As the major newspapers write their obituaries for the public option, progressives across the nation are making it clear: no public option, no mandate to buy private health insurance.
If it is true that there are not enough votes in the US Senate to pass the public option, then what do we do? Do we try to block any reform without the public option? Do we just hold our nose and support reform, and try to focus on the millions who will get coverage because of the subsidies, the folks with pre-existing conditions who will finally get coverage?
I suggest a slight tweak that could work for both sides: let individuals buy into Medicare as one of their coverage options if they are mandated to buy health insurance.
Letting individuals buy into Medicare fixes the problem that most sticks in the craw of progressives: it doesn't force millions of Americans to become customers of the private health insurance industry. It gives them a choice of going with a public option.
It also solves the problem brought up most often by conservatives: this public option would not be competing with private health insurance in the employer-based health care arena. Health insurance companies won't have to worry that employers will drop their health plans in favor of the public option.
We can leave for another day the thorny issue of letting Medicare compete with private insurance in the employer-based insurance market.
Adding millions of younger, (most likely) healthier individuals to Medicare will help spread the risk and bring down costs.
It's time for some creative compromise, and allowing individuals to buy into Medicare won't sound like a government takeover of health care--people like Medicare and will be relieved that we aren't starting up some new big government program. And it would be much better than some weak regional co-ops.