A good bargain

Instead of a “public option”: Medicare buy-in for those 55-64, Medicaid up to 150% of poverty, an a private health plan or plans negotiated nationally by the Office of Personnel Management.

The best use of the “public option” is as a bargaining chip.

Looks as if the Senate liberals are driving a pretty hard bargain:

– ├é┬áMedicare buy-in for those between 55 and 64.

– Medicaid coverage up to 150% of the poverty line in all states.

– A national private plan or plans to be negotiated by the federal Office of Personnel Management, which negotiates the federal employee plans.

If this works out as well as it seems it might, a bunch of people are going to owe Harry Reid an apology.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

8 thoughts on “A good bargain”

  1. So I am going to face a choice of either paying a fine, going to jail, or giving money to private insurance companies, who are invariably sleazy in my experience?

    In fact, I won't even be able to buy a cheap very high deductible plan, but will be forced to pay for types of coverage I will never need?

    Sorry, this is just another Obama/Reid corporate welfare sellout.

    Add it too:

    Endless middle east wars, billions in free money for Wall Street crooks, higher taxes on the middle class, selling out gays on marriage and DADT, nominating Napolitano and Sebelis to the cabinet when they were prime 2010 senate candidates, and nominating the old, obese, diabetic, lackluster Sotomayor to SCOTUS and nominating lower court judges at 1/3 the rate of recent previous presidents.

    Obama Year One has been failure after sell-out and failure.

    I guess I admire your optimism about Obama's intentions, ethics, and abilities, but I lost mine about 9 months in.

  2. No, I won't owe him an apology. I'll just be glad he finally followed the advice of those of us who said Medicare for All from the start, and told him to bargain harder. They backed into this because they let "public option" become a word as laden with negative imagery as the word…"liberal." Still, I'll take it either way.

  3. It's not nearly as good as it could be, but it appears to be a damned sight better than it was. 150% of poverty isn't good enough for Medicaid, though. Here in NM we're currently at 235% of poverty (we have a waiver from CMMS) and we still have uninsured rates in the low 20s: second or third to Texas and Mississippi.

  4. A "national private plan"? We already have plenty of those. Aetna, Cigna, etc.

    150% of the poverty level? Weren't the debates a couple months ago about whether Medicare eligibility would be at 300% or 400% of the poverty level?

  5. I understand (from Dick Durbin who spoke through Chicago's NPR station) that the 55-64 cohort has to wait three years, and that the plan for letting others sign up for the federal employee plan run by the Office of Personnel Managment will be through an "insurance exchange" that will take effect in a couple of years if the private insurance cartel still refuses to offer a decent plan.

    The first provision is "pie in the sky", or "the check is in the mail"; it does nothing now, and a lot can change in three years, such as the whole thing being repealed (assuming it passes in the first place). The second provision which leaves the under-55 cohort without a public option preserves the private insurance companies' freedom from competition, and fails to give the Medicare expansion the robustness that letting the younger population in would provide. In fact it is a gift to the insurance industry, as the government takes off their hands older people or people who the insurance companies don't want anyway. The last provision involves pretending that the private insurance companies have not already failed completely to provide decent options; it is that situation that sparked the discussion in the first place.

    I feel we ought to offer the Republicans and the new Dixiecrats two options: French-style complete coverage paid for by the government, or if they can't stomach that, this little bill, which the clerk could easily read in its entirety:

    "Anyone who wants to can buy into Medicare starting tomorrow morning at 8:30 a.m. If you cannot afford the premiums, the government will pay them for you."

    Neat, sweet, petite.

    Michael B. Kaye

    Notes: Cutting the military operations in Colombia alone would help pay for a lot of this. Of course, we need to start putting progressives into the primaries to replace recalcitrant legislators, or neither my bill nor any other reform will ever pass.

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