I've been desperately, mostly uselessly, wondering what the President and Democrats could do to increase support for the "Public Option" -- a term which the GOP has successfully muddied, along with much of the details of national Health Care Reform. I want to have faith, but I'm really worried that we're not going to wind up with overly compromised crap.
I know Obama's speech tonight is suppose to recast this thing -- but unless its done simply, affirmatively with a full-court press of PR, Policy and Politics, while getting the GOP stuck in some of their August talking points -- I don't know how it'll happen.
But here's my hope: Obama announces that "instead" of a "Public Option" -- a proposal to allow Americans of all ages to "buy into" Medicare. In the process, Medicare would be improved and stabilized by the influx of funds and new members.
Of course, a Medicare Buy-In would be a "public option" -- but the public option would know be a "known quantity" -- something even people who don't know the specifics of Medicare, will understand as a program that works. Heck, even the GOP, now, suddenly wants to defend Medicare!
Before I go too deep into this, I should admit I'm a single-payer die hard. The proposals from last decade to use Medicare as a means to provide single payer were some of the most compelling I'd ever seen. This study from the California Nurses Association showed it would lead to billions of dollars in economic stimulus.
Still, I get it, single-payer isn't happening anytime soon. But something needs to happen now. So, the "Public Option" as a compromise makes sense. Along with ending "pre-existing condition" liabilities, the house's health insurance "marketplace" and allowing people to keep their existing insurance (if they have it) I see a reasonable, if still expensive and overly complex, safety blanket for all citizens.
But a compromise reached before debate is open to more compromise... or destruction, as we've been seeing with the soft support for the "public option."
I won't go into the dueling arguments against the public option by the GOP. I love that declarations of "it'll be too expensive/government isn't competent enough" are mixed with "it'll be too cheap/too well-run" and will run existing insurance companies out of business... The whole thing would be the comedy hit of the season if it wasn't for what I think may be the GOP's most effective attack yet:
It'll harm Medicare (and, to a lesser extent, the VA). I went to several town halls this summer (NJ, PA and in DC), and this issue kept coming up. The GOP's newfound love for Medicare (and their "Senior's Bill of Rights" or whatever attests to its effectiveness. Given the party's antipathy for Medicare, and for Government-run anything, this is hilarious.
But it's also room for some quality jujitsu.
If the GOP loves Medicare so much -- let's get it reformed and properly funded! Much more so than Social Security, Medicare is facing a funding crisis. And what better way to build it up, but to get people paying for it!
In fact, Medicare buy-ins have been suggested for a while as a way to shore the program up. A CBO study found that just allowing seniors age 62-64 to "buy in" to Medicare early would do better than private insurance to decrease costs and stabilize Medicare.
So why not build on this? Medicare is a "public option" of health insurance, a government run plan that even Michael Steele endorses as something that works and deserves respect. If the GOP wanted to fight this, they'd have to be expressing concern either against Medicare, or that Medicare would somehow suffer by the inclusion of others. That would open Democrats to showing how this would IMPROVE Medicare... which would be a better argument to make to Seniors than that a Public Option won't HARM Medicare.
I don't know if studies have been done about having Medicare as a universal buy-in option for all Americans. I would be very surprised if there weren't, but my cursory Google search hasn't turned up much.
And then, if it goes really well... maybe an adventual move to a Medicare-as-Single-Payer could happen. And I'd get a living unicorn for Christmas. Anything's possible...
Any other thoughts? Any chances something this simple could be the solution?