Use reconciliation to expand Medicare - forget any industry reform

[grantcart]

Use the reconciliation process to make Medicare buy in available to everyone who wants it.


This would be relatively easy to do.

For uninsured have a single rate for 55 and above and a sliding scale down to 30 so that younger participants will not be carrying an undue burden.

Offer a medicare plan for employers. Since medicare medical loss ratio is 30 points less than the private structure it would be possible to undercut private plans by 20% (employers happy). Include federal workers. Use the surplus 10% to add to the subsidy.

Allow medicare to negotiate drugs like the VA.

With the savings from above use that to subsidize lower income people who want to buy in the plan but don't qualify for medicare. In the future additional taxes on the top 2% can be added to increase the subsidy.

In order to stop people from gaming the system and joining only when they know that they are about to get sick a number of qualifications can be added.

1) After the initial open season have restricted open seasons once every two years.

2) After the initial open season have an enrollment period for 6 months - you pay 6 months before any treatment is approved.

3) After the initial open season have a waiting period for major illnesses for 1 1/2 years - medicare would pay some but not all of the costs during this time.


You would have two competing systems - Medicare supported by the Democrats and the private system supported by Republicans, with no mandates.

It would devistate the private sector and Medicare would soon have 75% of the market making transition to single payer easy.

[undeterred]

1. Its a good idea.

But unless Obama pushes for it, I don't see it happening.

[SPedigrees]

14. +1 nt

[Cant trust em]

2. Why don't we just do both?

We can have the stripped down bill that eliminates pre-existing conditions and all of that. Then have a second bill that opens up Medicare?

[grantcart]

5. Because we are never going to get 60 votes to do anything close to real

reform.

So this is war.

Let them win this battle.

Now lets do the one thing they are most terrified of - go into direct competition with them.

[Cant trust em]

13. "Let them win this battle"

Which battle are we talking about? You mean letting Lieberman gut out the public option and medicare buy-in?

[grantcart]

18. Rather than trying to regulate the industry

I am suggesting we let it be and start a war on another front altogether -


Do the one thing that scares them the most - Have the government go into full competition with the Health Insurance.


Let them offer whatever they want and let Medicare enter the field and take them on - like the Post Office, the government offering services directly to the people, all the people.


If this were even mentioned Lieberman and the industry would fold in a minute.

[Cant trust em]

19. I still think we could just do both.

Have the simpler regulation bill (eliminate pre-conditions, can't drop people because they got sick, etc.) and then go for opening up Medicare.

We'll get a nice win, then hit them again.

[TheWraith]

11. Because that would be smart, therefore it's not going to come out of DU.

Pass this bill to get the process reforms through as well as the public victory, then run through a reconciliation bill in January or February with the stuff that couldn't get done before.

People forget that we CAN'T do any kind of insurance reform through reconciliation, due to limits on the process.

[TwilightGardener]

3. Well, that would be nice, except that individual coverage would have to be

very cheap for an entire family to be able to afford two (or three, four) separate policies--because it won't cover families, right?

[grantcart]

4. my suggestion is that Medicare offer the same type of policies that

are offered in the private sector


family, employer and individual.

[TwilightGardener]

7. I would like that. I actually have taxpayer-funded health care now, and

it's pretty good, really. If not Medicare for everyone, then Tricare for everyone!

[Mme. Defarge]

6. Bingo!

Could this be done as an Executive Order, if all else fails?

[HiFructosePronSyrup]

8. Wouldn't it be easier, and better, to pass this industry reform...

without the medicare. Then introduce a new bill that's just medicare, and pass that through reconciliation?

[begin_within]

9. I'd buy it.

[WI_DEM]

10. I agree with expanding MC thru reconciliation but also want industry reforms.

[Cleita]

12. Your last point is why the insurance lobbyists are dropping millions into

blocking any form of this. We will never have decent health coverage in this country until we figure out a way to make it illegal for the insurance industry to sell us health care coverage.

[Kermitt Gribble]

15. That would be excellent.

But if our corporate Dems can't even agree on a weak public option, how does this get any support?

[Tom Rinaldo]

16. If Lieberman knew this was in store as the alternative to the HCR measure he is fighting

He would sign on as a co-sponsor of a Senate bill with a medicare buy in for those 55+ and a modest Public Option. He only gets away with being an obstructionist because he has no fear of what might happen if he sinks a good faith compromise.

I say call his bluff and hope he stands his ground allowing us to move forward with real reform instead - if Democrats are vertebrates.

[grantcart]

17. Exactly my point