Richardson Champions Medicare Buy-in

There's not a lot of difference between the various Democrats running for president when it comes to reforming the health care insurance system. But New Mexico Governor Bill Richard, speaking at a Kaiser Family Foundation-sponsored forum yesterday, put several issues near the top of his agenda that I found particularly appealing.

First, he offered to expand Medicare to include anyone between 55 and 64 who wants or need to buy into the seniors' system early because they've either lost a job or their employers do not provide health coverage. This is simple, easy to do, relatively cheap compared to other forms of insuring these aging baby boomers, and, most importantly from the taxpayers' perspective, allows people to obtain preventive care in the decade when many chronic conditions of old age develop. This might raise Medicare's costs in the short run, but any form of universal coverage would. The only question is who will get to collect and then disburse the money.

"Getting those people to buy into the Medicare plan instead of private markets will reduce costs by 25 percent," Richardson said. "If those individuals 55 and over can get access to Medicare coverage, they can get access to cancer screening early, like cervical cancer screening, when women are at an age when they're starting to have those problems. I believe it will improve the overall quality of Americans getting health care."

But won't that send the sickest to Medicare?

"What's wrong with that?" he responded. "There's 14 million human beings excluded because of pre-existing conditions or they have minimal coverage. It's the right thing to do if we're going to have universal coverage."

But then he stumbled when the follow-up question focused on the "long-term budget crisis" that threatens to "swamp Medicare and Medicaid." The buy-in would only make it worse, his questioner claimed.

This question comes up repeatedly and the Democratic candidates have an easier answer than the hemming and hawing about making those public sector systems more efficient.

First, if they stay in the private system, then private insurance costs go up. Somebody's costs have to go up if we're going to have universal coverage.

Can private insurers (and the employers who pay that tab) afford to continue covering the sickest Americans (the 30 percent of the public that consumes 75 percent of all health care)? The fact is that the larger, long-term budget crisis isn't in the public sector programs -- it's in the private insurance market. According to the CBO report, private insurance costs over the next 30 years are projected to rise at a faster rate than Medicare and Medicaid. Holding down health care costs is a society-wide problem -- not just one for the public sector. Premiums in the private market are slated to soar; millions more Americans will lose their health coverage because their employers simply won't be able to afford it.

When will some candidates start talking about the crisis facing the private health care insurance market when reporters raise Republican-inspired questions about a "crisis" facing Medicare?

Posted by gooznews at November 20, 2007 08:36 AM