Use reconciliation to expand Medicare - forget any industry reform
Use the reconciliation process to make Medicare buy in available to everyone who wants it.
This would be relatively easy to do.
For uninsured have a single rate for 55 and above and a sliding scale down to 30 so that younger participants will not be carrying an undue burden.
Offer a medicare plan for employers. Since medicare medical loss ratio is 30 points less than the private structure it would be possible to undercut private plans by 20% (employers happy). Include federal workers. Use the surplus 10% to add to the subsidy.
Allow medicare to negotiate drugs like the VA.
With the savings from above use that to subsidize lower income people who want to buy in the plan but don't qualify for medicare. In the future additional taxes on the top 2% can be added to increase the subsidy.
In order to stop people from gaming the system and joining only when they know that they are about to get sick a number of qualifications can be added.
1) After the initial open season have restricted open seasons once every two years.
2) After the initial open season have an enrollment period for 6 months - you pay 6 months before any treatment is approved.
3) After the initial open season have a waiting period for major illnesses for 1 1/2 years - medicare would pay some but not all of the costs during this time.
You would have two competing systems - Medicare supported by the Democrats and the private system supported by Republicans, with no mandates.
It would devistate the private sector and Medicare would soon have 75% of the market making transition to single payer easy.
I am suggesting we let it be and start a war on another front altogether -
Do the one thing that scares them the most - Have the government go into full competition with the Health Insurance.
Let them offer whatever they want and let Medicare enter the field and take them on - like the Post Office, the government offering services directly to the people, all the people.
If this were even mentioned Lieberman and the industry would fold in a minute.
11. Because that would be smart, therefore it's not going to come out of DU.
Pass this bill to get the process reforms through as well as the public victory, then run through a reconciliation bill in January or February with the stuff that couldn't get done before.
People forget that we CAN'T do any kind of insurance reform through reconciliation, due to limits on the process.
12. Your last point is why the insurance lobbyists are dropping millions into
blocking any form of this. We will never have decent health coverage in this country until we figure out a way to make it illegal for the insurance industry to sell us health care coverage.
16. If Lieberman knew this was in store as the alternative to the HCR measure he is fighting
He would sign on as a co-sponsor of a Senate bill with a medicare buy in for those 55+ and a modest Public Option. He only gets away with being an obstructionist because he has no fear of what might happen if he sinks a good faith compromise.
I say call his bluff and hope he stands his ground allowing us to move forward with real reform instead - if Democrats are vertebrates.
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