Medicare over Managed Care

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Medicare over Managed Care

Since its inception during the tenure of President Barrack Obama, Medicare has experienced its share of criticism and comparison with other forms of medical insurance plans. The most common debate has to be the need to have Medicare for all as opposed to having citizens have private health insurance covers. While it is not in question that the private medical covers play a role in ensuring that the insured gets the necessary health services they require, the role of Medicare far outweighs that of private managed care. The paper will make a case for the need to have Medicare for all based on numerous benefits and the potential it has to make health accessible for all.

To start with, understanding the differences between Medicare and managed care plans will create a better understanding of the need to promote Medicare over managed care plans. Medicare is a government provided insurance covers made up of parts A and B being hospital and medical insurance respectively. Managed care plans, which are also known as Medicare Part C or Medicare Advantage plans, are insurance plans offered by private insurance companies but overseen by Medicare. Though managed care plans cover much more than Medicare would, they are required to cover everything the original Medicare covers. How such plans work is that they create a network of hospitals or medical professions(Barcellos& Jacobson, 2015).  An insured person will be required to see health providers who are part of the plan’s network for care to be covered by the insurance. There are however, certain variations in different managed care plans allow the insured to see health providers outside their networks but under higher costs.

From the understanding of how the different medical covers work, the greatest strength of Medicare is its universal application. Unlike the managed care plans where those seeking medical attention are restricted to the networks of the private insurance providers, Medicare is accepted across the country. Medicare for all would translate to equal opportunities for healthcare for all unlike in managed care plans. The universal application of Medicare means that there is efficient provision of healthcare than with private insurers.

The universality of Medicare is also because it is free making it accessible for all. Managed care plans are associated with higher costs for healthcare as there is competition in the private insurance sector and in some instances there are monopolies that control the cost of acquiring a private insurance cover(Archer, 2011). The high costs of private managed care make the case to have Medicare for all as it will be affordable for the citizens. By adopting Medicare, there are chances that the program would help to control the increasing costs of healthcare associated with profit-driven private insurance schemes.

Medicare has lower administration costs than private plans making it more appropriate for coverage for all. Medicare administrative costs include those incurred in the collection of Medicate taxes, managing fraud and other abuses of the Medicare program. The administrative costs in Medicare account for only 2% of the expenditures of the program(Archer, 2011). However, the private health schemes have to add marketing and the need to make profits to their administration costs which raise such costs significantly, making it unfavorable for application to the masses. Additionally Medicare has demonstrated the ability to regulate the health insurance sector as it still regulates the governing of managed care plans meaning that it will not require additional governing structures if it was to be introduced to all.

In terms of accountability, Medicare is publicly accountable making it better suited for uptake by all. Private companies that run the managed care schemes treat their data as trade or company secrets and therefore do not expose costs or any innovations towards costs that are incurred by the firms unlike Medicare whose data is open for the public(Archer, 2011). Accountability in healthcare is important especially for uptake by the public.

Even with the advantages of Medicare, there is still the challenge that it does not cover certain aspects of healthcare. Medicare provides a basic cover and specialized healthcare may not be covered by Medicare(Barcellos& Jacobson, 2015). The limitation of what is covered by Medicare needs to be addressed before it can be rolled out to serve all citizens. Since Medicare regulates even the managed care plans, it is possible to increase the allocations to the program so that it covers more health related expenses for use by all.


Access to healthcare is a basic right that all governments assure their citizens. Privately managed care plans serve a role in healthcare but are only accessible to selected few.  Adopting Medicare for all will ensure that there is access to healthcare for all and at affordable rates or even fully covered by the government. The adoption of national wide use of Medicare may be associated with increased taxes to run the program which may be a concern for citizens(Barcellos& Jacobson, 2015). However, this cannot be compared to the assurance that citizens would have knowing that their medical needs are fully covered using public finances.




Archer, D. (2011). Medicare Is More Efficient Than Private Insurance | Health Affairs Blog. Retrieved 29 September 2021, from

Barcellos, S., & Jacobson, M. (2015). The Effects of Medicare on Medical Expenditure Risk and Financial Strain. American Economic Journal: Economic Policy7(4), 41-70.