Wednesday, September 13, 2017

Medicare for All?

It's obvious that Bernie's "Medicare for All" bill is not about to become law, but that doesn't make it an exercise in futility.  It is a means for ambitious Democrats to define themselves as progressive, not slaves to the party establishment.

The single greatest obstacle to national health insurance is not Republican or industry opposition – it is employer provided health coverage.  As long as most Americans have that, they will not be especially concerned for those who do not; so public pressure for national health insurance never will be sufficient to bring about change.

There must be a means to transition from employer provided insurance to public insurance – and the most direct route begins with allowing employers to purchase Medicare for their workers.  This "free-market" approach would put a government-run program in direct competition with private insurance.  Profit-free, Medicare should have a competitive advantage; and by introducing younger, healthier participants into its insurance pool, Medicare should become more economically viable.  The new money in the system also would make the prospect of future cuts in benefits or increased premiums less likely.

The impact on the private insurance industry would be gradual, as employers switched over.  Since Medicare is far from a "Cadillac" plan, many employers also would shop private markets for supplementary, further softening the impact on the industry.  Over time, there would be plenty of public pressure to improve the coverage that Medicare offers, and to offer Medicare as an option in the ACA insurance markets.

Once a majority of Americans already are covered by Medicare, it would be far easier to find support for universal coverage, paid for by a combination of individual and business taxes.  Here in the USofA, "creeping" socialism is the only kind that ever wins the race.

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