Radical New Idea: Medicare Buy-In For Everyone

You only need 51 senators to pass a bill through reconciliation. But theoretically the main problem with reconciliation is that it can only be used for legislation that affects the budget. So, a public option or Medicare buy-in would definitely affect the budget, but getting rid of insurance practices like barring people for pre-existing conditions or denying them care through rescission could not be handled through reconciliation.

So, if you just want one bill you can't go through reconciliation because you can't keep many of the important elements of health care reform. That's conventional wisdom. But here is a radical new idea - how about we just do Medicare buy-in for anyone who wants it and not bother to pass any regulations about pre-existing conditions or rescission or anything else.

But what about all of the people on private health insurance who are getting screwed by those companies? Well, I guess they'd have to buy in to Medicare, wouldn't they? And if the private insurance companies lost enough customers, my guess is they would all of a sudden see the wisdom in actually providing better insurance. I believe they call that competition.

Medicare does not engage in any of the abuses that we are trying to address with this bill anyway. They don't turn people away. They actually treat you if you're sick. They don't take 20% of your money as profit for their executives and shareholders. It's a policy that a lot of people might feel very comfortable going with.

We know the Republicans can't possibly object to Medicare because they spent the last several months pretending to defend it against what they said were attacks by the Democrats. Great, we're on your side - Medicare it is.

This has the advantage of tremendous simplicity instead of the bureaucratic monstrosity that is the current bill with all of its regulations, mandates and loopholes. The government doesn't have to create a whole new entity. People pay the premiums for this Medicare buy-in, so it's deficit neutral.

And since it can get passed through reconciliation where you only need 51 votes, you remove all of the political headaches. Joe Lieberman can go ... himself. Ben Nelson, you are free to vote with your Republican friends. Olympia Snowe, you get to keep whatever perks you had within the Republican Party. Blanche Lincoln, you are free to be as conservative as you like in Arkansas (see how that works out for you).

Chris Matthews said the other day that passing health care reform through reconciliation would be Armageddon. Why? George Bush passed many bills through reconciliation, including the largest tax cuts in history. He got most of his legislative accomplishments in 2001-2005 when he had only 50 or 51 senators. And there was no Armageddon. In fact, nary a peep was heard.

There are only two groups who lose in this. The insurance companies that are going to see most of their customers walk away when they see how badly they've been getting screwed all of these years. And the Obama administration because they will be all out of excuses on why they can't get real reform passed.

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Somehow the congress will figure out a way to stop this as well. It is a fntastic idea. It would take someone who is willing to completely buck the system. The person who would introduce this and then convince 51 coleagues to come along would get crushed! Is there someone whe is willing to lie in front of that bus? Maybe we will see. I hold my head in shame until someone steps up and actually represents us. The voters.

by bgpblaze on 12/17/2009 04:49:52 AM EST

It's way too simple.  You could fit that bill on -- what? -- one?  Two pages?

Besides, how popular would it be?  Merely enormously?

Sorry, but that's not enough on either count.

You'd have to accompany it with a couple of hundred million slipped under the table to the half of Congress that is employed by the banks and insurance companies to get it passed -- and most of the rest, who would vote for it anyway, would feel left out.


The world is a strange place, but that makes it really fun to watch. -- bfaul

by EveningStarNM on 12/17/2009 04:56:26 AM EST

I have single payer in South Korea, and I couldn't be happier with it. We pay a monthly premium, for me around 45 dollars a month. Generally when I go visit the doctor it costs about 2 dollars for the visit and 3 dollars for medicine. My wife thought I was lying to her when I told her companies in the U.S. can drop you if your care is too expensive or you have a pre-existing condition, and was sickened when she realized it was true. They don't price gouge here like in the U.S. There are private companies that can add extra specialized coverage, but they don't leave you out to dry here like private insurance does in the U.S. You don't even have to have insurance, even without it I bet it's cheaper than having it in the U.S. and paying. I know the U.S. can't replicate this system, and it has some negative aspects as well. But good grief, most countries see Health Care as a human right, not as a bag of Doritos like Cenk mentioned on the show.

by UncleBadTouch on 12/17/2009 06:54:36 AM EST

Let’s face it, the old fuckers have been raping this country for years, yet as a whole they are the ones standing in the way of real change. It is absolutely insane that the working man is expected to pay for everyone else’s retirement and healthcare via taxes and higher costs but can’t have healthcare for themselves. It’s a fucking crime and it needs to end today.

by sisco66 on 12/17/2009 07:07:56 AM EST

"it has to end today?"  1 question ...   How? You all just hope for a pretty sevre winter?

by PinkEyeTowlie on 12/17/2009 08:31:32 AM EST

[ Parent ]
...what you are asking. Simply put, Medicare should be available to anyone who wants it. The framework is already there as so many have pointed out.

by sisco66 on 12/17/2009 04:57:56 PM EST

[ Parent ]
Listening to all this aguing over your health care is really depressing, listening to all the other people talking about how good their system is soul crushing when i think of my own country, we hospitals closing down , operations being indefinately postponed or even cancelled altogether, we have places with state of the art scanning equipment and noone trained to use it , as well as hospitals with more administrators than specialists, your health care system may be broken but atleast you still have healthcare

by PinkEyeTowlie on 12/17/2009 08:42:22 AM EST

What healthcare system do you have?

by Cenk on 12/17/2009 12:55:36 PM EST

[ Parent ]

From a report representing top CEO's (who aren't liberally biased last time I checked):

"...The United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France. The five nations cover all their citizens, and though their systems differ, in each country the government plays a much larger role than in the U.S.

The cost-benefit disparity is even wider — 46 points — when the U.S. is compared with emerging competitors: China, Brazil and India..."

 

by ihavenobias on 12/17/2009 01:35:54 PM EST

[ Parent ]
I'm irish and we have an incoherent public/private collage of health care, its a great idea but has been poorly managed and billions wasted , the system itself is probably best explained on wikipedia under "health care in the republic of ireland" our problem is not with insurance but the hospital quality , apart from some daft syatem we have called "risk equalisation" where companies with a younger healthier customer base have to pay compensation to ones with older "higher risk" customers , its a rule which forced one company out of our market (bupa) because they would have to pay millions to the (state run) vhi , its a great example of how stupidity can ruin everything

by PinkEyeTowlie on 12/18/2009 06:17:37 AM EST

[ Parent ]
The problem with Medicare/Medicare solutions to health care problem is the current reimbursement rates for physicians, hospitals, and care facilities. These rates were set decades ago and are extremelly low. As much as I hate to agree with the Repugs, they do have a point here. Medical facilities can simply not operate as buisnesses by taking only medicare/medicade. We will lose quality people that will not want to enter the profession due to the huge costs of medical school/malpractice insurance and no way to ever pay it back. I am completely on board for health care reform (single payer or public option) but it can not be done effectivley through Medicare/Medicade until the reimbursement rates are fixed otherwise your quality of care will go down signficantly.

by ethanmorton on 12/17/2009 12:57:34 PM EST

Say something like Medicare + 5%. The obvious point is that we can adjust reimbursement rates (and get rid of fee for service BTW) and still have a much less costly program. The whole point is that Medicare has incredibly low administrative costs because there is no CEO looking to buy another mansion, no private jet, no lavish corporate headquarters, no marketing or advertising, no shareholders and no lobbyists handing out money.

It's common sense we're talking here. Another benefit Cenk didn't mention is that this would rescue Medicare, which was only struggling because it had the oldest/sickest population which is not how an insurance pool is supposed to work. Oh, and Medicare Part D bars negotiating drug prices. That would be critical to fix at some point as well.

by ihavenobias on 12/17/2009 01:31:41 PM EST

[ Parent ]

Do this through reconciliation, and massaging Joe Lieberman's huge ego for having the idea in the first place [whether he did or not, he mentioned it last September].

Should be an opt-out, not a buy-in. That way the poor states like Mississippi or Alabama will opt-out, making residents angry enough to opt back in when they see they're being robbed of affordable insurance.

The most important feature that isn't being mentioned is that all health insurance, private or public, must be through nonprofit entities. As soon as they start profiting and paying huge salaries to execs they should be dropped--banned--from providing insurance.

Reconciliation and Liberman ego-massage might get us a good bill. Forget the Republicans. They hate everything--even legislation that reduces costs for everybody--because their corporate sponsors pull their puppet strings in the other direction.

by zenie on 12/17/2009 01:49:42 PM EST

Reps won't like this because they know that everyone and their dog with pre-existing conditions would be wanting to go with the public option and therefore make a public plan more popular.

by administrator on 12/17/2009 01:49:52 PM EST

This is not new...as a matter of fact this is exactly how insurance works.

The profitable (young and healthy) don't use as much money as they put in but still have "insurance"  in case of an emergency. You can't only allow people who use more than they put in, it is not sustainable.

by Contra Infinitum on 12/17/2009 04:36:45 PM EST

and Medicaid are what you are describing. Currently the rest of us pay the balance of the shortfall. In otherwords, we already have the worst form of single payer, the working class tax payer.

by sisco66 on 12/17/2009 04:55:57 PM EST

[ Parent ]

Hey Cenk you stole my idea. As early as August with all the kill grandma talk, all the screaming and yelling, I had a thought just make it possible for everyone to buy into medicare. It seems to make sense to me. Maybe, just maybe.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

by esd2000 on 12/17/2009 09:36:22 PM EST

The real reason we are not getting the reform we expected from congress and the white house is...

 They don't consider for a minute going against the  health insurance industry,or the  other corporations and the banks either. People don't seem to really believe that they are the real power in this country. They think it, but somehow don't let themselves realize that we will never get any real reform on ANYTHING because of it. These special interests get what they want and the government is a PR shill who are just  trying to paint this turd a pretty color for us, the Mob. Bread and circuses- this is an age old strategy that works.

The two party system is so locked in that we will never get any real representation. Howard Dean was a candidate that was skyrocketing to popularity  in 2000 with a huge influx of internet generated money.  For a short while he was a media celebrity, but he was soon recognized as a real threat to the system and he was destroyed by one video clip of him shouting like a madman to his audience of supporters, played a million times for a week or so. That was the end of Howard Dean for President, one of the very few honest men in politics to this day ( that's why he's out). The media consciously, deliberately destroyed him with that video clip that was completely false. What they did was isolate his microphone on stage and completely cut out the roar of the crowd that he had to yell over to be heard.  They purposely made him look like a madman, completely falsely.

 How do we stand a chance with the power they have to lie to us about everything? there is no more truth in politics, there are no facts anymore- it's all positions, talking points. and opinions. Truth and facts are dead in the mainstream.

 Here at TyT and at other progressive/anti-establishm ent/revolutionary websites, we get the truth but to a relatively microscopic audience.  the Owners (as Carlin put it) could care less if 20 or 30 or even 40 % of the population becomes aware and outraged at the game being played on them. Look what just happened in November 2008:  a significant majority were ecstatic over electing Obama and the change he promised. Do you all feel like  complete, gullible fools now or not? I do- I wanted to believe it too

I'm 64 years old,and I've seen this country go from bad to worse to terrible in my lifetime despite all the protests  marches and opposition that exists and has existed for ever.

We have had a high standard of living because we ( the corporate/banking/military complex,that is) have been raping the world for 60 years and now it's the American people's turn to be raped. Even our usefulness as "Consumers" is over- we have no money to consume with. But there's an emerging world out there of new customers, they don't need us any more. They have the worlds most bloated military to use against any other country that has something we want- Iraq, Afghanistan being only the latest victims. If they get their way, Iran is next and they are using the exact same lies to demonize Iran that they always use. And what's Iran's crime? They oppose the ultra-right wing government of Israel  and support the Palestinians. Oh, yeah, they have a lot of oil.

 I know this is pretty pessimistic - but there it is. After 64 years of seeing war after war,  a degenerating mass culture, a slow, piece by piece shredding of the constitution and bill of rights, and the ever tightening economic screws, I think this feeling is fairly well justified. 


 

 

 

by duster011 on 12/17/2009 10:58:08 PM EST

I love you, lan, and Imma let you finish, but Anthony Weiner got one of the best "Medicare for all"-propositions of the year!!!

by eborujion on 12/18/2009 06:29:50 AM EST

Unfortunately everyone forgets to look at the incentives. Cenk, you always look at the incentives (such as how the proposed bill would drive up prices).

 Well, think about the fact that if you have a public/private system, then the private sector will simply be cheaper than the public sector, while it rejects all the unhealthy people. This dilutes the public pool and leads to increasing costs. Eventually the public system becomes cost-ineffective and has to raise rates, then the private sector raises rates but still keeps it slightly lower than the public healthcare, and restricted to the healthy.. and so on. Eventually the entire system fails and the private systems bleed everyone to death.

 The system is flawed. You can't do anything other than a single payer system.  KILL THE BILL.

 I'm a Canadian btw, and all the people who complain about a lack of doctors in Canada, think about why.. The unethical doctors go to the US on TN visas because they can make more money while not servicing as many patients.

 We have to understand this is all or none, you can have as perfect a system as you want, but as long as there is one loop hole, there is one bad apple, and that will always ruin the entire system/batch of apples.

by Krish on 12/18/2009 05:06:29 PM EST

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