, conceived by the Dalai Lama. She also directs Compassion Education and Scholarship at HopeLab, an Omidyar Group research and development nonprofit focused on resilience. She lives in Palo Alto, California with her husband and three children.

Laudra's Lessons - Medicare for All

It’s fall already and by this time next year we will all (I hope) be thinking about who we will vote for in November.  I’m not going to go into President Trump’s policies and promises as we will have 5 years worth of those, counting the time he was campaigning.  I do urge you to consider what the opposition is proposing because there is a good deal to choose from. Unfortunately, Hawaii being a relatively small State, our impact is limited.

At least two candidates are proposing “Medicare for All.”  Medicare by itself is not enough. Seniors that have Medicare already either have employer coverage that supplements their Medicare or they buy a 

Supplement or Medicare Advantage Plan.  Medicare for All would be extremely expensive but our health system is already extremely expensive and it doesn’t serve everyone.  Medicare for All would cut down on the costs for claims administration and other bureaucratic paperwork and could cut the cost of drugs.  There is a bill in Congress right now that would do that but chances of passage are slim.

On the negative side, many medical professionals are leaving Hawaii and they cite low reimbursement rates.  Reimbursement rates even for insurance companies are set by Medicare. The insurance companies look at what Medicare is paying and set their reimbursement rates as a percentage or ratio of what Medicare pays; generally, a few percentage points higher.  That means that medical professionals would be making less money than they are now. And every year Congress would be able to cut the reimbursement level. 

We don’t get to vote on whether to have Medicare for All or the Patient Protection Act but the candidate that is elected will decide.  President Trump has said he has a plan but we have not seen any specifics. If John McCain had not had the courage to vote against the bill to cancel the PPA  three quarters of the country would have been without any medical coverage at all because there was no plan to replace it and it would have taken time for the insurance companies to get any new plans through State Insurance Departments.  

Think about it, and vote.