{Medicare Buy-In For ALL} and Forget Passing Pre-Existing / Rescission...

[quantass]

Cenk Uygur over at The Young Turks has a good idea of Medicare Buy-In For All: http://www.theyoungturks.com/story/2009/12/17/43552/636/Diary/Radical-New-Idea-Medicare-Buy-In-For-Everyone-

You only need 51 senators to pass a bill through reconciliation. But theoretically the main problem with reconciliation is that it can only be used for legislation that affects the budget. So, a public option or Medicare buy-in would definitely affect the budget, but getting rid of insurance practices like barring people for pre-existing conditions or denying them care through rescission could not be handled through reconciliation.

So, if you just want one bill you can't go through reconciliation because you can't keep many of the important elements of health care reform. That's conventional wisdom. But here is a radical new idea - how about we just do Medicare buy-in for anyone who wants it and not bother to pass any regulations about pre-existing conditions or rescission or anything else....

What would be the rate for a 35yo male? I've seen statements like Medicare + 5% but what exactly does that translate into monthly premiums?

I live in Canada so all of this direct paying for healthcare is foreign to me.

[valerief]

1. But how would the for-profit insurance companies get their massive plundering?

I mean, this idea is absolutely sterling but only for Americans, and we know the Senate hates America.

[quantass]

2. k

[quantass]

3. Medicare Rates....

What i found on Medicare.gov

The following is a listing of the Medicare premium, deductible, and coinsurance rates that will be in effect in 2009:

Medicare Premiums for 2009:

Part A: (Hospital Insurance) Premium

*
Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
*
The Part A premium is $244.00 per month for people having 30-39 quarters of Medicare-covered employment.
*
The Part A premium is $443.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.

Part B: (Medical Insurance) Premium

$96.40 per month*

Medicare Deductible and Coinsurance Amounts for 2009:

Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2009 = $1,068) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.

For each benefit period you pay:

*
A total of $1,068 for a hospital stay of 1-60 days.
*
$267 per day for days 61-90 of a hospital stay.
*
$534 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
*
All costs for each day beyond 150 days

Skilled Nursing Facility Coinsurance

*
$133.50 per day for days 21 through 100 each benefit period.

Part B: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

*
$135.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $135.00 deductible.)

Additional information about the Medicare premiums, deductibles, and coinsurance rates for 2009 is available in the September 19, 2008 Fact Sheet titled, "CMS Announces Medicare Premiums, Deductibles for 2009" on the www.cms.gov website.

*Note: If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $96.40 per month. For additional details, see our FAQ titled: " Medicare Part B Monthly Premiums in 2009"

[subterranean]

4. The problem with that idea is adverse selection.

The insurance companies would only insure healthy people, and everyone with pre-existing conditions would end up in the Medicare plan, making it prohibitively expensive.

[Andy823]

5. But if

It's cheaper to buy into medicare wouldn't a lot more people dump the private plans and pay into the medicare plan? If that happened wouldn't that actually help make medicare a better plan, and help lower costs to the program? Private plans would either have to lower their premiums a whole lot, or only cater to the rich who could afford their plans. Medicare for "ALL" seems to make a lot of sense to me!

[subterranean]

7. If it's cheaper and truly Medicare for ALL, with everyone eligible,

it could work. At this point, though, such a plan is nothing but a fantasy in this country, precisely because it makes sense.

[Andy823]

8. Yes it is a fantasy

But they could do it with a majority instead of the 60 votes they can't get now. It would tick off the republicans, but who cares, they won't do anything to help get health care reform, and they never will, so let them be as mad as they want. As for the people, well republicans would grip and complain about it being socialism, but like the current medicare, once it go going and many of them also found out it was cheaper and wasn't as bad as they had been told, they too would like it, just like they did in Canada.

I also think that if they did this it would help president Obama with his base, and by 2012 if it worked the independents would be happy and even some republicans. If things keep going the way they are now, I don't think things are going to look to good for the 2010 elections or the 2012 elections. If the base continues to get ticked off it can't help the democrats at all! Putting a medicare for all system in place would only tick of republicans, and the vast majority of them wouldn't vote for a democrat anyway, so who really cares!

[Oregone]

6. Only if you also kept sliding scale subsidies to make Medicare premiums affordable for all

But most Senators wont vote for subsidies (Democrats included), unless you created an exchange and let the private companies get their crack at the public funds. And thus, the shit dripping begins.

[Andy823]

9. I agree.

There should be a sliding scale for subsidies, and then if the exchange was open to private companies, they would have to really cut costs, and increase services if they expected to get many people in their plans. Those who had the money, and didn't care about high prices could still buy into the private plans along with all the teabaggers who think it's all about "socialism". I think the vast majority of americans would opt for the medicare buy in. Business could offer better wages instead of having to buy expensive health care coverage that would help the employee pay for their medicare buy in. I am sure there would be a lot of things to work out with such a program, but it seems to me that it would work far better than what we have now, and force any private companies that wanted to compete to really make serious reductions in costs, and increase their benefits to those who did purchase their plans.

As you said though getting senators to go for it might not be so easy, but with only a majority vote instead of the 60 they now have to get, it could be a lot easier!