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It really didn't take much time for me to come up with what I see as a compromise solution to the healthcare crisis that doesn't involve a lot of complex new arrangements, seems to satisfy some of everybody's wishes and gets us moving forward with solving the other crushing problems facing this country.

I'm sure there's plenty I haven't thought about, and a physician caller to Mark Thompson's Making It Plain this afternoon makes me think there's some doubt such a thing would work. Then again, it may just be pure even lends itself well to easy marketing.

Medicare, the Public Option We Know.

There is the idea of making available Medicare to all Americans, regardless of age. I think that is a fine idea, but I've never been convinced that creating a truly nationalized, single-payer healthcare system ought to be the goal. I see a market for private insurance, because, let's face it, some people have to have it better than other people.

But in our current context, let's do a couple of things.

  1. Leave private insurance the hell alone. Let them figure out how they fit in after the second change.
  1. Simply let the public option be that we allow individuals of any age to buy into Medicare if they can't get private insurance or even if they'd like to do it for reasons of moral disdain for private insurers.

Droves of young, relatively healthy adults, college students, graduate students, waitresses and assorted shitworkers would swell the ranks and the coffers of Medicare, a system they'll all end up on eventually if they live long enough anyway. Their payments as young healthy people will help save Medicare from bankruptcy as our increasingly older population drains it. Two birds, one stone.

Allow people to keep whatever they have now, but mandate that people do one or the other. Nothing would really stop people from doing both, to obtain supplemental care or new breasts or whatever.

I'm not a details guy, but it seems to me that something like this wouldn't require more than about 20 pages of 8.5x11 white paper to work out. We already have a struggling Medicare system struggling to stay alive, we have throngs of young people who'd love to pay, maybe even a little more than they do now, to be on Medicare and not have to sweat getting sick, getting in a car accident, etc.

Preventative medicine and public health situations improve overnight, Medicare has millions of new people paying in, and reimbursements to doctors could become more respectable. Private insurance is still there to try to compete and make a profit. Grease the skids here if we must...throw them some kind of corporate bone the government loves so much.

Instead of trying to come up with crazy regional co-ops, an all-new agency or some such, just let Medicare become the public option when the politicians speak of it. The Republicans already love them some Medicare, and this would be a good opportunity for them to save face by helping "to save it."

Seems pretty straightforward to me.

How about you? Medicare, the Public Option We Have, the Public Option We Know.

Originally posted to Freeborn Man on Thu Sep 17, 2009 at 10:05 PM PDT.

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Comment Preferences

  •  Tip Jar (4+ / 0-)
    Recommended by:
    Beowulf, budr, beyondleft, Riddlebaugh
  •  I write medicare for all in most of ny postings (1+ / 0-)
    Recommended by:
    Corwin Weber

    on Healthcare. I also assume that having younger people in medicare would help stabilize it but I don't have any numbers to back it up. Can the community come up with some to share?

    An alternative is to force insurance companies to act like regulated utilities either as not for profit or with a fixed 6% maximum profit. This would eliminate many of the worst problems with the private system.

    •  Not necessarily... (0+ / 0-)

      ...Medicare for All (although I'm in full support of that if it could even be discussed), but rather, Medicare for Millions More. There is a huge number of people like myself, somewhat underemployed, well-educated with an entrepreneurial bent, who'd like independence from their employer and their employer's healthcare insurance plan.

      I'm not suggesting people with insurance would be shunted into Medicare, though, against their wishes. They could keep what they have and let those of us who want no part of it help bolster a failing Medicare system.

      I guess it makes too much sense.

      Barring that, yeah, I like your second idea a lot.

  •  What added value do insurance companies (2+ / 0-)
    Recommended by:
    trevzb, Pluto

    bring to healthcare?

    Their function is to delay and deny care. They practice medicine. Their medical judgment supersedes that of trained healthcare professionals.

    The purpose of insurance companies is to make a profit not to provide healthcare. They are by law not responsible for the harm they cause.

    If you want to trust your life to the insurance parasites...fine, but do not force the rest of us to pay more just because you "think" something more expensive has to be better.  

    Public option or corporate option...pick one.

    by Jane Lew on Thu Sep 17, 2009 at 11:25:11 PM PDT

    •  the fact that private insurance companies do (0+ / 0-)

      exist in countries that have single payer universal coverage, such as France, suggests that those companies do provide something beyond the basic plan.  Maybe they in effect provide something like health savings deductions, a reduction in tax payments while establishing an "account" that can be tapped when needed.

      But they are around, perhaps the government run plan makes them more honest and less greedy, as if they don't offer enough no one would use them. I don't know, ask someone who lives in France.

      •  What added value do the insurance companies bring (0+ / 0-)

        to healthcare in our country? Not France.

        In the United States insurance companies are a law unto themselves. They have gotten used to it. They like being in charge; they like playing G-d.

        Once you are G-d, it is very difficult to accept a lesser role.

        Do you really believe they would willingly become like insurance companies in France? I supposed miracles do happen, but I sure wouldn't bet on them being cooperative.

        Public option or corporate option...pick one.

        by Jane Lew on Fri Sep 18, 2009 at 12:20:55 AM PDT

        [ Parent ]

  •  This is essentially Ted Kennedy's bill (0+ / 0-)

    ...which he called Medicare for All but was really Medicare opt-in. It would certainly be a vast improvement over the current system.

    However, it would be more efficient to simply remove employer based health insurance entirely from its role as providing insurance for primary care. Employer based health insurance, the primary form of insurance in the United States, is inherently wasteful and produces market failure.

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