Tuesday, January 17, 2017

Medicare For All?

President elect Trump has stated that his plan to replace Obamacare would allow everybody access to health insurance. While the Republican Congress struggles to decide what to replace the PPACA with, perhaps Trumpcare would be another version of the old public option, a Medicare for all.

It doesn't sound as preposterous as it seems. What are some of the advantages of allowing universal access to Medicare? First of all, it would have almost immediate bipartisan Congressional support. Universal Medicare was championed by Bernie Sanders during the primaries. Much wasted bloviating on both sides of the aisle would be eliminated by implementing universal Medicare instead of arguing about tax credits and and pandering to the wealthy.

Medicare is also widely accepted throughout the country. Virtually every hospital and physician already accepts Medicare. There would be far less concern about narrow hospital and physician networks. You can just go to your old doctor and the plan will be accepted. The claim that you can keep your doctor if you like your doctor will finally be true.

Universal Medicare is portable. Change jobs? Keep your Medicare. Move across state lines? Same Medicare in all fifty states. Universal Medicare would also drive competition in the health insurance market. Already hundreds of counties have only one choice for health insurance. Universal Medicare would give these companies more competition to lower prices and allow people to buy insurance if the private companies don't offer any plans. In essence, the entire country becomes one giant risk pool for health insurance, which was one of the goals of Obamacare.

Don't forget people actually like Medicare. It's one of the untouchable pillars of the federal government. It would have immediate mass appeal. Intuitively it makes sense to most people. This is what people think of when they talk about universal health insurance in other industrialized countries. Its appeal would make the legislation much easier to pass.

How to pay for it? People will buy into it just like they purchase any other health insurance plans. Unlike regular Medicare, people will buy the insurance, with the premiums based on income. The more money you make, the more you pay for Medicare plans.

Business deductions for health insurance could also be eliminated to help pay for universal Medicare. Right now this sweetheart deal brokered in the early 20th century gives unfair advantage and income to people who work for companies that offer health insurance. Small business owners, private contractors, part time workers, and millions of others don't get this deal. Removing health insurance deductions for businesses would free up billions of dollars and remove price distortions in the health insurance markets.

So could Trumpcare be a form of Medicare for all? It's hard to fathom what goes on under his orange hair every day but who knows? He is not beholden to either political party and can put forward his own plans without worrying about appeasing the right or the left. He just might do something this bold and Big League.

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