Solving the fake Medicare opt-out problem, with a fair health care system.
The debate about letting the healthy and the wealthy opt-out of Medicare is a fake debate. Each component has a pretty simple and feasible answer. The real debate is only as to the profits of insurance companies.
All the issues raised by the question of whether patients should be allowed to opt out of paying the Medicare tax if they buy their own private insurance can be fairly handled, with a little effort. Raising the issue is a booby-trap laid by insurance companies wanting to sell their policies and maximize their profits.
The response requires respecting the basic principle is that it is both morally and socially just and economically sound that the healthy share in covering the health care needs of the ill, that the wealthy share in helping with the needs of the less-well off– principles that are well accepted in core governmental policies, from social security to unemploment insurance public housing to the setting of progressive tax rates and our ddalyl-[too-day relations with each other. .
The basic answer is that in a fundamentally fair economy all should share in the ability to have good quality health care, regardless of their wealth or health. And all should have the same options. Further, the obscene level of paper work and rules and regulations about coverage should be eliminated. The need to worry about coverage, co-pays, prior conditions, time limits, source of coverage, overlapping policies is unnecessary, produces nothing, and is not cost-effective. Having a single payer or Medicare for All, or Universal Coverage, system (beware— “Medicare” means different things to different people) is not hard to structure. . Economically Medicare for all can simply give greater strength to taxpayers as against medical suppliers, when users can bargain collectively in setting rates with providers, preventing pharmaceutical companies and medical providers from taking advantage of their near monopoly position to fix rates. morally, simply requires adjusting tax and reimbursement rates to reflect the extent of need and the availavblity of the parties’ resources to met them. resources to meet them. A class system of medical care, in which the rich get better and faster care at the expense of the less-well-off A system of medical care in which the rich get better and faster care at the expense of the less-well-off is generally accepted as socially undesirable. Helth cares should be considered a necesity of lilfe, not a commondity to be auctioned off to the highest bidder.
Such a class system can be avoided by not permitting providers to refuse treatment to patients on the basis of the source patients use for covering their bills, Medicare vs. private insurance. The medical profession as a whole should join in fixing fair reimbursement rates for all providers, bearing in mind a good faith obligation of fairness both to providers and patients. Care can be provided by providers of the user’s choice, not only to the healthy and the wealthy, who are likely to get unfairly favorable treatment from insurance companies and providers if they can pay more for treatment than the less well-off. Options should be equal for all. This is a democracy, and fairness is a core value.
(Elizabeth Warren’s plan recognizes all of the above. On the cost side, see: https://prospect.org/health/warrens-medicare-for-all-plan-includes-no-new-taxes-on-the-middle-class/).
For an even better, but probably today not yet politically feasible solution, see Blog #129, Medicare and Beyond: for a Secure Health Care System.
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