If you had the option right this minute to enroll in Medicare (regardless of age) would you?

[Phoebe Loosinhouse]

I would be thrilled to. I have seen my parents get outstanding healthcare with very little out of pocket.

[annabanana]

1. yup. . . n/t

[grantcart]

2. yes

[Mike 03]

3. Yes, absolutely. My parents are both on it, and my father has cancer and is getting

remarkable coverage.

I would pay for it.

[sharesunited]

4. Darn right! Which is why the battle cry ought to be Medicare for All!

Cuts right through all the noise. People know this existing program and like it.

[CurtEastPoint]

5. yes

[The River]

6. Yes nt

[dweller]

7. sure would

dp

[timeforpeace]

8. Definitely.

[Daphne08]

9. Yes.

[patriotvoice]

10. Extremely likely. I would need to see exact configuration of services and cost breakdown.

But that's because I'm prudent.

[Lost-in-FL]

11. Yes.Medicare approve exams that are normally not approved by private insurance.

They (Medicare) also force hospitals to higher standards as a condition to accept their participants.

[Cleita]

12. I am already and I wish every body had it.

I think they do need to close the gaps that enable insurance to sell coverage to plug the holes and they need to update their fee schedule and cover dental and vision, but I don't see it as a problem if the money that goes to Wall Street profits and Washington lobbyists and politicians goes to Medicare instead.

[bbinacan]

13. No

I like my insurance

[Phoebe Loosinhouse]

14. so far 13 yes, 1 no ( I counted myself in the yes group) nt.

[bbinacan]

18. So what's your point? n/t

[Phoebe Loosinhouse]

22. My point was to give the tally up to your reply.

Was that unclear?

[bbinacan]

24. Your point

has a deeper meaning.

[Phoebe Loosinhouse]

25. O.. K..a...y .y .y ......, Sure, sure, whatever you say.

backs slowly towards exit

[bbinacan]

26. Who backs

slowly to the exit? You or me.

[Autumn]

15. Yes n/t

[madokie]

16. If I wasn't VA

in a heartbeat I would. As it is I am happy with the health care I get at the VA hospital, they've just been great to me. I wish everyone could have the same quality of care I enjoy today.

[fishnfla]

17. no

[BlooInBloo]

19. Depends on whether the plan was better than what I had through work per dollar...

Presumably merely having the option would make my work coverage cheaper, better, or both. The mere existence of the option is good for everybody.

[Brigid]

20. Yes, I would.

I thought I heard at one point the idea of Medicare for all was floated as at least a place to start on universal health care.

[Shrek]

21. No n/t

[nadinbrzezinski]

23. No, but let me clarify, we are already on Tricare Prime, the OTHER possible model

for a National System.

And yes, we have gotten outstanding healthcare in a Government run system.

Now if I had private insurance, in a heart beat.

[orleans]

27. absolutely. n/t

[Kaleva]

28. yes

[Yo_Mama]

29. But would you be willing to pay the cost?

That premium they pay out of SS (<$96.40 monthly for most people) is only part of the cost. Part D premiums are about $30 a month. But most of the cost of Medicare is paid by other sources. See the Trustees Report:
http://www.ssa.gov/OACT/TRSUM/index.html

HI is paid for by Medicare taxes which the entire population pays in the form of a 2.9% tax on all wages (there is no income limit). To cover about 45 million people, it cost 230.8 billion for HI (part A), and 250 billion for SMI (parts B & D). Plus there was a shortfall of over 20 billion. A lot of the cost is paid from general revenues.

So the total cost in 2008 for 45.2 million beneficiaries was about 500 billion, or half a trillion, most of which was paid for by the non-beneficiary population. 500 billion is 500,000 million, so the total cost per beneficiary was 500,000 million/45.25 million or $11,061 per beneficiary. That is a lot.

Total US population is about 300 million, or about 6 times the current beneficiary population. We would have to spend enough to cover an additional 250 million people. Assuming that the cost to cover the rest of the population would be about half of the cost of covering each older beneficiary, or $5,500 per extra beneficiary, it would cost us $5,500 X 250,000,000, or 1.37 trillion more.

If you had to cover a family of 4 on Medicare, the extra cost would be about 4*5,500, or 20K a year for that family. If you didn't want to raise current costs to Medicare beneficiaries, all of the extra cost would have to be paid by working people. However Medicaid costs wouldn't be extra, so Medicaid could come out of that. Medicaid cost about 333 billion in 2007. We'll make that 370 billion, and say the extra costs that would have to be paid by workers would be 1 trillion.

1 trillion divided by 150 million workers is 1,000,000,000,000/150,000,000 or 1,000,000/150 is $6,666 per worker. So the cost of the insurance would be about 12K for a working family of four. Most families do not currently pay this much for coverage through premiums and employer subsidy, nor do they currently get such good benefits. The average family medical insurance premium is about half this.

To cover this as a wage tax, which would make the most sense, use the 2.9% employer plus employee premium currently. In 2008 that raised about 200 billion (all of which went to cover less than half of the Medicare). Since we need to come up with another 1 trillion, which is 5 times 200 billion, the total extra payroll tax would be 5*2.9% or 14.5% of all wages (no cap). You can confidently expect that total wages would be reduced somewhat because some jobs would be lost and some compensation would be cut, so it would probably really cost about 16-17% of wages, plus the 2.9% of HI tax we are already paying, which would take us to close to 20% of payroll for universal health care and about an extra .5% to cover the lost income taxes. Of course, in a recession year we'd go in a hole, but when times improved there would theoretically be more money on the wage tax, so maybe it would balance out.

It is good insurance, but it is not cheap. Real average costs per worker would rise regardless each year, because the US population is aging quite rapidly. Within another 10 years, figure about another 2-4% of payroll for a total of 22 to 24% of wages. Within 20 years, figure about 30% of wages.

Btw, Massachusetts is currently spending over 6K per person for their covered population, so this back-of-the-envelope calculation really checks out. Also, the equivalent spent in the UK is about 20% of wages.

See, this doesn't solve the budget problem. It would be great right now for lower wage earners, but we would still need to ration healthcare as the proportion of older people rises to workers.

It would be a huge tax increase on higher wage earners. Let's say you earn $100,000 annually. Your share of the health tax would be $10,000 (employer pays $10K).

Your take home wages before income tax (see tax brackets link):
http://www.moneychimp.com/features/tax_brackets.htm
100,000 - 16,200 (SS & health tax) =
83,800 - 21,000 (income tax single, no extra deductions)=
62,800 (effective tax rate about 38%)

plus you'd have to pay state income tax maybe of 5%, so your actual take home would be about 58K.

One effect would be that some jobs would be lost, because some employers would not be able to pay the employer share.

[bemildred]

31. We already do pay the cost, for the most expensive health care system in the world.

And far from the best too.

[Yo_Mama]

32. I agree, Bemildred

We do pay the cost - it's just hidden.

Almost anything would be better than this weird mixture of public/private we have now, in which private insurance basically subsidizes Medicaid and other public programs, and in which no one is sure that they will be continuously covered. What good is paying for insurance all your life when if you get truly sick, you will probably find yourself uninsured at one point?

I'd prefer to see the true cost up front. Then we could have a real discussion on what we will pay for, and what we won't.

Not everything would be covered, though. There would still be rationing, but most people would have a lot more security than they do now.

I would rather do it this way than have a national sales tax. Somehow, just like the money went missing out of the SS taxes we were supposed to be paying to provide for our future, I suspect such a tax would be diverted. This way also, everyone would be in the same boat. The government workers would be getting the same thing we do, and Congress Critters would be getting the same care that a truck driver gets. I think the vast majority of the people would end up a lot happier with the end results.

I am curious as to what others think, though. Is there really a political barrier to this? Or is it just that the political establishment doesn't want to go there for their own reasons?

I am very unhappy about the current proposals in Congress. I still haven't figured out how they make people secure. If you can't pay, you can't pay, and when you lose your job you can't pay. I'm either stupid or they are, because I just don't see how those proposals really get people securely and continuously covered. It seems more like a game of "let's pretend" to me.

[Gormy Cuss]

30. Yes, for one reason: it can't be cancelled.

Even if it were shitty coverage, it would be better than nothing.

[Horse with no Name]

33. Yes.

And because of my healthcare needs, I would also purchase a supplemental policy.

[RobbinsdaleDem]

34. Yes.

[bermudat]

35. Yes