Medicare eligibility

[JMCoast]

I am a single payer guy but I know that is way off into the future, if at all. So, since we have Obamacare, if we were to lower the eligibility age for Medicare to 55, would that not help the exchanges in that less healthier people would no longer be on them? Wouldn't that allow the exchanges to operate more effectively for the insurance companies? In theory it should equal out the exchanges, with more insurance companies offering plans. I don't know how many people 55-64 are on the exchanges now but I assume it's a pretty substantial amount.
I despise the insurance companies but the law is what it is. We have to deal with them until we can get single payer. Hillary had mentioned this idea during the campaign and I heard Bernie bring it up the other day. I think it could work. Am I off base?

[still_one]

1. Yes, in the respect that it would take an older, more vulnerable demographic out of the

pool, and leave as you said, presumably more healthier people to cover.

Unfortunately, in this political environment, it won't happen unless 2018 changes things

[mwooldri]

2. Personally I'm for lowering the Medicare age to 0.

2018 is earliest for that. Then Trump can keep his promise of something better and cheaper than Obamacare

[HoneyBadger]

4. Yep

Something like a double digit percentage of healthcare cost is related to admin. Imagine how much admin goes down if everyone is qualified and there is no billing. It would be like taking a breath. Air is free for everyone and healthcare should be too.

[csziggy]

5. Under the ACA insurance companies are allowed to make 20%

So that amount would come off the top. They also have no real incentive to keep administrative costs down since those are not counted as part of the 20%. In addition the differences between the various insurance companies require much more work at the medical provider level, so those costs would be greatly reduced with single payer.

My previous doctor had a single office and he was the only doctor there with a nurse practitioner and three or nurses to assist. He had two receptionists and five insurance clerks for paperwork. His office costs would have been cut in half at least with a single payer system.

Medicare costs about 5% for administrative costs.

[JMCoast]

8. If we went to Medicare for all

what would happen to the thousands of people who work for those insurance companies? It's a pretty basic question but I've never heard a solution. Retraining assistance? It's one of those issues I'm sure would come up, if by some miracle Medicare for all actually came to fruition

[csziggy]

9. Maybe they could actually provide health care rather than denying it?

Any change in systems will disrupt societies - automation is doing that anyway.

[Ilsa]

11. He was talking about jobs lost by insurance employees.

They obviously aren't trained to provide healthcare.

I see the OP's point: if Medicare for all can't be passed, compromise by getting older workers on it. It gives employers a break on their insurance, and maybe they'll be less likely to layoff older employers who typically have higher salaries, too. It would be the start of a shift to a public option. Five years after that, look at moving maternity and ALL pediatrics to public coverage. Insurance will see their market shrink, but their market for supplemental will grow.

Look what has happened with the ACA: the shift is one that citizens demanded we keep. It was a very gradual step towards Medicare for all. I think we'll have it in the next ten years.

I had this idea a few days ago. Tried to call it in to the Thom Hartmann show today because Mark Pocan was on, but the hard commercial break got me.

[csziggy]

12. There are actually a lot of things that are not getting done in this country

We don't have enough help for addicts, for veterans, child care, elder care - and not all of those need medical care, just assistance by trained people. People could be retrained to do that work - and those are jobs that cannot be automated.

I agree that a gradual move over to Medicare would make the most sense. We just have to convince the rest of the country of that!

[Ilsa]

13. ITA, those are important and needed

Vocations if the person is temperamentally suited for it. A lot of people don't have the patience for this kind of work.

[csziggy]

14. True, though many of the people I have talked to with my medical insurance could it it

People at the insurance office and people in doctor or hospital offices who deal with insurance claims have been extremely sympathetic and seem as though they could handle counseling positions. Over the last fifteen years I have dealt with a LOT of those people and almost all of them have been wonderful human beings.

Of course it is different being nice over the phone and doing it face to face over an extended time.

There are still plenty of jobs that currently are not done well because of staff shortages. We should be able to shift people to positions that suit them. It just takes caring and some effort.

[HoneyBadger]

16. They could be retrained to perform other useful functions

As more people have health care coverage, more people will use health care benefits and they will live longer, using even more benefits. So retraining them to be health care providers is worth it. In any case it is not a long term issue, one generation at most, then the problem is resolved for all time, isn't that worth short term issues?

[Ilsa]

18. Not every one has the temperament to be a provider of health services.

I've met too many nursing students who dropped out when they realized how physical or how patient-oriented care is, including psycho-social tasks. Some people are not cut out for it. The last nurse or counselor you ever want to have is one that doesn't care about what they are doing, doesn't like hearing people complain about their problems, etc. They'll need retraining in other fields that are more technical, not healthcare related.

Sure, we will need more healthcare professionals, and I think college and tech schools should be free, but people need to be suited for their careers.

[former9thward]

10. Medicare is not free.

And there certainly is billing involved. The federal government uses dozens of private insurance companies to do the administration of Medicare. Federal employees don't do it.

[Ilsa]

15. True. Financing it and convincing

Doctors are still an issue.
I think there needs to be a student debt jubilee or forgiveness for medical professionals.

[HoneyBadger]

17. But it should be free

Or rather, the top 5% should pay much of it via taxes. 5% covering SS and Medicare was the plan. This is a better plan.

[frazzled]

3. That is precisely what Hillary Clinton proposed last spring

And Bill Clinton, before her. It's more complicated than just opening the gates to younger enrollees, but it's an idea that Congress should explore.

Earlier this month during a Virginia campaign stop, Ms. Clinton proposed reducing the Medicare eligibility age to 50 or 55.

While Ms. Clinton suggested that younger retirees would have to “buy in” to the program to some extent, they “would be buying into such a big program that the costs would be more evenly distributed.”

. . .

Ms. Clinton is not the first to propose lowering the Medicare eligibility age. Her husband and then-President Bill Clinton did so nearly twenty years ago.

“What about all those people who retire at age 55 and lose their employer-based health insurance and can't draw Medicare until they're 65?” he asked during a speech to the Service Employees International Union in 1997.

A year later, the Clinton administration formalized the proposal that would have allowed employees 55 and older who lost their jobs and exhausted COBRA coverage to purchase Medicare coverage for $400 per month until they turned 65. But Congress never acted on the plan.

http://www.businessinsurance.com/article/00010101/NEWS03/305229989/Clinton-proposal-would-expand-Medicare

See also:

Clinton suggested that removing older people from the market would lower costs. And their own costs wouldn't necessarily go up, she said, because they'd be part of such a big group.

"If you were able to let people 55 or 50 [years old] and up who are the biggest users of health care into the Medicare program — they would have to buy in, but they would be buying into such a big program that the costs would be more distributed," Clinton said.

. . .

Jacob Hacker, director of the Institution for Social and Policy Studies at Yale University, says Clinton's idea could slow down health care inflation because Medicare is very efficient.

"While Medicare is often criticized as not being effective enough at cost control, in fact Medicare has done a better job than private plans in restraining prices," Hacker says.

Hacker became known as the "father of the public option" during the 2010 debate over the Affordable Care Act because he was an early proponent of the idea. He says Medicare, or another government plan, is in the best position to lower overall costs because the government can best negotiate lower payments for doctor visits, tests and medications.

http://www.npr.org/2016/05/12/477836054/fact-checking-hillary-clintons-medicare-buy-in-proposal

[crosinski]

6. I've read that it would help stabilize and extend Medicare too.

Because that 55 thru 64 year old group is healthier than the 65+ group that Medicare generally covers now. It'd be a win-win for everyone, except for insurance and pharmaceutical CEOs who seem to know which wallets to pad.

[HoneyBadger]

7. By extension, covering from birth would lower Medicare costs even further

As 0-64 is certainly healthier than 65+ overall