A modest proposal for Medicare [View all]

[BlueStreak]

There seems to be some agreement that the funding for Medicare is a problem. Although we keep dumping money into the system, health care costs keep rising. At this point, it appears the system is solvent for about 10 years, and it really should be solvent for 40-70 years.

So what to do?

The most common proposal is to gradually increase the entry age from 65 up to 67 or 68. That actually is a step backwards on many levels. It MIGHT make Medicare more solvent, but the total cost to society is very negative.

Here is my proposal. Give the right-wingers that gradual increase in the entry age for full paid benefits. But in return, make two other changes, which will both solidify the system and have a highly positive effect on society:

1) By raising the entry age, we cut out millions of people out of the system. These 65-year-olds are healthier, on average, than the rest of Medicare participants, so we don't actually save that much in costs. But the excluded 65-year-olds are, on average, LESS healthy than the younger population, so private insurance companies don't want to carry them. The solution is simple. At the same time we raise the entry point for full, paid benefits, we create another Medicare pool (a public option) for those age 55 through the point of entry into Medicare. Medicare simply tallies the actual cost of health coverage for this pool, divides that by the number of participants, and that is the premium these participants pay. It doesn't cost the taxpayer a penny, but it gives those approaching retirement a more affordable option. And this is good for the private insurers because they can concentrate on the younger population, which is generally healthier, so premiums should also go down for those under 55.

2) Enable Medicare to negotiate drug costs with the goal of Medicare patients paying the same price that patients pay in Canada, for example.

The only argument against either of these ideas is corporate greed. If a person is honestly interested in preserving and protecting Medicare, these ideas will clearly do that.

The point is that a unilateral increase in the entry age is just plain wrong. That is a bad idea. It is the OPPOSITE of where we should be headed. If we are going to accept that because of the need for long-term solvency, then the negotiation should include these other items that solve the financial problem AND improve our access to affordable care.