For people who realize that "single payer" is the only way to move this nation beyond death-by-spreadsheet, this past six months' health care debate has been a painful reminder of how much more work we need to do to actually change our government.
But despite what most of us think of Senator Reid's testosterone levels, there are some very significant implications of the proposal to open Medicare up to people as young as 55...and many of them go well beyond health care.
In this country today there are millions of capable mid-career professionals who are either laid off or underemployed. Tens of thousands of others would like to reduce their involvement in their primary employment in order to begin entrepreneurial efforts--the kind of innovation that we do best as a nation.
Most of these workers collect the top salaries in their companies, and the cost of their health insurance is embedded into our products and services. And in the majority of cases, the work they do could be divided among younger workers with a little mentoring from them on a contractual basis. But they can't do that due to health care. The sort of health care they could purchase as an independent contractor or small business owner is undependable and very expensive.
Then there are the older under- and unemployed; Many postpone treatment for really serious diseases, creating health and financial time bombs for Medicare when (and if) they reach 65. The most expensive and common of these conditions is diabetes. Leave it untreated for a decade and Medicare gets the bill. The same for stents, non-invasive treatments for osteoarthritis, and other conditions.
Provide an avenue to good basic insurance for 55s and you will get jobs, healthier seniors, and tens of thousands of new small businesses. Provide a way for many manufacturers to skim the highest salaries from the top and you get a better market and balance of trade.
And there are actually financial benefits for health care too. AARP sells a really good umbrella policy over Medicare. They should be dancing at the thought of a new market.
It's amazing that the AMA came out within 24 hours against the plan. It seems evident their string-pulling supporters popped out of the woodwork here. Medicare is a billing system their offices already know; it means that they won't need a whole new system to get their cash, and that's a financial benefit to them. They know full well that most of those who come to their offices with Medicare have a supplemental, too, so the whining isn't justified.
And finally, this is a very, very good political ploy. It gives an almost-immediate benefit to a class of voters who tend Republicans, rather than a vague promise of an exchange four years down the road. (The public option in the exchange is still not a bad idea; these aren't mutually inclusive.) It's very easy to imagine amending the age to 50 and including college students in the next round!
With four or more Neanderthal Dems in the Senate, a perfect plan is beyond anyone's reach. (Stop blaming Obama for Lincoln and Baucus.) This is a great move toward single payer, and a great example of the politics of the possible.