March 14, 2017

Medicare – Make it Portable!


Issues: Social Security and Medicare

Medicare – Make it Portable!

by Karen Lee, DAGR Chair

We in Greece often gloss over reports on Medicare. Like other American retirees around the world, we can’t use its benefits unless we travel back to the US. And let’s face it, free medical treatment isn’t so free if it includes the cost of a plane ticket. A checkup combined with a family visit is smart; major medical with multiple follow-up visits is expensive and disrupting.

For this reason, ‘Medicare Portability’ is a plank in the 2016 Dems Abroad Platform!

As then-DA Mexico member Paul Crist* pointed out over 8 years ago, Medicare Portability is smart for everyone. US retirees who’ve paid into the program receive the benefits they deserve. Otherwise, they have to pay travel expenses OR pay out-of-pocket for local treatment.

Good for Enrollees

For instance, retirees in Greece can pay 9.5% of their Social Security check to get IKA coverage. But with the Greek medical system struggling after ‘memorandum-imposed’ cuts, availability of some therapies and drugs may be insecure or inconvenient.

Moreover, while the premium for inclusion is needed from the Greek point of view, the fact remains, that many US citizens have already ‘paid’ into the Medicare system for services they are now paying for a second time.

Good for US Budget

The US budget would also gain from Portability. Because high-quality health services are much cheaper in most other developed countries, the system would actually pay out less for beneficiaries to get their treatment

US authorities have also argued that certifying health providers abroad would be complicated and cost-prohibitive. The fact is, most developed countries have their own state health systems and certification mechanisms. If a doctor or hospital is good enough for French, or Greek, licensure, they would also pass US muster.

What’s Holding Up Portability?

So, what’s the problem? Why not get on with enacting a Portability law that’s to everyone’s benefit? On the one hand, many US lawmakers are simply unaware of citizens abroad and their particular concerns.

More important are two major blocks of opposition. Corporate interests invested in medical profits contribute to candidates in both major parties. Results: 13 Dems, including a few high-profile ‘progressives,’ voted with GOP senators earlier this year to quash importation of drugs from Canada.  Their excuse was that the bill lacked a way to check the safety of the drugs. From Canada. Canada? Really?

Also, in the current climate, conservatives such as Speaker Paul Ryan, want to privatize the Social Security and Medicare systems. They argue that a privatized system will bring lower prices and better care for all. It’s an argument that defies logic when the pre-Obamacare uninsured and continuing high costs are compared to countries with state or mixed public-private health systems.

But, common sense be damned! These ideologues are certainly not going to enact a system that would lower costs and make quality services more available to all.

Bringing it Back to Greece

In the meantime, Medicare-eligible retirees in Greece have three choices. We can travel back to the US for diagnostics and treatments. Or we can pay for a private insurance plan here in Greece. Or we can purchase coverage through IKA, which seems expensive until compared with travel and other costs. With prodigious hunting, we might find a supplemental private insurance at a reasonable cost wherever we get services. Still, any way you look at it, we are not currently getting the benefits we, like our counterparts in the US, have paid in for.

Advocating on behalf of Medicare are AARP and other organizations, such as Kaiser Family Foundation and, of course, Democrats Abroad. For a solid overview, read the statement by AARP president, Bill Walsh, entitled ‘A Battle Looms’. The full report is available at the same link. They’ve run the numbers and looked at the possible outcomes. The DA 2016 Platform, pg 6, Medicare and Healthcare, is found here.

Medicare – buttressed by cost-savers such as Portability and drug-price negotiation – wins hands-down!

* Paul Crist, a former aide to Sen. Paul Sarbanes, had his ‘Medicare in Mexico’ pilot project ready in 2008, and returned to DC to promote it. Unfortunately, it was overtaken by the noisy negotiations that eventually became Obamacare, and has yet to be acted on.