Money doesn't grow on trees

Money doesn't grow on trees

6. Medicare for all American citizens or another single-payer healthcare system, adjusted by a means test (i.e. citizens who can afford it may opt-out and pay their own health insurance or opt-in and pay a means tested premium). The Medicaid program, fraught with corruption and fraud, will be eliminated except for the purpose of providing emergency room care to indigent non-citizens who will not be covered by the single-payer program.

Kathryn Nix, Policy Analyst at the Center for Health Policy Studies:

Before considering the notion of universalizing Medicare, Occupy Wall Street should explain how it would propose the United States finance the current Medicare debt. Today, Medicare has $36.8 trillion in long-term unfunded liabilities—promised benefits to current and future generations of seniors that it cannot pay for. To highlight the sheer size of this fiscal mess, that number is more than twice the size of the current national debt. And we’re just talking about one of many federal programs.

Its massive insolvency is just one of the reasons Medicare is proof that the federal government should not run a single-payer health care system. Its system of central planning through administratively-set price controls and statutory updates to provider payments does not reflect the actual costs providers incur to offer their services and keep their doors open. The consequences include cost-shifting to the privately insured, reduced access to doctors and other providers, and decreased quality in the care seniors receive. Meanwhile, traditional Medicare’s fee for service system has no way to promote value in the health care goods and services seniors use, and consumer insulation from cost contributes to overutilization and unnecessary use of services.

There are better options to save Medicare and expand access to affordable coverage among the nonelderly population. Transitioning Medicare to a premium support plan would allow seniors to purchase a health plan of their choice using a government contribution based on the cost of the plans available and retirement income. This transformation would unleash the power of the free market to improve the value seniors receive for the taxpayer dollars spent on their health benefit. It would encourage beneficiaries to seek out the highest quality for the lowest cost when purchasing a health plan and seeking out health care providers. Tying the government contribution to the cost of the lowest bid would reflect actual market conditions, meanwhile using competition among insurers to better meet demand and drive down costs. Adjusting the federal contribution according to income would ensure that Medicare dollars were directed to those with the most need, and though the wealthiest individuals would no longer receive a taxpayer-subsidized benefit, they would benefit from access to the same regulated marketplace.

For the nonelderly population, the creation of tax credits and additional subsidies for low-income families, alongside other commonsense insurance market reforms, would expand access and encourage Americans to obtain and keep health coverage. The plan would pave the way for the creation of a competitive, consumer-driven health care system where insurance was affordable and portable.

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