"I believe 'honor thy mother and father' is not just a good commandment to live by; it is good public policy to govern by. That is why I feel so strongly about Medicare."
-- Barbara Mikulski
Whether you believe that mothers and fathers should be cared for and honored by their children alone or by their children with the help of government programs, there's no getting around the fact that Medicare today is caring for a lot of mothers and fathers. Most of us know a few things about Medicare, but there are many important things to know about the program, some of which are rather surprising.
Here are 14 Medicare stats that might impress you.
Medicare is enormous
You surely know that Medicare is big business, but you probably don't appreciate just how big. Consider:
- $709 billion: That's how much Medicare benefit payments are expected to total in 2017. That's roughly equal to the gross domestic products (GDP) of Vietnam, and Greece combined. If that's not eye-opening enough, it's also roughly equal to the recent market values of McDonald's, Boeing, Nike, Starbucks, American Express, Lowe's, FedEx, Ford, and General Motors -- also combined.
- 20%: In 2015, Medicare spending accounted for 20% of all health spending in America in 2016. It also made up a remarkable 15% of the federal budget.
- 57,959,578: There are nearly 58 million enrollees in Medicare, as of April 2017. Considering that there are roughly 325 million people in America, that's a hefty 18% of the population -- nearly 1 in 5.
- 18.3 million: Among the 58 million folks in Medicare, more than 18 million are estimated to be in Medicare Advantage plans as of 2017. Medicare Advantage plans are alternatives to the "original" Part A and Part B of Medicare, offering as much coverage and often more.
Medicare has an interesting history
History is full of fascinating details, and the history of Medicare is no exception:
- Four months: When Medicare was introduced in 1965, it required that hospitals be fully racially integrated to receive Medicare reimbursements. This requirement caused about a thousand hospitals to quickly (and often quietly) integrate, within four months, marking a major step forward for equality in America.
- No. 1: The first enrollee in Medicare was none other than former President Harry Truman. While President Johnson signed the program into law, Truman's administration had done much of the work putting it together, and so he was honored with the initial enrollment.
Medicare got a big boost from the ACA
The Affordable Care Act (the ACA, often referred to as Obamacare) has had a major effect on Medicare:
- 4.4%: The ACA was designed, in part, to contain healthcare costs that were rising at rapid rates. Data from the Kaiser Family Foundation (KFF) shows that Medicare spending grew at an annual average of 9% between 2000 and 2010, and then slowed to an annual average of 4.4% between 2010 and 2015. And that's even as baby boomers started to enter the Medicare rolls in 2011. The KFF also notes, "Average annual growth in spending per beneficiary averaged 1.4% between 2010 and 2015, down from 7.4% between 2000 and 2010."
- $0: The ACA required Medicare to offer enrollees more coverage -- especially in the form of preventive services -- for no additional cost.
Medicare is threatened by current proposed legislation
As most of us are aware, there are many changes to healthcare, including Medicare, being proposed in Washington these days. The current administration is pushing to repeal and replace the ACA and has proposed legislation that's likely to deliver less care at a higher price. Here are some things to know:
- 3 years: Congress' plans to repeal the Medicare tax on high-income taxpayers will weaken Medicare, hastening the depletion of its Part A trust fund by about three years.
- $660 billion: Repealing the ACA will be a big deal. The Center on Budget and Policy Priorities notes that the bill the House of Representatives passed to repeal and replace the ACA "would eliminate ACA taxes on wealthy households and insurance and drug companies and greatly expand tax-sheltering opportunities for high-income people." It added: "These tax cuts (plus several smaller ones) would cost $660 billion over 2017 to 2026."
- $1.55 trillion: The Committee for a Responsible Federal Budget has noted, "According to our latest estimates, repealing the ACA in its entirety would cost roughly $350 billion through 2027 under conventional scoring and $150 billion using dynamic scoring." Also: "Repealing the ACA's coverage provisions would save $1.55 trillion through 2027, while repealing its tax increases would cost $800 billion, and repealing its Medicare (and related) cuts would cost another $1.10 trillion. Repeal would also lead to a small increase in economic growth, which could produce over $200 billion of additional net savings." Clearly, there are costs and savings realized from a repeal -- though some of the costs are human -- see the next point.
- 23 million: If the ACA is repealed, it has been estimated that about 23 million people will lose health insurance coverage. That will lead to tough or impossible choices for many: Risk financial disaster to pay for healthcare or go without and risk a shorter life. While the ACA has indeed introduced some new costs to the federal budget, it has also ushered in some greater financial efficiencies while covering millions of Americans. Also, according to Kaiser: "Medicare spending would rise primarily as a result of repealing the ACA's reductions to payments to providers and Medicare Advantage plans. An increase in Medicare spending would likely lead to higher premiums, deductibles, and cost sharing for beneficiaries, and would accelerate the projected insolvency date of the Medicare Hospital Insurance trust fund."
Making the most of Medicare
Despite all that turmoil and uncertainty about what Medicare will look like in the future, it's still with us, and making the most of it can save you money and boost your health.
- $0: That's how much you pay out of pocket for an annual wellness visit with your doctor, through Medicare. It's also how much you pay when you get certain screenings, such as mammograms, colonoscopies, diabetes screenings, and many more.
- 5: Medicare has a five-star rating system for services and facilities such as hospitals, dialysis centers, Medicare Advantage plans, nursing homes, and more. A five-star rating is the best you can get, but as of July, when 3,617 hospitals were rated, only 102 earned all five stars. For 2017, about 49% of Medicare Advantage plans with prescription drug coverage were rated with four or five stars -- covering about 68% of enrollees. The rating system for hospitals takes into account measures such as the rate of post-surgical infections and emergency room wait times. Medicare Advantage plans are evaluated on measures such as how well they're keeping their members healthy (with screenings, checkups, and more), how well they're managing members' chronic conditions, and how good their customer service is. You'll find the star ratings of plans available to you by using the Medicare Plan Finder at the Medicare website.
Most of us will probably be enrolled in Medicare at some point in our lives, so it's smart to learn more about it to make the most of it. Making the most of Medicare can save you a lot of money over the course of your life, and it might even extend your life, too.
Selena Maranjian owns shares of American Express, Boeing, Ford, and Starbucks. The Motley Fool owns shares of and recommends Ford, Nike, and Starbucks. The Motley Fool recommends American Express, FedEx, and Lowe's. The Motley Fool has a disclosure policy.