Buying Into Medicare and John Kerry’s 2004 Plan Now Back on The Table

The public option is in trouble in the Senate but this actually might result in a valuable compromise. There is talk of allowing people between the ages of 55 and 65 to buy into Medicare. The plan had been proposed in the past but seemed to have been forgotten during the recent health care debate.

Being able to buy into Medicare starting at age 55 would help those who face the greatest problems in obtaining coverage on the individual market. In theory these problems will not exist after health care reform is passed, but fear that the insurance companies will continue to find ways around the new regulations has fueled the demand for a public option on the left. While unfortunately this will only help those who are 55 and older (at least immediately) it is a true solution for the health care problems for those in that age range. It might be better to have a solution which really works for those who reach age 55 than a watered down plan which helps nobody.

Allowing a buy in at age 55 could also gradually turn Medicare into a nation-wide equivalent of the public option as the age is lowered. Ironically conservatives have objected to a strong public option based upon Medicare but their success in blocking such a plan might wind up ultimately turning Medicare itself into the public option if this compromise is passed.

Another idea being considered is to set up a national plan based upon the plan which members of Congress and other federal employees have access to which provides the choice of a variety of health care plans. Sound familiar? That was actually the heart of John Kerry’s 2004 health care plan. At the time Republicans claimed that this would be a “government take over of health care.” Now it is a plan being proposed to appease the moderates as opposed to a public option, which shows how far health care reform has progressed in the last five years.

Yet another proposal is to increase the number of people eligible for Medicaid coverage. The House bill allows those earning up to 150 percent of the poverty rate to receive Medicaid while the Senate bill allows those making up to 133 percent. Increasing this up to 150 percent would cover more people but I do not consider that to be the ideal solution. This would provide some coverage for more people but would force even more people to receive Medicaid coverage. The quality of Medicaid coverage is already unsatisfactory and the goal of universal coverage should be to provide true health care coverage–not force more into Medicaid.

Those on Medicaid already have difficulty finding private physicians who will accept them. This problem will be even worse if there is a sudden influx of new patients with private insurance and Medicare seeking physicians. This would be great for Medicaid mills, but not for those receiving Medicaid coverage. Ideally the patients who would be on Medicaid should be provided assistance to choose from the same types of public and private plans which are made available to all Americans. While more expensive, expanding the subsidies would be a much better option than expanding Medicaid eligibility.

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3 Comments

  1. 1
    Eclectic Radical says:

    Well, one idea that is not under discussion at all, is actuall reforming Medicaid so that it provided proper health coverage. This has been tried on the state level. Tennessee’s expansion of Medicaid into the TennCare program, as far as it extends to covering individuals and providing them with medical care, was tremendously successful. Of course, the program was gutted because no one wanted to pay for the cost of success. Now TennCare is just another Medicaid program.
     
    The problem is not the economic impossibility of paying for health care. It is economically possible to make Medicaid better than private insurance. The problem is the political disrepute of helping the poor. The social Darwinism of secular, economic conservatives/libertarians and the Neo-Calvinism of the religious right both place the blame for poverty squarely on the poor and preach ‘personal responsibility.’
     
    Under the circumstances it is highly ironic that ‘social Darwinism’ is one of the evil results of the theory of evolution cited by the religious right. Social Darwinism is identical in all respects but the spiritual to the Calvinist notion of ‘the Elect’ to which predestinarian evangelicals prescribe whole-heartedly.
     

  2. 2
    Ron Chusid says:

    They are at least talking about increasing reimbursement for primary care services to the level of Medicare but I doubt this will be enough. I fear that as long as the poor are in a separate program it will be under-funded. Besides lower reimbursement this often leads to more difficulty in receiving reimbursement for claims submitted. Moving the Medicaid patients into the same types of plans as others are in would be the most effective change to provide them with the same quality of care as others.

  3. 3
    Eclectic Radical says:

    ‘I fear that as long as the poor are in a separate program it will be under-funded.’
    I regretfully agree with this, this is why I tend to be so outspoken in favor of real universal health care. If the upper middle class and the poor are all on the same plan, the government is a lot more likely to properly fund it.
     
    However, direct subsidies are a tricky thing. One of the biggest problems I have to them is that is essentially pumping federal money into private insurance companies in what would be a sort of ‘Medicaid Advantage’ program.
     

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