Medicaid pays a quarter of the health expenditures of people 18 and under, compared with 11 percent for the entire population. Seniors' expenditures for prescription drugs vary considerably. Congress should build a universal prescription drug benefit into Medicare, covering all beneficiaries just as Part A hospital coverage protects all enrollees. 10 percent of the population accounts for 68 percent of health care spending. This decile spends six to seven times as much as the average.
Risks vary, regardless of income or insurance status.
This high level of risk variation demonstrates why it is so important to keep the healthy and the sick together in one combined risk pool. Dividing the healthy from the sick will deplete the risk pool of needed premium dollars, and will inevitably lead to higher premiums for those with higher risks. Tripling of premiums for traditional coverage would occur if all of the healthy people migrated to MSAs. Congress should reject public policy proposals that fragment the risk pool, dividing the healthy from the sick. It should ban limits on lifetime benefits that limit reimbursement to families with the most catastrophic need.