Robbie Whelan
speaker
85 appearances
1 recordings
1 series
first heard Sep 2020
last heard Sep 2020
Robbie Whelan’s voice in public audio — every appearance, attributed to the second.
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Appearances
There are all kinds of problems because cost sharing has only been waived for this one illness.
And it sort of speaks to this patchwork system of universal health care, but only for one illness.
When the pandemic first hit, Congress authorized the CARES Act, which included a couple of provisions that are relevant here.
One is that all testing ought to be free.
The other really relevant piece here is they authorized $175 billion in what are called provider relief funds.
And those are funds that hospitals and other medical services providers can apply for for reimbursement for the cost of treatment.
So there's two components, testing and treatment.
And those funds were actually primarily used by people who are uninsured.
So in theory, if you're an uninsured patient, you don't have health insurance, which is about 28 million Americans.
and you get the infection, you go and get treatment for it, you should be able to apply through your hospital to have that coverage covered by the federal government.
But however, with other types of patients, there are certainly some cracks that people are vulnerable to slipping through.
Well, Medicare generally is a pretty expansive program.
It covers most of the ailments and procedures that Americans who have it need, particularly older Americans.
But there are about 10% of Medicare patients, there's about 6 million people in America don't have what's called supplemental insurance, which is also called gap insurance.
The result of that is that if you have a long hospital stay, you know, more than two or three weeks for COVID-19, and a lot of outpatient care, and perhaps even a lot of prescription medicine that you need to take,
Then if you don't have this gap insurance, you might end up paying a big out-of-pocket bill because you still have to cover the 20% cost sharing that Medicare basic asks of beneficiaries.
And the reason for that is unlike the private insurers, Medicare has not suspended cost sharing for COVID-19.
And secondly, Medicare has never had an out-of-pocket spending limit like most private insurance plans have.
And this is sort of a political football that's been kicked around since at least the 80s when every few years someone in Congress will say, we should really limit how much Medicare beneficiaries can pay out-of-pocket so fewer people –
who have chronic illnesses or big unexpected medical procedures don't go broke.
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