TWO BIRDS WITH ONE STONE: OBAMACARE & MEDICARE
For years, the out-of-power Republicans had promised, if elected, to improve the lot of the millions who struggle to pay the sky high pemiums for coverage with unaffordable co-pays under Obamacare. That commitment helped the party win both houses of Congress and the White House. They have thus taken ownership of the healthcare insurance crisis, as well as the capacity to cure it. Unfortunately, internal divisions have so far prevented them from devising a remedy on which the requisite minimum 50 senators could agree.
Republican Congressional leadership may be coming to a realization that future hopes of retaining their dominant position now require them to consider otherwise unthinkable options. I want to suggest that one of these, if viewed from the proper perspective, can be seen as a likely popular, winning strategy of not only fixing Obamacare, but also providing a widely desired solution to another even more important program.
An understanding of the fundamental principle of insurance must be the starting point of any sensible discussion of healthcare: risk must be spread among many, so that only a relatively few will make claims during a given period. As a corollary, the larger the risk pool, the lower the premiums to be paid by those who are insured. A genuine solution to the problem posed by Obamacare must follow these guidelines.
Although apparently not widely recognized, or at least not widely discussed, our nation’s populace that is not already served with health insurance is a ready made, gigantic health insurance risk pool. Maintaining that group intact and insuring its members through a single program would most closely adhere to the design criteria for the most efficient insurance plan. And a working model already exists: Medicare. Why not expand that program to include the Obamacare members? These folks would move from the bankruptingly expensive and often unusable Obamacare to the affordable broad Medicare coverage. Senator Sanders and others, mostly Democrats, have advanced this so called ‘single payer system’, but it has always met knee-jerk right wing Republican opposition.
But there seems to have been a failure to emphasize the apparent benefits that would accrue to the Medicare program from such a move. The addition of the Obamacare millions would infuse the mostly post-65 Medicare congregation with much younger, less claim-prone, participants. Would that not produce the additional bonus of shoring up Medicare ? In recent years there has been much fretting, but little action, directed toward the need for reinforcement of that vital and popular program in order to assure its continued viability.
It should be noted that the currently stalled Republican proposals are the polar opposite of one humongous national risk pool. Instead, these measures follow the fragmented Obamacare state-by-state format. As a consequence the nationwide risk pool is divided into 50 smaller pools. It is certainly fair to ask whether the many unfavorably received features of these plans are the result of the smaller than necessary number of insureds. Or, phrased another way, might not the immensely greater size of the group to be covered on a national basis allow a broad spectrum of benefits at a more affordable premium?
As previously mentioned, the “single-payer system” has been an anathema to the right wing, conservative ‘tail that has so often wagged the [Republican] dog’. But the blame for a continuation of the Obamacare misery for millions of Americans now rests on Republican shoulders.
Perhaps this is the time for the leadership to recognize their situation as an opportunity “to make lemonade out of a lemon”. Provide affordable broad health insurance coverage to those now suffering financially and medically under Obamacare by their inclusion in Medicare, with the attending widely desired and badly needed strengthening of that program. Would not these twin accomplishments be of such magnitude as to be greeted with overwhelming praise ?
Is this not a simple and elegant solution to two seemingly intractable problems ? Our country’s health demands that it receive serious discussion.
I am a lifelong registered Republican.
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