In recent days Democrats started floating the idea of a “Medicare Buy-In” proposal, and as of last night, there appears to be a deal, although the details are not fully known. I addressed the lack of merits in a prior post.
What is critical is that this is being done behind closed doors, with a CBO scoring being obtained before the details are released to the public. If Reid thinks the score helps, there will be a mad push to pass a bill before Christmas, in less than two weeks.
Once again, the Democrats are making clear their fear of the public. If the Democrats wanted a massive expansion of Medicare, Democrats could have rolled that out in one of the numerous committee and full House and Senate bills which have been debated for months. (The status of the further expansion of Medicaid — above and beyond the estimated 15 million person expansion already in Reid’s bill — is unclear.)
Instead, at the last minute, we have another mad rush of the goal line. What correctly was termed the final scrum:
This brings you to the final stage, the scrum. This is the set of all-night meetings … when all the different pieces actually get put together.
You want the scrum to be quick so that the bill is passed before some of the interests groups realize that they’ve been decapitated. You want the scrum to be frantic so you can tell your allies that their reservations might destroy the whole effort (this is how you are going to get the liberals to water down the public plan and the moderates to loosen their fiscal rectitude).
The Stimulus Bill was the model. A deal done in secret, rolled out quickly, and passed in haste out of fear of the public reaction.
Harry Reid’s despicable and unapologetic use of the race card — comparing opponents of his proposals to slave owners — reflects this fear. The disdain for the public is palpable.
The implications will be clear. We will be on a straight path to a single payer system, and much sooner than anyone imagined just a couple of weeks ago. Ezra Klein has it right on this point about lowering the Medicare age to 55:
The national non-profits [in the proposal] are not exactly like, but not that far from, the compromised public plan in the House version of the bill. They won’t be publicly run, but with the OPM regulating them tightly and carefully choosing which offerings are accepted into the market, the impact might not be that different in practice. They have the advantages of offering a single product nationally and being freed from the profit motive, both of which were key to the theory of the weaker public option. Indeed, they’re like publicly-regulated utilities more than private plans….
Meanwhile, the Medicare buy-in lets people in the broader insurance market see what national bargaining power can do for individual premiums. Right now, Medicare’s rates are largely hidden, as no one pays the full premiums, and so no one can really compare it to private offerings. But if the premiums become visible, and Medicare’s superior bargaining power is capable of offering rates 20 to 30 percent lower than its private competitors can muster, we’ll see how long it is before representatives begin getting calls from 50-year-olds who’d like the opportunity to exchange money in return for insurance as good as what 55-year-olds can get.
That is the logical path. Increase the Medicaid rolls by 15 million as the current bill does, increase those participating in Medicare by a 10-year age bracket, subsidized tens of millions of others, and what is left before people not on the public dole demand their handout? And the necessity of going on the dole will be compelling because of the destruction of the private market which cannot compete on price with a government-run, ultimately taxpayer-backed, program.
In one fell swoop, in the dark of night in a holiday rush, Harry Reid and Barack Obama will have put us on the path to the single payer system they really want.
The fact that we cannot afford the current Medicare system, well that is just a detail. And will serve as the justification for government-determined rationing once a majority of the population is living off the government.
If Harry Reid gets this done, call him Harry Houdini, because he will have pulled a single payer system out of a holiday hat.
Update 12-10-09: In a similar vein, House Democrat: Senate public option “compromise” is a total victory for fans of … single-payer and now this from the Washington Post:
However, the last-minute introduction of this idea within the broader context of health reform raises numerous questions — not least of which is whether this proposal is a far more dramatic step toward a single-payer system than lawmakers on either side realize….
The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.