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Wed Jun 27, 2012, 11:52 PM

Stupid question, I know: could Obama order that Medicare be opened to insure those who pay for it?

What if Obama said "OK - Medicare will expand to make policies available to those under 65, but they have to pay premiums. It will neither lose nor make money on the deal."

This would cut the cost of health insurance by 20% or more right off the bat, because:
1. Medicare's overhead is about 5% of spending, whereas private insurers have overhead greater than 20%
2. I believe that Medicare generally negotiates the lowest prices from providers, because they're the largest insurer and thus have the most leverage

I strongly suspect that this couldn't be done, but I'm not sure why. Since it wouldn't require money, Congress wouldn't have a say in it.

9 replies, 1191 views

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Arrow 9 replies Author Time Post
Reply Stupid question, I know: could Obama order that Medicare be opened to insure those who pay for it? (Original post)
MannyGoldstein Jun 2012 OP
cynatnite Jun 2012 #1
MannyGoldstein Jun 2012 #2
Hoyt Jun 2012 #4
Zalatix Jun 2012 #3
Enrique Jun 2012 #5
elleng Jun 2012 #6
unblock Jun 2012 #7
msongs Jun 2012 #8
DevonRex Jun 2012 #9

Response to MannyGoldstein (Original post)

Wed Jun 27, 2012, 11:54 PM

1. I don't think Medicare negotiates costs with providers. n/t

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Response to cynatnite (Reply #1)

Wed Jun 27, 2012, 11:56 PM

2. Well it kind of does

It sets a price and providers can take it or leave it. But they need to set a price that most will take, or else recipients won't get care. So it's an implicit negotiation.

Because they're bigger, they can set their price lower.

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Response to cynatnite (Reply #1)

Thu Jun 28, 2012, 12:02 AM

4. About the only one lower is Medicaid. Most providers take some Medicare. Far fewer Caid.

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Response to MannyGoldstein (Original post)

Thu Jun 28, 2012, 12:00 AM

3. That sounds like a good idea.

 

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Response to MannyGoldstein (Original post)

Thu Jun 28, 2012, 12:04 AM

5. that has been discussed seriously

But every discussion involved Congressional action. Joe Lieberman shamefully flip-flopped on it, once being clearly in favor of expanding Medicare and then for no good reason turning against it. I thought my opinion of him by that time couldnt get any worse, but it did when he did that.

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Response to MannyGoldstein (Original post)

Thu Jun 28, 2012, 12:10 AM

6. I like it.

No President could just 'order' medicare to do such; that's the only 'stupid' part of your suggestion, The changes would have to be approved by Congress, so around and around we go again.

It WOULD cost money, actual services for many more means much more administration/bureaucracy, and the cost of services to many more. Spending bills have to go through Congress, and as insurance companies would be adversely affected to some extent, they would fight it tooth and nail. Again.

I think Medicare overhead is so low due to lack of need for marketing/advertising. Cuts a LOT. Don't know that they negotiate with providers; Fed gov. agency does negotiate with them for Federal Employees Health Benefits Plan.

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Response to MannyGoldstein (Original post)

Thu Jun 28, 2012, 12:57 AM

7. the powers of congress aren't limited to appropriations.

it absolutely would require a change in law, which necessarily involves congress.

unless you're talking about a 100% outsourced concept, involving zero government employees and zero government money.
if obama can somehow get a self-funding non-profit started that simply uses the medicare concepts and prices that are already public information, then sure, that would not require congressional input.

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Response to MannyGoldstein (Original post)

Thu Jun 28, 2012, 12:58 AM

8. gee maybe we could all have the same plan congress has nt

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Response to msongs (Reply #8)

Thu Jun 28, 2012, 01:03 AM

9. Choosing private insurance companies?

Just like federal employees. Like ACA.

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