Medicare was originally established as a quasi single-payer system in 1965 because of the insurance industry’s refusal to cover seniors since they didn’t generate enough profit. Over the decades, powerful industry lobbying and weak, unprincipled, bipartisan Congressional connivance are permitting the same forces of privatization that control the rest of our healthcare delivery system to destroy Medicare.

Traditional Medicare provided payment for about 80% of covered healthcare costs but intentionally was legislated with coverage holes that necessitated separate “gap” insurance to pay for costs not covered in the original plan.

Enrollees also pay a monthly premium deducted from their Social Security check and an annual deductible. Also, traditional Medicare does not cover prescription drugs, dental, and vision. To obtain these coverages, one must “purchase” more insurance plans.

With costs rising, now you’re starting to talk about real money, making it more difficult for more and more people to keep traditional Medicare. For example:

In 2023, I figured the costs for my wife and me for Medicare deductions from Social Security, Medigap premiums, Part B deductibles, Part D premiums and deductibles.

The total amounted to: $9992 – out-of-pocket costs to be on “traditional” Medicare

This does not include all copays for physician visits and prescriptions which brings it well over $10,000 /yr. Dental and vision added even more costs. Friends I have talked to are paying even more due to higher prescription costs.

This ever-escalating amount is fuel for the right-wing privatizers as Medicare is fast becoming a “high deductible plan” like most of the health insurance being sold on the market and available via employers.

MEDPAGE TODAY ran an article titled, Will All Seniors Eventually Have No Choice but Medicare Advantage? MedPAC chair, Michael Chernow says there is a problem and tinkering around the edges by cutting some of MA will improve the fiscal solvency of the Medicare program. He is not asked nor does he comment on what value or savings (none) MA brings to Medicare. Nor is it asked why not solve the problem by eliminating all privatization, including billions in tax subsidies and overcharges which bring no value to health care delivery?

Unlike Medicare Advantage which is tax-subsidized private insurance, people like traditional Medicare because it does not have gatekeepers that limit access, most providers accept its payments and it has no networks, geographic restrictions or excessive denials of care. It’s no mystery why people are unfortunately turning to Medicare Advantage. These costs have made traditional Medicare increasingly difficult for many and hence the rise of MA enrollment — yes– doomed to privatization unless we act accordingly.

How Do We Deal With This?

For starters, let’s understand that the for-profit monster controlling the American healthcare delivery system has its tentacles around us all. No one is immune. Whether you’re young, old, sick, healthy, a worker, independent contractor, disabled… or a business.

Given the systemic nature of our dilemma and with a supportive public looking for honest and independent analysis, we must clearly educate, organize and act to expose why the whole for-profit healthcare delivery system is our problem.

That’s why the privatization monster and its acolytes do not fear those who talk about finding “common sense and realistic” solutions with the insurance industry, drug companies, spineless politicians or those who preach the “practicality” of such efforts. It’s more than a few “Bad Actors” who are creating the problem with Medicare Advantage. It’s the systemic decades of bipartisan privatization, billions of wasted tax dollars and insurance profits handed out to the whole industry that has to go. This must be our focus. We must work in labor unions and talk with workers everywhere to show that many of the 600-plus labor unions that signed resolutions for M4ALL over a decade ago are now led by leaders who say that the “political climate” is not right to end the profiteering in healthcare and it’s “unrealistic” to oppose Medicare Advantage Plans so go ahead and sell these “unrealistic” plans yourself. A totally losing strategy that must be exposed.

Confront the Monster Head On

What is needed is an organizing call to replace the corporate healthcare monster with the only solution: A National Improved Medicare For All single-payer system that covers everyone. Educating and organizing for it promotes the elementary and common solidarity needed between the millions in the USA without any coverage and those struggling with high deductible plans, medical debt, narrow networks, co-pays and ever-rising premiums eating more and more of paychecks or retirement income.

What hinders our movement is the cavern between what is needed and possible and the political disconnect that talks of piecemeal backward steps as all that is possible when the public needs and wants much more – dumbing down and deflating our goal for real healthcare justice rather than inspiring, lifting up and showing the way forward.

The rising costs of traditional Medicare bring with it the siren song of privatization inherent in the for-profit American healthcare system. Unless it’s stopped, its insatiable demands in its DNA will destroy, commodify and sell everything benefiting the public interest. Nothing is safe. Along with our healthcare, labor rights, environmental protections, health, safety and everything benefiting the public will be subordinated to the profit motive.

We at National Single Payer believe that we have the people on our side. Join us in building the kind of strong independent movement that can provide the new direction needed to deliver the healthcare system we all deserve.

Join us to get involved.


-Ed Grystar has more than 40 years experience in the labor and healthcare justice movements. He is co-founder and current chair of the Western Pennsylvania Coalition for Single Payer Healthcare. Served as the President of the Butler County (PA) United Labor Council for 15 years. Has decades of experience organizing and negotiating contracts for health care employees with the Service Employees International Union and the Pennsylvania Association of Staff Nurses & Allied Professionals.

This article first appeared in CounterPunch.