Framing the public option: why not call it “Medicare”?

No one knows what a public option is. Everyone knows, or at least thinks he knows, what it would mean to be allowed to buy Medicare coverage before you reach age 65.

One problem with the politics of the public health insurance option is that roughly zero percent of the voters know what it is.  Would it be go down more easily with the public if it were called “allowing people to buy in to Medicare”?  It shouldn’t be impossible to compute a set of break-even premiums, adjusted for age and location, at which Medicare could provide its current level of coverage to people not currently Medicare recipients.

Or it might make more sense to create a new program – to be called “Young Medicare” or some such - that had somewhat different coverage.  Even then, administering through the current Medicare bureaucracy would save having to set up an entirely new system.

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

11 thoughts on “Framing the public option: why not call it “Medicare”?”

  1. The supposedly brilliant Obama team has missed every beat on this issue, starting with the framing of this as reforming medicine, rather than insurance.

    Everyone hates the insurance companies because they are hateful.

    How can one not understand that the middlemen are hated because they are part of the problem – not part of the solution? Well, perhaps if one doesn't see the middlemen as a problem. Given the track record of the administration in first satisfying the needs, wants and whims of big corporations, and only afterwards thinking about those whom Leona Helmsley referred to as little people (aka Democrats aka the majority that voted in Obama) one has to wonder.

  2. Can we come up with a third suffix to go along with Medicare & Medicaid, calling the public option Medic___? That way we wouldn't need to change the program at all to fit it into Medicare – it would be all framing, and it wouldn't be too misleading.

  3. I suspect everybody believes that giving people the option of "buying into Medicare" would be too popular and too efficient (like single-payer), and that the insurance industry would strangle it in the cradle. But I gotta figure after HRC passes, and Congress and the relevant agencies get around to implementing the public option (not due to start until 2013), it'll be obvious that duplicating Medicare is pointless, and then the public option will turn into buying-into-Medicare.

  4. How about because if people know anything at all about Medicare it is that (1) it is operating at a deficit, and (2) many doctors are refusing to accept new Medicare patients? Sometimes the devil you know isn't really something you can be comfortable with.

  5. It shouldn’t be impossible to compute a set of break-even premiums, adjusted for age and location, at which Medicare could provide its current level of coverage to people not currently Medicare recipients.

    I like it, but it would pretty much send the "Public Option is a Stalking Horse for Single-Payer" conservatives into Over-Drive. They'd probably be right, too; once you have a system like the above, it's pretty easy to see it evolving into either single-payer or a system where the overwhelming majority of the population is on the federal health insurance plan.

    (2) many doctors are refusing to accept new Medicare patients?

    You know, I keep hearing this talking point, but where's the proof? How many doctors are turning away Medicare patients for low premiums, and in what specialties?
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  6. Oh, crap! Please ignore the spam at the bottom of my post – I thought I got rid of it with a virus scan! Seems not so.

  7. Americare. Save term "Medicare" for seniors (that would be me). Start the buy-ins immediately.

    And yes, in Texas when my husband went shopping for a new doctor, he heard over and over, "Doctor isn't taking any new Medicare patients at this time."

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