Expanding Medicare

One consequence of spending the week traveling is that I’m missing a lot of news. I’m got the chance to catch up today as my wife and daughter were resting after we moved up the coast from Monterey and Carmel to San Francisco. I’ve been going through my RSS reader this afternoon, and found this item:

Bob Shrum gave a non-canned talk at a local party for his book two weekends ago: One of the mildly contrarian things he said–that it was crazy to write Obama off–is now CW, thanks to the intervening release of this quarter’s fundraising totals. Another resonant point isn’t yet CW, though–he argued that all the Democratic health care plans are too complicated, that whoever is the Dem candidate should just say he or she plans to let everyone join Medicare and leave it at that. People know Medicare. It’s hard to attack Medicare as “socialized medicine.” P.S.: I’ve never quite understood why this politically appealing position is fatally flawed on policy grounds. (If there are problems with Medicare, fix them! Surely they need to be fixed even if the program doesn’t get extended to younger Americans.) …

Shrum makes a good point. Also keep in mind that the proposals of the Democratic candidates and the idea of expanding Medicare coverage are not mutually exclusive. If we have a mandate for insurance coverage such as is advocated by John Edwards, or even attempt to make changes such as those advocated by Obama and Richardson, the problem remains that coverage for those in their 40’s or 50’s becomes increasingly expensive, especially among those with a history of medical problems. Allowing them the option to buy into Medicare (as well as eliminating the one year waiting period for the disabled) may be the best way to provide affordable coverage for those who cannot currently afford it, regardless of whether used as the sole plan or if paired with the plans advocated by the Democratic candidates.

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