I have had Medicare since about 1999/2000. Medicare pays 80% of what they consider is "reasonable cost." Believe me - that isn't much. For example: Suppose I have a bill of $1000. Medicare determines that reasonable cost is $400; they pay 80% of that. And even though I have a private insurance which supplements Medicare, Medicare still sets the reasonable cost which means in my example that my private insurance will pay 20% of $400. Whoever performed the service (doctor, hospital, whoever) is out $600. When my doctor retired about five years ago I called four places which wouldn't take me on as a patient because I have Medicare.
Even though private insurance companies are in it for profit, because they charge much higher premiums than the government does for Medicare, they can afford to pay more out because of those higher premiums. It's truly a case of you getting what you pay for.
Because I don't work, Medicare is primary and my Blue Cross/Blue Shield is secondary so Medicare sets the reimbursement rate. Secondary insurers REQUIRE that a person be entitled to Medicare if they are eligible to cut down on the costs of the secondary insurance.
If I didn't have Medicare and I wasn't eligible for it, my Blue Cross/Blue Shield would be reimbursing my doctors and hospitals at a much higher rate than what Medicare does.
Now why doesn't everyone in the United States have Medicare? The insurance companies wouldn't stand for it and the medical community would be backing them up. Our representatives and senators wouldn't dare extend Medicare to all Americans!
Frankly I think Medicare should be extended to everyone with increased premium rates and higher payments to providers of services and it could be administered through the private companies. But who am I?