December 22, 2009

Medicare Buy-In: Popular and Saves Money...It Will Be Back

A new poll shows the Medicare buy-in for 55-64 yr olds is quite a popular idea in the electorate:

24. Do you support or oppose allowing Americans ages 55 to 64 to purchase Medicare coverage?

             Tot    Rep    Dem    Indep   Men   Women

Support 64% 50% 81% 57% 64% 63%
Oppose 30 44 14 36 32 29
DK/NA 6 6 5 7 4 8

Even the majority of Republicans like this idea. Throughout the electorate it has a huge 2-1 popularity advantage.

This makes sense. A Medicare buy-in is clearly a good idea. It would lower the cost of health reform, since it would lower the absolute cost (including total cost sharing) of insuring 55-64 yr olds.

Joe Lieberman was entirely wrong on this.

Since Medicare has lower costs, the total federal subsidies to help people pay for health insurance premiums would be lower overall (nationwide, public and private together, in total) since direct health care costs for that age bracket would be lower (due to Medicare administrative efficiency!).

Further, since more people in that age bracket would get excellent Medicare coverage, more preventive care delivered to the 55-64 age bracket would then lower Medicare costs over time as that group with better early preventive care ages over 65. (This is a profound structural advantage of Medicare -- Medicare knows its policy holders will stay in Medicare, therefore it can invest in long term preventive care and wellness efforts that take years to break even and payoff.)

So Medicare buy-in would strengthen the financial soundness of Medicare.

Two large benefits.

Joe is wrong six ways to Sunday.

And the American people clearly like this good idea.

The reason the current version of health care reform has lost some of its popularity is exactly because the public option and the Medicare buy-in were taken out.

The current version of reform has lost popularity among some of those that believe reform is deeply needed and right. The loss of popularity has been because reform has been weakened.

I think this idea will be making a comeback.

The only question is when...

Will we do this addition to reform in 1-2 years? In 5?

We will do it, or some version of additional reform that is very similar, unless Congress keeps its spine and strengthens the measures still inside the current version of reform to improve efficiency and slow health care cost inflation. Elements such as the final medical loss ratio regulation, and the strength and functionality of the panels that will guide Medicare innovation and the applicability of their innovations to Medicare providers, including hospitals.

The bottom line is that the people want powerful reform.

This desire will only grow as medical inflation continues.

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