PARALLEL UNIVERSE: Problem: Medicare's Ailing; Solution: Open it up to everybody

By David M. Kinchen
My old (from 1976 to 1990) newspaper home, the Los Angeles Times, opined Sunday, April 17, 2011 about saving Medicare, offering many suggestions, some good, some not so much. I thought the best suggestion didn't come in the story, but in the comments from readers.

The editorial contains some wise suggestions, like pegging medical costs under Medicare and Medicaid to the consumer price index, which doesn't recognize "volatile" food and energy costs and which has kept my Social Security benefit at the same number for two years running.
 The suggestion from a reader, whose name I'll keep secret, says:

Actually, one thing that would help save medicare is opening it up to buy-in from any U.S. citizen. Medicare is already the least expensive insurance going, if it covered others besides the old and sick its economy would improve. Of course, this would injure the private insurance companies and their multi-million payments to their officers, and we can't have that, can we?

I've suggested the same thing quite a few times in the past, making the same point as the L.A. Times reader:  that expanding the pool of those paying into the system to include young and presumably healthier clients would go a long way to toward saving Medicare, which turned a mature 46 this year. (Four more years and it will be eligible for AARP membership!) In my opinion, Medicare was the best thing that came out of the administration of President Lyndon B. Johnson.

In my Jan. 27, 2011 Parallel Universe column I praised President Bill Clinton's labor secretary Robert Reich, for suggesting that we offer Medicare for all:


 "...opening the highly regarded program to anyone willing to buy into it.  I've blogged repeatedly in the past in favor of just such a move, especially since tens of millions of Americans are still without health care coverage, even after the passage of last year's "Obamacare." (A link to a  blog by me on the subject: "

Another cry in the wilderness -- My Oct. 22, 2009 Parallel Universe column -- is worth repeating in part:

Sharp-eyed readers may have noticed the absence of an opinion piece from me promoting one of my pet projects -- offering Medicare as a public option as part of an overall health care reform plan. I've argued frequently in the recent past on this site that Medicare is popular, affordable and would benefit by expanding its risk pool to younger, presumably healthier people from the current base of elderly and disabled people. 
I've decided to weigh in again because Sen. Jay Rockefeller has maintained his view that a public option is necessary, most recently on Tuesday, Oct. 20 issuing a position paper advocating it (Link: Rockefeller, D-WV, chairman of the Senate Chairman Finance Subcommittee on Health Care, has been steadfast in his support of a public option while other Democrats such as Sen. Max Baucus of Montana and Sen. Mary Landrieu of Louisiana don't think it's necessary. Sen. Joe Lieberman, I-CT, a former Democrat who votes with Democrats on most issues, is vehemently opposed to a public option. Will Rogers was on target when he famously said he didn't belong to any organized political party -- he was a Democrat! 
The Hill, a widely read publication inside the Beltway, has just published a story (Link: saying that many Democrats would like to see a Medicare "Part E" -- as Rep. Dennis Kucinich, D-OH, called it in his 2004 Presidential run -- or expansion of Medicare to everybody. The story and accompanying reader comments makes the point about expanding the risk pool and says that reimbursement levels to health care providers could be adjusted. Both my wife and I have Medicare and the program pays about 80 percent of the costs. We don't have supplemental insurance, so we don't overuse the program. 
As T. R. Reid points out in his new book "The Healing of America" which I recently reviewed (link: in countries like Canada and Taiwan, which use plans similar to our Medicare, doctors and other medical providers have adapted to the reimbursement levels, even if they don't like them. By the way, I recommend the Reid book to all, especially those who mistakenly believe that all foreign health insurance plans are single-payer "socialized medicine" schemes. That's simply not true. 
Rockefeller's paper is worth reading. He cites figures from the Kaiser Family Foundation showing that in the past decade, health insurance premiums have jumped four times faster than inflation: 109 percent vs. 26.5 percent. While not specifically advocating Medicare for all as a public option, the paper's talking points note that Medicare's costs rose an average of 4.4 percent in the decade 1997-2007. This compares with private insurance costs that grew an average of 7.7 percent. 
The story in The Hill notes that: 
"While much of the public is foggy on what a public option actually is, people understand Medicare. It also would place the new public option within the rubric of a familiar system rather than something new and unknown." 
Among those supporting "re-branding" the public option as Medicare are Rep. Mike Ross, D-Arkansas, who had previously "loudly proclaimed his opposition to a public option," the story notes. 
Rep. Jim Oberstar, D-MN, the veteran chairman of the House Transportation Committee, also voiced his support, as did House Majority Whip James Clyburn, D-SC. 
John Schadl, a spokesman for Oberstar, explained the congressman likes the idea because people are familiar with Medicare, The Hill story says, adding: 
"'One of his concerns is that people don’t know what a public option is. Medicare is a public option,' Schadl said. He said Oberstar started talking about 'Medicare for Everyone' during August town hall meetings." 
Hey, maybe something is happening inside the Beltway after all! I'm taking heat from my libertarian and conservative friends about my support for Medicare for all, but I don't care. As my friend Joe Honick says: "Labels are for whiskey and medicine." I believe in using the best, most practical ideas from all sources and promoting them. That's why I'm for a public option, specifically a "re-branded" Medicare.

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Sometimes a simple solution is the best one. I'm willing to bet that, faced with competition from the government, private insurance companies would come up with competitive plans as alternatives to my Medicare for All. It's worth trying. 

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