I — speaking only on behalf of myself — suggested one possible idea could be that instead of creating an entirely new government bureaucracy to administer a public option, Medicare could be offered as a choice to compete alongside private insurers for those Americans eligible to enter the national health insurance exchange, but at a reimbursement rate much greater than current Medicare rates.
The last sentence is key: reimbursing providers who treat the new enrollees at market rates satisfies the provider community and conservative politicians from rural states who argue that their hospitals would close if they were reimbursed at Medicare rates. This scheme preserves the integrity of a single national program and takes advantage of Medicare’s administrative efficiencies to lower costs and spearhead delivery reforms. Still, Ross’ solution will likely save less money than a robust public option that uses Medicare-like rates and leverage.
After cutting a deal with Energy and Commerce Committee Chairman Henry Waxman to increase the public option’s reimbursement rates in August, Ross announced last month that “he will vote against health care legislation if it includes a public option.” “I have been skeptical about the public health insurance option from the beginning and used August to get feedback from you, my constituents,” Ross wrote in a newsletter to constituents. “An overwhelming number of you oppose a government-run health insurance option and it is your feedback that has led me to oppose the public option as well.”
LSB: Finally! Someone thinking along the same lines that I have been advocating for a while - why create a new bureaucracy when there is already one in place. If the age requirement were eliminated from Medicare, wouldn't that be in effect a public option? Each month a Medicare tax is already deducted from my paycheck as it is for everyone. Even if that percentage were increased a little (yes, I know - a tax increase), it would be offset by the elimination of the additional health care premium I pay above the amount paid by my employer - thus neutralizing the effect on my paycheck. The employer amount could likewise be increased a similar amount, which would also be offset by eliminating the employer portion of employee health care insurance. [EX: If the Medicare tax were increased by 5% for both the employee and employer, for an employee making no more than $48,000/year this would mean a monthly increase in the Medicare deduction of $200 by the employee and $200 for the employee - which is probably the average amount both currently pay to private insurers for employee health coverage. For individuals making less than $48,000 annually, this is a net savings to them while maintaining coverage; for employers of those making $48,000 or less annually, it similarly does not increase the net amount they pay for health coverage for their employees - and may decrease that amount, - but it simply moves the payment from private insurance to Medicare.] Small businesses that don't currently provide insurance benefits to employees (those with a small number of employees) could be exempt from the increase and still have their employees insured; those employees earning a high dollar amount, for which the increase would mean a greater total cost than their currently monthly health care payment, could opt out of the program in favor of private insurance and pay only the current Medicare percentage. Since the majority of those not currently covered are not the high-wage earner, private insurance companies would lose only a small portion of their current customers and it would force them to compete more aggressively for the high-wage earners they currently cover. And with the additional revenue through this percentage increase, Medicare could make adjustments in their payments to hospitals and doctors to eliminate those concerns expressed by Rep. Ross. How can having more patients insured and getting payments from Medicare be worse than having so many uninsured and indigent patients? Sure, insurance companies will not be making the obscene profits they are currently making, but that is a sacrifice I'm willing to make! (snark) Am I missing something here?