LETTER TO THE EDITOR | Universal coverage is doable
November 9, 2009 · Updated 1:23 PM
To the editor:
Many people say Medicare's looming bankruptcy is proof of government incompetence. No, Medicare is just a victim of its own success.
Imagine a private insurance company insuring only the highest-risk people in the country, and then paying virtually all of their medical claims without tossing them out or raising premiums to drive them out.
That's what Medicare does, and it has prolonged the lives of so many seniors that the cost of keeping them alive is driving it into bankruptcy. Such is the price to "promote the general welfare" in the first paragraph of the Constitution.
You want choice? Open Medicare to everyone, establish a suitable premium to be paid through a payroll tax (as Medicare is funded today), mandate that everyone choose some form of coverage, and let the market decide.
Every nation that has some form of universal coverage subsidizes people who are too poor to pay the full premium.
Tricare for Life, the military retirees' plan, provides a free Medicare supplement, so each beneficiary's total monthly premium is only $96.40 for Medicare Part B. (Denis Cortese, the president and CEO of the Mayo Clinic, says Tricare is a pretty good model for a universal plan.)
If everyone else who chooses Medicare buys a reasonably priced supplement (subsidized for the poor) to provide the same coverage as Tricare, the risk would be spread over the entire population, and universal coverage could be both affordable and "deficit neutral."
Could insurance companies compete with such a plan? Japan's low-cost system is based on private, nonprofit insurance. If our insurance companies really want reform, going nonprofit would be a good first step, and only lobbyists would suffer.
House Resolution 676 describes a plan very similar to this concept. The trick is to get our heavily lobbied politicians to give it a chance.