Why not allow people to buy into Medicare as part of the plan?

[democrattotheend]

I have mixed feelings about mandates (although I completely agree with what Obama said tonight that mandating insurance is not the same as providing it), but I think I would be more comfortable with the idea of mandates if people were offered the option to buy into Medicare. Without that option, mandates are simply a windfall for private insurance companies. People with disabilities who make too much to qualify for Medicare automatically are able to buy into it, and I think it would be a good idea to allow others to do the same. It might also bring down the cost of Medicare by bringing in revenue from people who are less expensive to insure than seniors. The buy-in could be a percentage of income rather than a flat amount.

What do you guys think of that idea?

[BlackVelvet04]

1. That is part of the plan....

to expand Medicare to cover more people.

[ingac70]

4. Not Medicare...

Hillary's plan has us paying premiums to The Federal Employees Health Benefits Program (FEHBP).

http://govexec.com/story_page.cfm?articleid=38274&sid=46

[Maven]

33. No. Wrong.

There is a public plan option that would be similar to Medicare, administered by the government and with beefed up benefits to match the FEHBP.

Just take 10 MINUTES, go to her website and READ THE PLAN.

[hiaasenrocks]

2. EXACTLY!

That is one of two options that I like. Either open up Medicare or open up the plan that is available to members of Congress.

The mandate idea is just plain stupid.

[democrattotheend]

3. I think the Congressional plan

utilizes private insurers. But it is a pretty good plan.

[hiaasenrocks]

5. It does.

And what is good about it is the huge pool that would be created, driving prices down.

I wouldn't mind that plan. When was the last time we heard a member of Congress complaining about their health insurance?

[ingac70]

6. Anything involving private insurers is not good...

single payer is the only "good" coverage.

[hiaasenrocks]

8. Why?

I asked above and I'll ask you the same question: When was the last time we heard a member of Congress complaining about their health insurance?

[ingac70]

14. Because private insurance...

is in the business of making profits. and will still need to make a profit if the whole country is on their plans. Know how you make profits? Cut corners and fuck people.

Congress ain't complaining because we foot the whole bill... all of us on it and there will be budget issues, and the insurance companies will still want their profits.

Tenncare here in my home state is a perfect example of what a clusterfuck this will be. It only covers one fourth the people it used too. Because the insurers weren't making any money and the state had to cut the budget, as companies started refusing coverage.

[hiaasenrocks]

17. The reason I asked about members of Congress complaining is because

they don't. They get coverage.

Aside from the talking-points about profit being a bad, evil thing, I see no real reason to believe that the plan would be any worse if we were to open it up to the public.

In fact, I hope profit continues. If they don't make a profit, they stop research. Who's going to do that for free? You?

Sorry, I just don't buy the "cut corners and fuck people" line about profit. By the way, do you work for free? Ever ask for a raise? Or do you simply do what you have to do to get just enough to have a roof over your head, food on the table and clothes on your back?

I have a feeling about the kind of rant I'm going to get in response, but let's see.

[ingac70]

21. Look into Tenncare...

you'll see what I'm tellin' you.

http://en.wikipedia.org/wiki/TennCare

[hiaasenrocks]

26. I didn't take issue with Tenncare.

I have no doubt that there are problems with various examples. That's the good thing about having 50 states. We can see what works, what doesn't, and formulate policy.

So we don't disagree on Tenncare. I just wouldn't assume that one example means that all similar plans are bad. And I wouldn't take the extreme position you indicated in your earlier post, either. But I already addressed that and got no response so I'll drop it.

[ingac70]

23. Since when do insurance companies do medical research? n/t

[hiaasenrocks]

27. My mistake. I meant to mention the profit of drug companies

which also come under attacks very similar to your anti-profit message.

[ingac70]

30. The drug companies will be part of the problem..

but a much smaller part than the insurance companies. The administrative costs of doctors and hospitals fooling with private insurers makes up %36 of overall costs.

The insurers will make a plan go bust.

[hiaasenrocks]

32. OK, so what do you want to do about drug companies?

What's your source for the "%36" reference?

[ingac70]

36. Eventually we will have to negotiate with them...

to keep costs down.

http://en.wikipedia.org/wiki/Health_care_in_the_United_States#Administrative_costs

This sites it as %31 (from 2003)... I'll have to hunt up where it has hiked up in recent years.

[hiaasenrocks]

38. You're reading (and/or stating) that incorrectly.

That's overhead in the insurance industry, not in the hospitals.

I referenced that in this post: http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=4707250&mesg_id=4707804

But we are in agreement about the overhead cost being a problem. There are ways to address this, mainly through competition, as I suggested in the link above.

[ingac70]

40. Its the insurance industry I am talking about...

The costs get past on to the doctors, hospitals, patients ... that is TOTAL healthcare dollars.
From the link...

--This system has considerable administrative overhead, far greater than in nationalized, single-payer systems, such as Canada's. An oft-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 31% of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis----

[hiaasenrocks]

29. I answered your question. Will you answer mine?

By the way, do you work for free? Ever ask for a raise? Or do you simply do what you have to do to get just enough to have a roof over your head, food on the table and clothes on your back?

[ingac70]

31. Actually I am unemployed...

Private insurers need to be cut completely out of any plan for it to work.

[hiaasenrocks]

35. That doesn't answer the question.

Do (or would) you work for free?

I'm guessing not. You work to make money. The motivation is profit. It's the same motivation, on a smaller scale, but since you do probably understand the motivation, you should be able to see why destroying that motive destroys the incentive to produce. Therefore, if you take, for example, the drug companies' profits, they'll stop, and who will do the research that I asked about earlier? You? And will you do it for free?

I don't know how old you are but when you get in the real world, you'll understand these principles.

The free market should never be without restraint, but if you kill the free market (as implied in your post) you can expect to live in a society where none of this will get done.

[ingac70]

37. This isn't about "working for free"...

I don't want the health insurers to work for free... I want them completely out of the picture.

[hiaasenrocks]

39. That's not the purpose of my question.

I was addressing the larger anti-profit issue you raised.

I understand what your position is, but you're not going to get to a point of doing away with private insurance. Sorry. Isn't going to happen. It's as silly as the people who want to do away with the IRS.

I'm getting ready to log out, but I will say that you express the idealism of youth, which is great, but it's just not a realistic world-view by any stretch. I know you don't believe me now, but as you get older you'll see what I mean.

[ingac70]

41. Folks who want to buy their crap...

should still be able to.. but they should not be putting their sticky fingers in a national health plan.

[papau]

10. true - but we get there via the Medicare for all option

[ingac70]

15. That's what I think...

but that isn't the plan.

[Ivote]

7. You already Pay Into It n/t

[nonconformist]

25. Hillary's plan does offer you to plan available to Congress. nt

[papau]

9. The mandate is needed - it works - and Obama uses it in his plan for kids - Medicare is

in both plans as a choice for everyone - but the difference is that Hillary will fight for it.

With Obama I do not expect the Medicare for all option to be included in the choices

Obama will remove the Medicare for all option because fighting for it would harm that new DC atmosphere of cooperation with corporations and the GOP that he wants - and after all it is best that we accept his judgment that a plan with a Medicare option - like a plan with a mandate - just would not pass

that will be the only "change" I expect from an Obama president.

In other words I expect the Obama plan as passed to be no more than welfare for insurance companies with no Medicare for all option

[hiaasenrocks]

12. "Hillary will fight for it."

With more or less of the same success she saw in 1993? :shrug:

I'm not hopeful that either of them will get it done, for the record.

[Hoyt]

11. Medicare is pretty much what we will have with Universal Health Care or Single-Payer.

No matter what you call it, a "Medicare" like system is what will occur. And that is much better for most people than the current system we have.

I don't think there is much difference between Clinton or Obama's proposal. I do think the criticism levied at Obama is wrong. He clearly states that anyone that wants it can get it. He just realizes there are going to be some screwballs out there -- like some "Klan" members living in the backwoods of Idaho or Georgia -- that won't purchase "gubment, socialized" health care. Their warped opposition shouldn't kept the rest of us from participating in a more rationale approach to health care delivery.

Hopefully, as others have mentioned, the coverage would be expanded to include much more preventive care, long-term care, etc.

[CountAllVotes]

13. Medicare is not free

and it doesn't pay for lots of things - like an annual exam. You have to have paid into it to receive it as well. Only certain doctors take Medicare and you pay at least $100.00 a month for it. Thus, you find yourself in need of better coverage and find yourself purchasing a "supplemental plan" - cost can be as much as an additional $500.00+ a month for this.

Still you have no long-term care nor help in the home if it is needed. Medicare suggests you borrow against your home if you need help.

You might learn more about the reality of Medicare by visiting here: www.medicare.gov

It isn't that great but it is better than nothing.

We need something better.

We need CHANGE.

:dem:

[madrchsod]

16. why? cuts into insurance companies profits

i`d take medicare with a supplemental chaser please...my parents were on that and were never denied any treatment and never paid a dime in co-pays. the only problem they had was the cost of drugs.

dennis's plan was well thought out and easy to implement. it even covered the insurance companies losses

[ingac70]

18. Bingo. n/t.

[reality based]

19. Without mandates we will all get saddled with the costs that those who opt out

should otherwise be paying. It is this "antiselection" (as some actuaries call it) that makes partial coverage impractical. More drop out as the costs go up and pretty soon you have an unsound plan. Sorry to go "wonky" but sooner or later we have to face facts rather than assume faith based positions on the issue.

[pinto]

20. I favor Medicare for all. Current premiums are under a hundred dollars a month (individual).

Good access to health care. Some co-pays due to reimbursement levels and some inequities on physician reimbursements due to outdated regional standards. Yet, an *existing* good framework for access to universal health care.

I emphasize *existing* in that expanding membership is a no brainer, imho. The structure is already in place. Broadening the membership base will only reduce costs overall. As the State/Federal partnership of Medicaid gets decimated (these folks are generally not eligible for Medicare), the broad middle class gets squeezed for health care dollars (these folks are generally not eligible for Medicare) and the eligible population grows - it would seem prudent to go with the flow.

Allow access for all. Buffer the losses in Medicaid. Enroll middle class citizens. Spread the already set, basic administrative costs over a larger membership. Ease some of the burden on the States for Medicaid costs, businesses for employee private insurance programs and the self employed for self paid private insurance health care coverage.

It seems fiscally doable to me.

Politically I realize there's the big bugaboo about "socialized health care" touted in the right wing, yet the health care crunch is a great opportunity to re frame the issue, and revisit it as a national agenda.

[hiaasenrocks]

22. That makes a lot of sense. Good post.

I think that, along with an option (the Congressional plan) would add even more competition to drive the price down. If the private insurers can't keep up, they lose and that's that.

Part of that competition would be to drive the overhead cost of private insurers down. It's much higher than Medicare, which a lot of people don't realize.

[Hoyt]

28. I too favor Medicare or something similar, but the "premiums" don't cover the cost.

The premiums Medicare beneficiaries pay don't come close to covering the actual cost of care. Taxes from various sources pick up the rest. But, I do agree that the Medicare model is the way to go -- there will just have to be some tough "management" decisions to make it affordable for everyone.

Interestingly, folks eligible for Medicare don't have to take it. Most do, but they aren't mandated to take or use it.

[rasputin1952]

42. Crunching #'s here...

The answer to the situation is to take the money out of the insurance companies, which are for profit, and put "premiums" in the form of a tax, into a fund that will reimburse physicians/facilities at a decent rate.

If a family pays, say, $600 a month/$7200 per annum, for insurance today, has a $2500 family deductible, (making out of pocket $9700, not including co-pays), that can be brought down to say, $400 per month, or $4800, no deductible, no co-pays, the savings to the individual would be just over half. There would be input from business as well, but their costs could be cut in half as well, and no paperwork would be involved.

There are immense savings to be had, particularly if people received preventative care, as well as early diagnosis, which would happen because all you'd have to do is go to a Dr or Clinic and show your card. You could still have the physician/clinic/hospital of choice; meds would be fantastically cheaper because of bulk and generic sales. The nation would be healthier, and there would be far less sick days off from work, (although that is a bummer). Productivity would rise, simply because a great burden would be lifted from the shoulders of the workers.

The only ones to really lose would be the insurance and big pharma industries, and who really cares about that?

Oh...and that argument about "you'd be forced to see a physician that the 'govt wants you to see'", is bogus, because virtually every insurance company has contracts w/physicians 'in network', go out of network, and you pay out the kazoo. So it is really the insurance industry that is telling people who to see.

[pop goes the weasel]

24. What?

People with disabilities who make too much to qualify for Medicare automatically are able to buy into it

That is not true. If it was, I wouldn't know so many people with disabilities going without any health care whatsoever. What is true is that, once a person has qualified for Medicare, even if they start to make too much money to qualify them to be on SSDI, they can still buy into Medicare. But first, they have to be on SSDI and Medicare. If only it was as simple and sensible as you indicate!

[Maven]

34. That IS part of the plan!

Just go to her website and READ IT.

:banghead: