why hasn't a Medicare expansion been directly pushed again?

[themaguffin]

It seems that would be the realistic 50 votes getter and easier to inact - plus logistically faster.

I just don't believe a public option is going to happen but an expanded Medicare was likely until Lieberman fucked it up.

Far from ideal, but certainly it's a step...

[Oregone]

1. It could endanger private iinsurers' profits

Reform will not occur if private industry isn't guaranteed to benefit, according to the dominant political philosophy of the day

[Cleita]

2. Wake up and smell your corrupt Senate. They never wanted it and it was

all a Kabuki dance to make sure it never got on the final bill with Lieberman as the fall guy. It would be easy enough to do if there was the will to do it. All we can do now is try to get more progressive Democrats in the Senate in future elections. In the long run we will probably have to do this state by state like Canada did it, province by province.

[DrToast]

3. I don't know if it would work...

I didn't see at the time it was being discussed how it would work and I still don't see how it would work.

Even if you use Medicare reimbursement rates, you still have a pool solely consisting of high-risk individuals. You need the younger people to balance out the risks.

[dkf]

4. Is the truth of health insurance that what we need is redistribution from the young to the old?

I keep seeing this assertion that we need young people in the system.

[DrToast]

5. The young will benefit too

Most young people don't make enough money to buy insurance, but they will be eligible for subsidies.

[dkf]

11. So if we need young people in the system but they will be subsidized who is really paying?

This doesn't make any sense.

[FrenchieCat]

6. Because nothing is ever as easy as what someone would wish.....

it is easy to pronounce a panacea of a solution
as long as the path to getting to there is not completely discussed.

Kind of like saying, is there a reason that we don't have peace on Earth.

[Ozymanithrax]

7. There is every indication that a public option can get 50 votes.

But nobody has tried to get a whip count, that I've seen, on expanding Medicare to cover all American's. If they did, there would have to be a bill written.

In the 2009 budget, Medicare was estimated to cost between 417 billion and 480 billion. In 2008, there were 45 million Americans enrolled. In order to expand Medicare to cover all Americans, we jump to cover everyone, that number would be around 310 million. That would put an estimated cost of 2.7 trillion to cover the entire population.
Of course, there would be savings due to scale. But even if we cut half that is 1.35 trillion a year. There is simply no support at this time to set up a 1.35 Trillion dollar a year program, let along 2.7 trillion dollars. That is why it is not on the table. It would be a good system, especially if it maintained the efficiencies and continue with only 3% overhead.

[Lint Head]

8. A Medicare expansion would actually help private insurance companies.

Private insurance companies bid for Medicare contracts all the time. CIGNA is a major DMERC and Part B Medicare contractor for the federal government.

[SanchoPanza]

9. Provider Reaction

The notion that insurance companies are opposed to a Medicare buy-in is somewhat comical, especially considering that the buy-in was targeted at people who private insurers don't want on their rolls: 55-64, who are more likely to be financial liabilities for insurance companies than revenue generators.

Most insurance companies actually have a favorable view of programs like Medicare and Medicaid, because they provide a dumping ground for people who would normally lose them money and opens up a supplemental market that is fairly profitable because Medicare assumes most of the costs. But provider associations, like the AMA, who don't want to serve more people paying them through the Medicare reimbursement system, really hate them.

[dionysus]

10. too many bought off senators to pass, unfortunately

[WonderGrunion]

12. Medicar expansion is strictly budgetary and could be put through by reconcilliation

Do we have 50 votes + Biden to pass it?

[tsuki]

13. Too many 55+ persons would retire. Bringing down the number of

eligible workers is not good for the corporations.