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Bernie's Single Payer v. Hillary's ACA

There’s an interesting dust-up between Sanders and Clinton on health care. Bernie, predictably, is promoting a single-payer system akin to “Medicare for All” (MFA). Hillary is maintaining that the ACA is working and that we’re better off focusing on ways to improve it, not tossing it out and starting over. She’s also pointed out that Bernie’s plan would be virtually impossible to get through Congress.

Paul Krugman has weighed in on the debate basically backing Clinton. He acknowledges that Sander’s program is a better solution to the country’s health care woes but sides with Clinton in that trying to shift over to a MFA would be horrifically disruptive, would be resisted by those who are comfortable with their present coverage through employee benefit programs and fought tooth and nail by insurance companies.

Well, I have a solution: a gradual drift from where we are today to a full-bore MFA. Begin by lowering the age of eligibility for Medicare to 63 in 2017. Then drop it three years to 60 in 2018, lower it another five years to 55 in 2019, then ten years to 45 in 2020, etc. In a relatively short time you get MFA. During the gradual shift-over phase the ACA continues to cover those who are still below the age-threshold.

The gradual approach gives all parties time to make adjustments in medical care and insurance coverage. Since Medicare doesn’t cover everything, insurance companies could continue to provide plans on the free market for extended coverage and even supply “Cadillac” plans for those who want fuller, perhaps more “luxurious” forms of care (e.g., guaranteed single-bed hospital rooms).

So how come no one’s talking about something like this? Surely I’m not the only one who’s come up with it.

Reader Comments (1)

Why not make Medicare available to anyone who wants it but "mandatory" by the schedule you suggest?

January 20, 2016 | Unregistered CommenterKeith E. Glading

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