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Medicare Part E: Everybody
Let's use Medicare, which nearly every American understands. Just create "Medicare Part E" where the "E" represents "everybody." Just let any citizen in the US buy into Medicare.
It would be so easy. No need to reinvent the wheel with this so-called "public option" that's a whole new program from the ground up. Medicare already exists. It works. Some people will like it, others won't - just like the Post Office versus FedEx analogy the President is so comfortable with.
Just pass a simple bill - it could probably be just a few lines, like when Medicare was expanded to include disabled people - that says that any American citizen can buy into the program at a rate to be set by the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) which reflects the actual cost for us to buy into it.
Thus, Medicare Part E would be revenue neutral!
To make it available to people of low income, Congress could raise the rates slightly for all currently non-eligible people (like me - under 65) to cover the cost of below-200%-of-poverty people. Revenue neutral again.
This blows up all the rumors about death panels and grandma and everything else: everybody knows what Medicare is. Those who scorn it can go with United Healthcare and it's $100 million/year CEO. Those who like Medicare can buy into Part E. Simplicity itself.
Of course, we'd like a few fixes, like letting negotiate drug prices, and fill some of the other holes Republicans and AARP and the big insurance lobbyists have drilled into Medicare so people have to buy "supplemental" insurance, but that can wait for the second round. Let's get this done first.
Simple stuff. Medicare for anybody who wants it. Private health insurance for those who don't. Easy message. Even Max Baucus and Chuck Grassley can understand it. Sarah Palin can buy into it, or ignore it. No death panels, no granny plugs, nothing. Just a few sentences.
Replace the "you must be disabled or 65" with "here's what it'll cost if you want to buy in, and here's the sliding scale of subsidies we'll give you if you're poor, paid for by everybody else who's buying in." This creates Part E.
And if this fails - if the Congress can't get out from under their corporate overlords - at the very least pass the Kucinich amendment that will allow individual states to create their own single-payer systems, as was done in Canada a generation ago.
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83 Comments so far
Show AllThis should have been the policy from the start. Medicare for everyone. Period.
More than one of the corporations I worked for over the years had the unwritten motto that there is "PROFIT IN CONFUSION". Turn an issue into a shell game and you are sure to win.
Nowhere has PROFIT IN CONFUSION been applied more effcetively than in the current "health care reform".
While health care has inherent complexities, Obama, Congress, the insurance and drug industries continue to add unnecessary complexity for the purpose of confusing the victims (you and I).
Single-payer will streamline a complex, fragmented adminstrative protocol that currently consumes 1 out of every 3 health care dollars, money that will be freed up to spend on actual health care.
Brilliant in it's simplcity. What possible objection could they have? We should all be on the WH lawn DEMANDING this!
There is plenty of money out there for those who would choose to keep their private carriers. But, "plenty" is never enough for the corporate hogs. They want it all. And we have a prez that will get on his knees to give it to them.
Corporatists, hence lobbyists, wouldn't be able to make their blood money.
So the f**k what?
Obama's bill will criminalize individuals and businesses that refuse to pay extortion to insurance companies, thereby further rewarding the insurance companies.
A good idea, but I'll quibble with Hartmann's opening sentence: "The President this morning admitted on national television that he lost control of the message with health care."
No, Obama did not lose control of the message because that was one message he did not want to deliver once he became the most powerful man in the world.
This is a good idea but we all know what needs to be done. The obstacles are primarily political. We need money to counter industry lobbying and access to mainstream media.
But the biggest obstacle of all is cultural: the intransigent ignorance, selfishness, and narrow-mindedness of a substantial portion of the US electorate.
q
BTW, does anyone else keep getting hit with this spam filter?
Simplicity itself - great idea.
Let's see if President Obama comes anywhere close to this in his address to Congress this evening.
Bill from Saginaw
The "biggest obstacle" is that we haven't been screaming for it.
The majority of Americans say they prefer a single-payer like healthcare system and 80% of Democrats prefer it. Democrats have a triple majority which means they could have it any way they please. Why are they pretending to be bullied by a minority? If they side with the health denying corporations, which is what they've been doing, we need to bring them down as soon as we can. I don't care if a bodysnatcher runs against one of these sold out Democrats, I will not vote for any Democrat who isn't fighting for single payer or at the very least an option. It's absolutely the only way.
"Whenever we compromised, we lost." The Arch Druid, David Brower
Jeevee
YES, we're hit with the so-called "spam filter" and we're tired of its wasting our time! No more money for Common Dreams.
Jeevee
YES, we're hit with the so-called "spam filter" and we're tired of its wasting our time! No more money for Common Dreams.
To make it available to people of low income, Congress could raise the rates slightly for all currently non-eligible people (like me - under 65) to cover the cost of below-200%-of-poverty people. Revenue neutral again.
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I have a better suggestion.
Level an "E" tax specifically on Hedge Funds of 20%.
I'm sure that raising their tax rate from 15% to 35% will cover the bill.
Thanks for bringing that up. Congress tried to get up the gumption to tax hedge fund managers at the same rate everyone else pays. They still only pay 15%. One guy made $4.5 Billion in one year. Congress tried, but was unable to find the moral starch, to change that loophole.
But Thom, this idea violates the God-given right of for-profit insurance parasites to make billions over the dead bodies of their enrollees as well as those who can't afford to enroll. Where's the fun if they can no longer torture, maim, and kill people for bigger and bigger profits?
Besides, it also violates the sacred myth of the free market which always results in lower prices and better service due to competition as compared to the inefficiency of government programs.
Do you want our great capitalist nation to descend into the barbaric, socialist savagery of Norway or Sweden?
For shame, Thom!
Maybe I'm confused, about this, but isn't Mr. Hartmann caving in a good bit here?
I thought the idea was free healthcare for everyone in the same way highways, public safety, and schools are free.
Anyone who has been through the humiliating process to get welfare benefits (and in many southern states, even unemployment) knows that we especially need to avoid any kind of means-testing for benefits. It needs to be everyone in and nobody out.
The highways, schools etc aren't free. They're paid for with your taxes. If your income is nominal then you don't pay any taxes but you still get to use the roads and schools, correct?
Thom is suggesting subsidies to people with nominal income.
Most seniors have their Medicare deducted from their Social Security.
Therefore everyone has access.
Yes, professor, I know taxes pay for public facilities (but mostly for war, bailing out billionaires, and other stuff) but they are indeed "free" in the common usage of the term, ok?
You didn't read the second half of my post. If you have ever experienced the welfare process, you would know that there are huge holes in who can actually get welfare benefits and presumably this cost-subsidy. For example single males cannnot get medicaid, even if they are completely destitute and homeless.
"Anyone who has been through the humiliating process to get welfare benefits (and in many southern states, even unemployment) knows that we especially need to avoid any kind of means-testing for benefits. It needs to be everyone in and nobody out." -- pjd412
I agree with you!
Here in NY state, according to Barbara Ehrenreich, in order to receive benefits from the state, the poor and needy are fingerprinted, as if they are criminals. Other states, too, fingerprint like NY state. However, it is a good way of cataloging people, isn't it?
How would you ensure that the people applying are the same as the names and papers they are carrying? How do you ensure that a person applying in one office is not also applying in another office under another name?
These were common problems until fingerprinting was used. What alternative do you propose for security that would make folks feel better?
You are right Henry8.
Cheaters will be getting multiple heart transplants unless we fingerprint them to prevent such abuse.
With multiple hearts installed, they can break the three minute mile.
One factor that I never see mentioned ANYWHERE, is that WE ALREADY COVER 60% OF AMERICANS WITH SOME FORM OF 'SOCIALIZED' HEALTHCARE ! ! ! So what's the big deal about letting some of the remaining 40% buy in to Medicare???
SO GET THIS DONE, CONGRESS, BEFORE WE TAR AND FEATHER ALL OF YOU ! ! ! ! ! !
liberalbias September 9th, 2009 11:50 am....................Why wait...I'll get the feathers. But, let's use honey instead...to be ecologically safe. And let the ants finish the job.
I'm still laughing! thanks, I needed that.
What a picture! Thanks!!!!!
Amen!
From the start, from the guest list of those at the table, this has been all about what the industry needs with the needs of the American people being a sound bite tacked on to keep up appearances. Any public option that appears at this late date will be a fig leaf over another corporate plunder of the pubic - socialized - treasury.
Congress is getting ready to mandate that we buy a defective product from private companies! How uniquely American is that? If they are going to mandate it, don't they owe us the right to opt in to Medicare as a CHOICE?
Not being able to opt out completely is completely un-American and that drumbeat needs to be heard at least as loud as the one about the commie Van Jones.
Unfortunately, the Suupreme Court has said the beef check-off and pork check-off are constitutional. I fear it's just one short hop to mandating funds to private corporations for services one may not want as long as its "for your own good".
What happens to those, like my adult daughter with physical and mental handicaps, who cannot "buy into medicare" (unable to work, but are refused Medicaid/disability status at the state, local and national levels? Will she move to France, along with millions of our fellow citizens in her situation?
What happens to those, like my adult daughter with physical and mental handicaps, who cannot "buy into medicare" (unable to work, but are refused Medicaid/disability status at the state, local and national levels? Will she move to France, along with millions of our fellow citizens in her situation?
From Thom's article:
"To make it available to people of low income, Congress could raise the rates slightly for all currently non-eligible people (like me - under 65) to cover the cost of below-200%-of-poverty people. Revenue neutral again."
So low-income people are covered.
Thanks. Low-income? What about no-income people? Are they going to be refused the SSI equivalent by state governments that are now bankrupt?
I'm in. Plain and simple. Let's spread the news, make pins and wear them, blog it, share this page on Facebook, and TWEET it: As per @Thom_Hartmann, we need Medicare Part E: Everybody - http://tinyurl.com/lh3va5 #hcr #p2
I (@PeaceHugs) just tweeted the above and there is plenty of room for re-tweeting. (FYI, progressive tweeple should sign up for Tweet Progress -- http://tweetprogress.us/ )
Peace hugs!
Medicare is already in the red and needs to be completely replaced with single payer for all. We cannot afford to rely on expanding on a system already in the red unless we want to engage in more deficit spending. What we need is a fiscally responsible but caring health care system and single payer health care is the answer.
Heard Martha Livingston from Physicians for a National Health Program again last night (www.pnhpnymetro.org). They are for single payer which they refer to as Medicare, expanded and improved. Martha is a great speaker and one of the editors of 10 Excellent Reasons for National Health Care (forward by Rep. John Conyers). Good stuff!
Hi Kate. I don't oppose Medicare but it's just that it isn't what it used to be and it has been fudged over time and pushed into the red. As for John Conyers, love his bill but still cannot understand his refusal to use his own powers to for the bill to be discussed in the House let alone voted on.
"his refusal to use his own powers to for the bill to be discussed in the House let alone voted on."
Why doesn't he?
Jennifer, Medicare is the canonical "single-payer" system by definition.
I can go to any doc (I'm about to go to a new one this morning, since I recently moved to a different city) and, if they accept Medicare -and I've not found one that doesn't, so far- then all I do is show my card and I'm in. The doc provides healthcare and is paid from public funds by submitting a single, simple invoice. Once the doc is paid, s/he submits a bill for my piece (my co-pay) and I pay that. But the co-pay and the deductible aren't necessary features - they're just, like the lack of dental care and non-critical vision care, a way for the "our" representatives to make sure we continue to "know our place" --which is to feel properly humble and screwed.
This suggestion is so rational, so simple, so obvious, so necessary, and so fair that it would never occur to the self-aggrandizing members of Congress whose only goal is to enhance their personal self-importance by having the rest of the population do their bidding!!!
LET'S ALL FIGHT LIKE HELL FOR THIS!!!!!
P.S. - I just this minute heard on the television that $280 billion dollars have been spent so far on lobbying for this legislation! What a DISGRACE!!!
I suspect you mean $280 billion dollars have been spent so far on lobbying AGAINST this legislation! And yes that IS a DISGRACE -- though it sounds a little high. $1.4 million is spent on lobbying per day according to Sen. Bernie Sanders (plus donations to campaigns). And I have heard others say as much as $2 million per day, fyi. In any case, yes a real disgrace.
Yes, you're right - I did mean "against" this legislation. Thanks for picking that up!
Thom is right on the money: I've been asking the same thing for weeks. Give We the People the option of buying into Medicare.
Unfortunately, Congress and the Senate (nor apparently Obama) do “simple.” Or to put it differently, common sense is off the table.
This plan is not only desirable but a necessity. If you look at Medicare only serving individuals 65 and older, this is when you are most likely going to utilize healthcare. Factor in all the boomers who are now eligible for this program growing every year. Without the inclusion of a much larger risk pool including the young and healthy, Medicare will be insolvent as healthcare costs skyrocket. If you open the program up to everyone the viability of the program will be safe. You will still need to do drug price negotiations.
If a trigger style "public option" attached to mandated coverage is passed, what happens when the Republicans return to power? They will use the failure of said health reform as a means to justify the elimination of Medicare and Medicaid, which has been their end game all along.
This is probably the best idea I've heard--if only, as JenniferB points out (12:31pm), we could stop going in the red. Without negotiating drug prices with emphasis on generics and off-patent drugs you can't get off the ground. How about those $100 MRIs in Japan? Why aren't those machines used here? The insurance companies deserve to go under for not demanding those kinds of cost cutting measures rather than cutting people off when they need it most. And, of course there are thousands more ways to cut costs and improve care.
I continue to believe that we need to guarantee health freedom of choice and think that Medical Savings Accounts for all (include grants to all on Medicaid) would reduce insurance premiums, lower costs, and result in a much better quality and quantity of primary care. Everyone would then pay cash for primary care without needing approval of anyone, gov't or ins. co. And just think, Medicaid recipients would actually be able to get their teeth fixed.
Cassandra, your first paragraph also reminded me of what I forgot to mention earlier. The education for being a doctor is so long and yet there are more doctors and nurses poorly trained. Even amongst those who are well trained, most of them are strained to the point of getting into riskier scenarios of making serious errors on numbers and on the equipment themselves and that could make one hell of a difference for a patient's life. There's also some doctors and nurses who will put profits before care first regardless of the risk of putting a patient's life in danger as was the case with my remote friend JWVerez who finally recovered last month. I hope I don't end up with a sleepless doctor or a nasty one the next time I end up in the hospital.
I agree wholeheartedly.
One partial solution would be to add one year of high school to the curriculum and force everyone to tour hospital emergency rooms and attend interviews with doctors and nurses as well as covering the basics of a healthy life style. Predictable outcomes of unhealthy lifestyles with real life examples should be taught and harped upon.
There are so many improvements that could be made but all those people that control health care want to bill for every breath and every request. Why do I have to pay to ask my doctor a question? Why doesn't he have a web site where his patients can ask questions and request prescription renewals without having to make a visit? Why aren't people taught that ALL bacterial or viral infections in humans are defeated by the immune sytem in 5 days? IF something lasts longer, THEN you go see a doctor. That alone would probably free up most doctors to attend trauma and serious long term diseases with more deliberation. This crap started when employers started demanding a "doctor's excuse" when people called in sick. I don't need a doctor to know if I feel sick or not.
There is a book callled the PDR (Physician's Desk Reference) that has a massive amount of data on therapeutic drugs, illegal drugs and drug interactions, dosage, and precautions. Doctors probably have it in a computer now but before they would routinely consult this book before writing a prescription. Hey, we can read too. Why aren't we or at least a pharmacist trained to renew a prescription without going through the almighty doctor? Life and death issues? An overdose? Give me a break. The software to handle a request could flag a doctor if there was any danger. You can overdose on SUGAR or SALT if you insist on killing your self. We have to get off this deifying of the medical profession and start using automation to serve humanity.
"Why aren't people taught that all bacterial or viral infections...are defeated by the immune system in 5 days?" Because if people finally grasped the concept that, given the proper conditions (rest, fluids of water and dilute juice, etc) the body can heal itself, the jig is up. And mostly it can be done without need for the PDR.
What you said on the first paragraph reminds me of my first year in college when everyone would get fattened up after their first semester alone. I can't say I wasn't one of them but I wasn't as much a glutton when I did my education online. If students had that extra year to do what you pointed out, I could imagine even the fast food chains begging customers on their knees to try out their healthier products provided and they would probably have it for real since Big Food would realize that it's facing a more knowledgeable set of customers.
And unhealthy lifestyles and their outcomes? A definite must-train. I would hear some conservatives preaching personal responsibility on eating and lifestyles and use that as an excuse to oppose single payer health care. While it is true that unhealthy eating and lifestyles do drive up general health care costs, I would love to tell them your idea on making it mandatory to teach what you proposed in Grade 13. I'll bet half of them, most likely the poorer faction, might get interested in it while the money grubbers would make up some silly dilly libertarian excuse to not include this in the school curriculm.
The rest of what you wrote is also enlightening. Thanks. :)
Medicare is pretty much a Single Payer system and it wouldn't take much to clean it up.
"Of course, we'd like a few fixes, like letting negotiate drug prices, and fill some of the other holes Republicans and AARP and the big insurance lobbyists have drilled into Medicare so people have to buy "supplemental" insurance, but that can wait for the second round."
This would pretty much would take care of it along with stopping most of the scamming.
Like most things this isn't that complicated. When people try to obfuscate something with a lot of verbiage you can be fairly sure they are trying to hide the truth or simply want to make themselves seem superior.
Almost anything can be reduced to a page and a half if you are acting in good faith.
Time to stop playing at politics and speak realistically about how to solve our problems.