Open Thread

December 11th, 2009 9:36 AM

For general discussion and debate. Possible talking point: is the Medicare buy-in/extension worse than the public option?

Mr. Reid's buy-in simply cuts out the middle man. Why go to the trouble of creating a new plan like Medicare when Medicare itself is already handy? A buy-in is an old chestnut of single-payer advocate Pete Stark, and it's the political strategy liberals have tried since the Great Society: Ratchet down the enrollment age for Medicare, boost the income limits to qualify for Medicaid, and soon health care for the entire middle class becomes a taxpayer commitment.

In the case of Medicare, this means expanding a program that is already going broke. Medicare reimburses doctors and hospitals at rates 70% to 80% below those of private insurers, which means below the actual treatment costs in many cities and regions. Providers either eat these losses—about half of U.S. hospitals are running a deficit or close to it—or they raise prices for private payers. This cost-shifting isn't dollar for dollar, but all empirical research shows that it adds tens of billions of dollars to consumer health bills, and this will accelerate if several million new patients are added to Medicare. That means higher prices for health insurance.

Did the GOP shoot itself--and the country--in the collective foot by (successfully) opposing the public option?