Monday, May 07, 2007

A Modest Proposal

Medicare [2005, 2006]:
37 million old folks [2005]
$324,911,000,000 spent on their medical care [2006]
not quite $9000 per person

Veterans Affairs [2007]:
5.5 million veterans
$31,510,000,000 spent on their medical care
not quite $6000 per person

Nobody wants to see the health insurance industry go belly up [well, I do]. They're taking in and throwing around a chunk of money: $227 billion last year [about $12 billion of it profit] for the 13 largest companies. The disappearance of those 13 companies alone would [theoretically] put 200,000 or so folks out of work [not entirely].

Thud! Thunk! Crash! That's the sound of free-marketeers falling over in a dead faint at the very thought. Nanny state! Socialized medicine! Government interference between a woman and her doctor!

Oh. Boo. Hoo.

So, a proposal for them [and you]: let ordinary people buy their way into their choice of either Medicare or the VA system.

How much should the government charge? It would be a challenge, but I could swing $6000/year if in return I got guaranteed coverage. In fact, that's just about what I was paying before, to the insurance company, for coverage that turned out to be useless once I reached my [$1500? I forget] out-of-pocket maximum. Funny thing, but about the same time I reached that magic out-of-pocket number, the insurance company had paid out about $5000 to my doctors, hospitals, labs, etc, at which point they started denying the rest of my claims.

It's not like any for-profit insurance company is going to offer to cover me now for $6000 or even $10,000 per year in my present state of health. What have they got to fear from uninsured and uninsurable little me?

I'm firmly of the opinion that we could and should jump right into single-payer universal health care, but until the rest of you agree with me, I would be happy to follow the Libertarian mantra and go vote with my dollars.


Keifus said...

And it's not like the people in Medicare or the VA are sicker and older or... Oh wait, they are.

(Like I said before, the insurance oligopoly ain't all that special in the vaunted free-marketin' sense. And yeah, it seems the plans are so demographic-targeted, it's almost pointless.)

I think I've seen that proposal floated before, by the way. [Gooogling.....Aha!] Late in his term, Clinton proposed that people as young as 55 could buy into the Medicare program. The Kaiser Family Foundation was predicting (evidently) in the neighborhood of $3300 per person annually for coverage in 1998. I skimmed the report, but it looks worth a closer read, especially if you have any problems with insomnia.

I think I remember this because it came up in the discussions of MA's sort-of univsersal private care. (Fuzzy on that--this isn't exactly the sort of stuff that gets me hitting hte books.) I don't remember why the Clinton plan didn't go anywhere. Probably a Repulican congress bitching about inevitable subsidies (as the KFF report suggests). If that's true, it's funny about the turd they got through just a couple years later under Bush.

hipparchia said...

president clinton's plan "... was a complex proposal running more than 1,000 pages, the core element of which was an enforced mandate for employers to provide health insurance coverage to all of their employees through competitive but closely-regulated health maintenance organizations (HMOs)." [*]

essentially one thousand pages forcing everybody in the country to support the for-profit health insurance industry.

Keifus said...

No, this was in 1999, as part of Bill's Medicare reform plan. Evidently, it was a proposal that instantly died in congress. Some articles.

For what it's worth, I think your proposal makes sense.

hipparchia said...

some interesting articles there. thanks for that link.

my proposal isn't all mine, i've seen the "allow citizens to buy into medicare" suggestion before [ezra klein? maybe. i forget.] it's been touted as a way to incrementally push the u.s. into universal health care.

quite frankly, i don't think the incremental approach is likely to work, but i'm willing to give it a try. besides, i'm rather jealous of my friends who are covered under the [revamped] v.a. health care system, which is the main reason i added that one to my proposal, as an alternative to medicare.