'Would you like the option of buying into Medicare before you turn 65?'

[BurtWorm]

This is Josh Marshall's question at TPM, in respose to more Republican idiocy, this time from Dick Armey, over the public option. (Personally, I wonder if "buying into" is the right term. Makes it sound like any other insurance plan. We've already bought into Medicare. The question is really, do you want to cash in on Medicare before you turn 65--isn't it?):


http://feedproxy.google.com/~r/Talking-Points-Memo/~3/tApxap5SslY/adventures_in_the_rabbit_hole.php


Adventures in the Rabbit Hole

|||Today 2:45 PM|

Josh Marshall


In an interview with the Economist magazine recently, former House Majority Leader and current FreedomWorks Capo Dick Armey said that something like a Public Option would be great. But the issue comes down to choice.

"If you in fact freely choose to enroll in Medicare that's a wonderful gift," said Armey, "it's a charity, it's something I applaud. But when they force you in, that's tyranny."

Needless to say, Armey, albeit a native English speaker, has not apparently focused in on the 'option' part of 'public option' since obviously in the reality-based world, this is the whole point. It's an option if you either cannot or do not want insurance from a private company.

It also points back to the question (a frustratingly good one) of why the advocates of a public option and just reform in general have not simply explained this as allowing people to buy into Medicare at any age. Because, essentially, that's what it is. And I think I could pretty much guarantee you that if the question in the public mind was "Would you like the option of buying into Medicare before you turn 65?" the opposition would be vastly diminished.

This isn't just rhetoric. This is the most accurate and graspable explanation of what's being proposed. Indeed, the big secret not many people are discussing is that the current iterations of the 'public option' in most of the bills in committee is that that option isn't given as an option to many people. Most people aren't allowed to access it in order to crimp any competition it might provide to private sector insurers.

But what we're stuck with is "public option" who a crew of bamboozlers have warped into some sort of Logan's Run government program in which your ten year old will need to make his case for his future contributions to society to ensure he can get his broken leg set rather than be euthanized and ground into Soylent Green to feed yet more illegal aliens on welfare.

Why this isn't being used as a way to explain this program is simply beyond me.

[xchrom]

1. ...

'Most people aren't allowed to access it in order to crimp any competition it might provide to private sector insurers.'

[pinto]

2. Yeah. "Subscribe to" might be a more neutral term. I always thought

gradually expanding the age for entry into Medicare a good compromise between Medicare-for-all today (which I favor) and some of the other convoluted options being floated / debated in various committees.

[dysfunctional press]

3. i already have- i became disabled 12 years ago when i was 36.

i just wish that they'd do away with medicare advantage, since NOBODY will sell me the coverage for that 20%, and they aren't required to do so until i turn 65.

[elocs]

4. Buying into Medicare? With what?

I get by leading my life of quiet desperation. I can scrape together enough to meet my basic needs, but there is nothing left with which to "buy into Medicare".

[Faryn Balyncd]

5. K&R...Currently those denied insurance are charged 250-400% more than insurance companies pay.

Opening Medicare for younger Americans to buy in would be the logical solution.


Not only is it already set up, Americans understand Medicare.

[Cleita]

6. By buying into it, it means that employers or unions who want to supply

medical security to their members could have a choice of buying into a less expensive but comprehensive plan that Medicare offers. It should also offer this option to self-employed business people and others who don't get medical benefits on the job but who can afford to buy into it. This is why the insurance companies are having hissy fits all over the place about Medicare as a public option. For those who can't afford any of the above, they still can be enrolled in it like all seniors are. Incidentally, there is a figure floating around that Canadians average health care costs are $61 a month for a plan similar to our Medicare and even more comprehensive. If so, you can see why this would work for many people who have been squeezed out of decent health care by our indecent for profit system.

[Yo_Mama]

7. This is total BS

It is a meaningless question, unless one sets the price for "buying into" Medicare.

Medicare is funded partly through a payroll tax of 2.9% (no wage limit), partly through premiums, and partly through payments from the general fund, i.e., income tax. It is also funded very significantly by excess payments from the uninsured and the private insurance companies - because Medicare payments are set by a board, and in many case are less than the cost of the treatment. Thus, in many cases the fees charged by hospitals and doctors are set higher for everyone else to cover the costs of treating Medicare patients.

If you are wondering what it would cost to "buy into Medicare", the answer is something like a 20% payroll tax plus the $100 premium, and that only gets you 80% reimbursement. We would have also have to hike income tax significantly on the top 30% of wage-earning households, plus impose additional income tax on median and higher income households (household AGI over 50K).

I can absolutely promise you that if most of the population were currently covered by Medicare, many patients would have little or no access to doctors, because the doctors wouldn't be able to provide the services for the schedule payments. Therefore, if everyone "bought into" Medicare, we would have to significantly raise schedule payments, which accounts for part of that 20% wage tax.

I don't think the idea of making Medicare open to all is a bad one, but we must be realistic about what it would cost. We would also have to somehow curtail the malpractice lawsuits and unfunded treatment for illegal aliens. Doing so (and imposing a high wage tax would take care of the unfunded illegal care problem) would cut that payroll tax down to 18% or so although as our population ages it would have to rise rapidly. But for everything except hospital insurance, the general fund currently pays over 3/4s of the cost - the rest comes from premiums. So general fund revenue would have to be greatly increased from a new payroll tax or a much higher income tax.

So the question Josh Marshall should have asked is "Would you agree to pay a 20% wage tax plus $100 per person monthly premium for 80% insurance coverage for doctor and hospital costs?"

If people want the Medigap policies, they will have to pay $100s more a month for them, plus income tax would have to be raised on everyone across the board. If people also want drug coverage, they would have to pay another monthly fee plus income tax would have to be raised again, across the board.

From what I have read on this board, many would not answer yes to the question if the costs were included. I am also aware that many could not pay for it. In many ways Congress is trapped by unrealistic public conceptions of what healthcare can cost.

I personally believe that we do need major changes in our health care system, but people have to understand that we must pay for the coverage. Pretend insurance is no insurance at all.

One fallacy that is almost universally accepted on this board are that Medicare is solvent. It is not. We will be both raising current Medicare taxes and cutting benefits to take care of the retirees as things stand. If we admit more people to Medicare, the costs will rise massively again. If you want to understand Medicare's current problems, I recommend the American Academy of Actuaries' report:
http://www.actuary.org/pdf/medicare/trustees_09.pdf

The hospital insurance fund has been in deficit since 2005. In 2008, total Medicare funding from general revenue (think income tax) was 166 billion, but that includes SMI (parts B & D). As the number of persons covered under Medicare rises, that number will gallop up even if medical costs completely stopped rising. Over the next 10 years, the total gap between revenues coming into Medicare and benefits being paid out is estimated to be 2.5 trillion dollars, or about 250 billion a year. But that is only the cost to cover about 1/5th of the population. If you want to cover the whole population, you are looking at more like 10 trillion. Seriously. That money must be raised somehow, and the easiest way is with a payroll tax.

Currently (in 2009), Social Security plus Medicare cost about 1/2 of the revenue (taxes and fees) received by the federal government. That will rapidly rise over the next decade as more people retire.

[eridani]

9. That's horeshit

Medicare for All HR 676 has a 3.75% Medicare tax on income.

[Critters2]

8. "albeit a native English speaker"...

:rofl: