Healthcare in America — The Next Conversation Part 3 – Understanding the System Before Trying to Fix It

Part 3 – Understanding the System Before Trying to Fix It

So far, we have looked at three healthcare models used around the world. Each has its strengths. Each has its weaknesses. None is perfect, and none mirrors the healthcare system we currently have in the United States.

One point that is often overlooked is that when we hear campaign slogans like “Universal Healthcare,” it is rarely mentioned that the United States has already traveled part of that road. We already have Medicaid, a joint federal-state program designed for lower-income individuals and families. We also have Medicare, a federally administered program that primarily serves Americans age 65 and older, along with certain younger individuals who qualify because of disability or specific medical conditions.

What we do not have is a government-sponsored system that fully addresses the millions of Americans under age 65 who earn too much to qualify for Medicaid but still struggle to afford private health insurance. The Affordable Care Act—better known as Obamacare—was designed to help bridge much of that gap.

In Parts 3A, 3B, and 3C, I want to step away from politics and simply explain how our current system is organized. Before we decide what should change, we first need to understand what already exists.

This may seem like a lot of information, but I am condensing thousands of pages of federal laws, state regulations, insurance policies, and decades of changes into something the average person can understand. Even after studying it, I still find parts of it confusing. But before anyone can honestly say, “Here’s how we should fix healthcare,” we need a common understanding of what we already have.

As we work through these three sections, several larger questions will naturally emerge. Should healthcare be administered entirely by the federal government, or should the states continue to play a major role under federal guidelines? Should eligibility continue to depend on age, income, or some combination of both? Should we continue operating multiple programs, or would a more unified approach make better sense?

I’m not asking those questions because I already have all the answers. I’m asking them because they illustrate just how complicated healthcare has become. Before we can decide where we want to go, we first need to understand where we are.

Part 3A – Medicaid: America’s State-Federal Safety Net

A look at the nation’s healthcare program for lower-income Americans, how it is funded, how states administer it under federal guidelines, and why Medicaid can look very different depending on where you live.

Part 3B – Medicare: More Than Just Turning 65

An overview of Original Medicare, Medicare Advantage, Medigap, supplemental coverage, prescription drug plans, and why understanding the differences is often more confusing than people expect.

Part 3C – The Private Insurance System: Filling the Gap

An examination of employer-sponsored insurance, individual marketplace plans, the Affordable Care Act, and the millions of Americans who fall between Medicaid and Medicare while trying to navigate the private healthcare system.

Healthcare For All, The Evolving Series