This concept of "Cost shifting" exists, but there is some academic debate if its actually whats happening. Medicare also does something invisible to the patient

This concept of "Cost shifting" exists, but there is some academic debate if its actually whats happening. Medicare also does something invisible to the patients: it pays the least and has the highest stringent requirements for providers. You need to be up to code to the last detail, you will be under scrutiny for your documentation, you have no bargaining power and medicare pays 20-50% less to providers than private insurance. It is also not the same as PPO's (which most employees in HN must have) you will have a lot fewer options for care. (remember, you can only get a doctor that collects a much smaller fee, so forget about swanky offices and convenient locations)