Avg monthly healthcare spending for enrollees age 60-64 in large employer plans is 38% higher than that for traditional Medicare beneficiaries age 65-69.
Why? Price. Provider payment rates from private plans tend to be much higher than those from Medicare kff.org/medicare/issue…
Why? Price. Provider payment rates from private plans tend to be much higher than those from Medicare kff.org/medicare/issue…
large employer plans pay between 1.6 to 2.5 times more than Medicare for the same type of inpatient admission. Over time, the payment rate differential has also been increasing, per KFF
kff.org/medicare/issue…
kff.org/medicare/issue…
This is part of the reason why expanding Medicare (either to just to 50ish+, or everyone) is politically difficult. Advocates say it would reduce overall U.S. healthcare spending -- which it might, but probably only if providers (hospitals, doctors, etc.) take a big haircut.
Reducing provider prices is sort of the 3rd rail of health reform. Americans hate greedy insurers, which they think earn too much money (even tho insurers' profit margins are effectively capped; providers' aren't). But they like their dr, & local hospital is often a big employer
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