John O'Connor
John O’Connor

Democratic lawmakers introduced Medicare-for-all legislation in the House Wednesday. The idea here is to let Uncle Sam take over for private insurers. Talk about a case of pick-your-poison…

Rep. Pramila Jayapal, a Washington Democrat, is one of the measure’s staunchest supporters. During a call with reporters Tuesday, she noted that she’s excited “to get to work on providing true universal coverage for everyone in this country.”

No word on her excitement level about the government providing free college for all, zero-interest home financing, a $50 minimum wage or dancing unicorns for birthday parties. Those also would be awesome for beneficiaries. And they are just about as likely to happen. Which is to say none of these things will be happening anytime soon.

That’s the case for a variety of reasons, not the least of which is that our Treasury is in no position to underwrite any of these new benefits.

As things now stand, Medicare in its current form is on track to go bankrupt in less than a decade. Larding up Medicare’s saddle bags only will shorten that runway. But if we can’t afford to make Medicare a universal benefit, then maybe we instead could do some incremental things to make it better?

For all of the questionable things Medicare will cover – such as surgeries for people who clearly have less than a year to live – the program gets parsimonious in some strange ways. One glaringly obvious example: assistive devices. Think things such as canes, walkers, shower seats, raised toilet seats and so on.

If you’re old and need any of those items, better break out the charge card or phone a friend. Because those devices currently are not covered by traditional Medicare.

The good news is that things are getting better. For example, the CHRONIC Care Act, which became law last year, does allow Medicare Advantage plans to offer supplemental benefits that cover things like wheelchair ramps and grab bars. But the inadequacy here is twofold. One is that the plans are not required to offer such things. The other problem is that if an older person is in a traditional Medicare plan, they are completely out of luck.

So here’s a simple fix: Include supplemental products as a standard Medicare benefit. It surely will make the program stronger. Plus, unlike universal coverage for all, it’s an improvement that actually could happen.

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