I'm encouraged by what I'm reading about the Medicare buy-in. I'll have to wait -- like the rest of you -- to see how much of the devil is in the details. CBO scoring will tell us a lot. And we still don't know if this gets us to the vaunted 60-vote threshhold.
But the bottom line seems to be this: This proposal expands the reach of Medicare -- which means it expands the reach of single payer.
And that's a step in the right direction.
Of course this cannot happen fast enough, but I'll take it for now because THIS expansion will make future expansions that much easier.
Having gotten on the bottom rung of the ladder, it'll be easier to climb up each succeeding rung.
Here's one blueprint for future expansions:
Blend Medicaid into Medicare. A lot of work needs to be done to make sure it is financially sound. Let's focus on that. For example expand the blended program to everyone regardless of age, but means test it for income, e.g., whether or not you make some multiple of the poverty line.
If you fail the means test -- regardless of age -- you pay a premium to buy in.
Another fix would be to get rid of the Medicare Part A payroll tax. It's too low anyway so it could be sold as a deficit killer and/or a tax cut. Fund the program straight out of the Federal treasury. This would have the added benefit of taking the states off the hook. Probably half the states would breathe a huge sigh of relief, because they would be relieved of a huge budget expense -- perhaps their largest one.
I'm sure there's more, but that'll do for a start.
In summary: anything that moves in the direction of expanding single payer -- Medicare -- is a good or even great thing. All the rest is details.