'Medicare Buy-In' Is Really a Subsidy to Private Insurers: Harvard Professor

The Senate proposal to allow uninsured people over age 55 an
opportunity to buy into Medicare constitutes yet another government
subsidy to the private health insurance industry, a leading health
policy analyst and single-payer advocate says.

Dr. Steffie Woolhandler, co-founder of Physicians for a National
Health Program and professor of medicine at Harvard Medical School,
told a radio host Wednesday morning, "One of the better provisions of
the reform legislation was that it prohibited charging older people
more than twice (or thrice in the some versions) as much as you charge
younger people in the individual market. But by saying everyone over 55
in the individual market can be picked up by Medicare, you've really
let the insurance industry off the hook."

Woolhandler continued: "That is, the highest-cost patients in the
individual market will be taken off their hands and paid for by the
taxpayers; and private insurance will remain the only option for people
under the age of 55 and for anyone who gets their insurance through
their employer. Another way of saying that is: if you now have private
health insurance and you don't like it, you're forced to keep it.

"The buy-in to Medicare is only for those 55 to 64 and it's only for
people who are not offered private health insurance through an
employer. So it turns into just a subsidy to private health insurance:
the taxpayers will pay for the high-cost patients and the health
insurance industry can take the lower-cost patients."

Woolhandler, who also practices primary care at Cambridge Hospital
in Massachusetts, is a prominent advocate for single-payer national
health insurance, sometimes called an expanded and improved Medicare
for All. She says research has demonstrated that replacing today's
multi-payer system, with its wasteful paperwork and bureaucracy, with a
streamlined single-payer system would save about $400 billion annually,
enough to assure everyone comprehensive, quality care.

"I want to remind people that at its core, this bill takes $450
billion in new taxes from the taxpayers, and hands it over to the
private health insurance as subsidies. So, the core of the bill is a
financial strengthening of the private health insurance industry. Now,
one of the small things that was good about the plan, that is, forcing
the insurance industry to lower the prices for older enrollees, has
been taken out of the bill, essentially."

Woolhandler also said the proposal for an exchange of private,
nonprofit insurance plans for those under 55 will be of little benefit,
noting, "It's similar to the menu that is offered to federal workers,
but of course federal workers actually get money to buy the health
insurance. They don't just get the menu, they get the money."

A full audio recording of the interview, conducted by an affiliate of KPFK Pacifica radio in Los Angeles, is available here.

Woolhandler is also co-author of several studies published in
prominent medical journals this year, including one showing 62 percent
of personal bankruptcies are linked to medical bills or illness and
another showing that nearly 45,000 excess deaths annually are
attributable to lack of health insurance.

Dr. Woolhandler and other leaders of Physicians for a National
Health Program are available for interview on the most recent
developments in the emerging health reform legislation.