Medicare Part E – “Everybody”

healthcare imagesThe President this morning admitted on national television that he lost control of the message with health care.  It’s time to reboot – and use a very, very, very simple message so all Americans can understand it.

Let’s use Medicare, which nearly every American understands.  Just create “Medicare Part E” where the “E” represents “everybody.”  Just let any citizen in the US buy into Medicare.

It would be so easy.  No need to reinvent the wheel with this so-called “public option” that’s a whole new program from the ground up.  Medicare already exists.  It works.  Some people will like it, others won’t – just like the Post Office versus FedEx analogy the President is so comfortable with.

Just pass a simple bill – it could probably be just a few lines, like when Medicare was expanded to include disabled people – that says that any American citizen can buy into the program at a rate to be set by the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) which reflects the actual cost for us to buy into it.

Thus, Medicare Part E would be revenue neutral!

To make it available to people of low income, Congress could raise the rates slightly for all currently non-eligible people (like me - under 65) to cover the cost of below-200%-of-poverty people.  Revenue neutral again.

This blows up all the rumors about death panels and grandma and everything else: everybody knows what Medicare is.  Those who scorn it can go with United Healthcare and it’s $100 million/year CEO.  Those who like Medicare can buy into Part E. Simplicity itself.

Of course, we’d like a few fixes, like letting negotiate drug prices, and fill some of the other holes Republicans and AARP and the big insurance lobbyists have drilled into Medicare so people have to buy “supplemental” insurance, but that can wait for the second round.  Let’s get this done first.

Simple stuff.  Medicare for anybody who wants it.  Private health insurance for those who don’t.  Easy message.  Even Max Baucus and Chuck Grassley can understand it.  Sarah Palin can buy into it, or ignore it.  No death panels, no granny plugs, nothing. Just a few sentences.

Replace the “you must be disabled or 65” with “here’s what it’ll cost if you want to buy in, and here’s the sliding scale of subsidies we’ll give you if you’re poor, paid for by everybody else who’s buying in.”  This creates Part E.

And if this fails – if the Congress can’t get out from under their corporate overlords – at the very least pass the Kucinich amendment that will allow individual states to create their own single-payer systems, as was done in Canada a generation ago.


Gregg Moore (not verified) 13 years 38 weeks ago

Call it Medicare Part "S".

"S" for sick-people-will-be-the-only-ones-who-will-opt-in.

Or maybe that would be Medicare Part "SPWBTOOWWOI", but that would be harder to remember and less catchy.

Because there would be no reason for well people to pay for health insurance if they know they can get it later when they get sick.

That system would be great except for the fact that it will surely come crashing down in a huge failure. Why? Because the rates you would have to charge if only sick people are paying will be wildly prohibitive.

You are missing an essential element of any insurance system: a way to get people to pay for the protection during the time that they don't know yet whether or when they will end up needing it.

Anita (not verified) 13 years 38 weeks ago

I am the mother of a very medically fragile kid - actually he is 19 now, and disabled. I also own a business and pay the premiums for all employees at 100%.
The point I never hear is that I would be spending my income so differently if I were not paying so much out of pocket each year (personally for the past nearly 20 years).
Are other corporations and businesses really in favor of a plan that puts so much of this kind of money into the hands of the insurance companies and not into their pockets. I am not taking vacations, buying new cars, new clothes at anything like I might be if I were not putting so much money out each year for the high cost of the non-covered portion of my medical.
As the employer, I had to change premiums this year because I could not afford the plan we had for years, the costs were too high. So, the bottom line is that individual out of pocket went up by a hugh degree.

So why are Republicans in favor of lining the pockets of the big insurance companies instead of their own?

Just wondering why this argument has not come up.

ignatzfattis (not verified) 13 years 38 weeks ago

I think "Medicare for all" is an eventuality -why bother creating another program when all we've got to do is slightly alter the one we've already got? It's just a matter of when in my opinion.
Besides -I notice that nobody (on the Left) has tried to nip the idea in the bud -that's a good sign it's in the works already.

FrankNblast (not verified) 13 years 38 weeks ago

First I want to thank you for what you do. I have listened and agreed with your positions from the first time I heard your show. I am not sure if you were doing it from back east then but I feel you bring civility and a well thought out view of the world. I am proud to live in the same community here in Portland.
We are similar in age and although you grew up in the Mid-West and I in South-Eastern Idaho our backgrounds and the aspirations of our parents were similar. Although very conservative my parents stressed hard work and community service. They believed that you have nothing until you give something back. They taught me we will be judged by the way we treat the least among us. Now I hear you and Bernie say the same thing every week.
I know you have little time for long winded emails so my point is this. I believe the country owes its citizens an education, health care, a dignified retirement, and sense of value that does not revolve around an economic race to the bottom.
I worked as touring rock musician for many years and considered it the “American Dream”. However I gave nothing back. In reality I had very little worth giving. After that I became journey level carpenter and worked like a dog to save for a home and a retirement all the while watching the middle class deteriorate. I lost my carpenter job a few months after 9/11 and being in my forties decided to go back to school and get a GED. I happened to be at the community college getting my GED on the day folks sign up for classes and decided to take a few just to see if I could do it. I eventually received my degrees in Social Science and Geography then a Graduate degree in GIS Urban planning. This was accomplished by blowing through my savings, playing music every weekend, taking the odd carpentry job, and getting on a social program that allowed me to collect almost 2 years of unemployment during retraining. Also I took out about 4 years of education loans. I should mention my wife went through school and finished her BA degree at the same time and my children are grown. I was so proud of my wife for teaching English in China, also myself for landing a job here in Multnomah County as a GIS cartographer. I was sure we would live the dream now no matter what happened politically in this county.
Not long after she finished school my wife suffered a severe spinal injury requiring multiple surgeries and ongoing medical care. I was lucky to have medical insurance when I needed it. We had been without any medical insurance for much of our lives because it was just too expensive. My dream has become my nightmare. Even with the best medical coverage and a good job I cannot pay the mortgage, household bills and student loans. I see myself losing everything in the not so distant future.
If someone like me who worked hard and believed in the dream can be ruined by simply not having two incomes. I fear for everyone in America.
In my job at the county each transaction or conveyance of property comes across my desk for evaluation and mapping. I must tell you I see more foreclosures than anything else and it has not let up a bit. I do not want you to quote me but for your own information it is many thousands just this year in this county alone.
I know that although I am hanging on by the skin of my teeth. I am the lucky one. I do hope for change and something better. I believe it is not too late. I have been an active democrat since the 1972 elections. I imagine a world where the Kennedys lived, where McGovern won and there was strict antitrust enforcement. I am sure we would have had the problems and scandals of entrenched power, but I also think we would have had a more honest and open dialog with our representatives’ the way we do with you and Bernie. Perhaps we would have had a world where the fortunate helped the “great unwashed” instead of blaming and despising them.
When I read “blessed are the meek for they shall inherit the earth”. I wonder if Mathew meant: you get to lay under six feet of it after suffering at the hands of the ruthless and greedy. My real point being we need a “million man march in tin foil hats” and we need it now.

Textynn (not verified) 13 years 38 weeks ago

The medical insurance industry is nothing but a money handler. I call them nothing but billers.

It's like a lawyer has a secretary and she(the secretary) starts billing HIS (the lawyer's) clients for her time to bill them. She charges more and more until the lawyer's clients are paying her as much as the lawyer. Finally at one point the secretary quits her job, gets a fancy office and hires a lawyer to be HER employee.

It's really weird and it's a racket. When you add in the life or death decisions the Medical insurance industry brings to the mix, its a deadly racket. Killing for a living.

Just what all will we submit to at the demand of a self appointed, killer-for-greed, fallacious authority figure. Further, that fallacious authority figure has no real authority outside of the power of their money. Not legal, not moral, not anything. Because what they do is absolutely crime on the level of an individual. i cannot neglect my dying mother to expedite my inheritance without being considered a criminal.

The whole arrangement is based on a fallacy of authority that is literally breaking the laws that pertain to all other business and people. We are hypnotized by a lie. Hypnotized into believing we are to do as we're told like children in a classroom run by an enormous and cruel tyrant. The Milgram Experiment at the National Level.

belletiane (not verified) 13 years 38 weeks ago

I just read this on Davis Sirota's site. More nails in our coffins. This has been a done deal for months now. After stripping us to the bone they will suck the marrow. and Pearly, Impeachment off the tablet Pelosi continues in her "first woman Speaker of the House" circus.

belletiane (not verified) 13 years 38 weeks ago

Sorry, that is David Sirota.

Loretta (not verified) 13 years 37 weeks ago

It's too bad everyone can't cancel their insurance policies all on the same day and kill the bastards in the insurance industry just as they have been so ruthlessly murdering our families and friends. Would there be some way to do this?

I am tired of hearing that the insurance industry is such a large portion of the GDP that we can't just shut it down. Commercial spending is 70% of GDP, and if the insurance industry were completely eliminated, that would take care of helping to raise commercial spending. Obama could promise to offer retraining programs and guaranteed income for people who would lose their jobs in the insurance industry, and we would still be ahead wouldn't we?

Textynn (not verified) 13 years 37 weeks ago

Dear Thomm,
I am absolutely floored that you will not address the fact that Kaiser Permanente AKA Group Health are part of the same empire as Kaiser Mines which are heavy polluters in this country and that there is a very unsavory conflict of interest being had when a major polluter is also caring for people in another hat through a health care insurance company pseudonym (Group Health) .

I did not come upon this information by accident. I worked in Spokane at a site that was affecting my health for over 7 years. I could not see that this school site was polluted but i began having a serious rash the first week on the job. I thought I was allergic to a cleaning product being used there. Three years later I had thousands of sores bleeding through my clothes and no idea what was happening to me. After a while I started have my joints lock up and was becoming unable to walk. An old shoulder injury became completely frozen and my shoulder swelled up to about 3 to 5 times its normal size. I became deformed like a hunch back and couldn't more the arm at all. i worked still two more years on heavy meds but the pain was off the charts. Soon I slowly became bedridden and was unable to work.

Right before I quit my job, I found out the site was a Superfund site. It had been the location of a oil refinery for over 70 years prior. There was a tank farm still out back of the school polluting under cover of darkness less than 30 feet away and many many building size tanks. I hung on to my Group Health as long as I could and I begged my doctors to run tests to see if I had any of the heavy metals in me that were listed by EPA. The chemicals listed were lead, chromium 4 and 6, arsenic, cadmium. My Group Health refused to run one tests even though the rash and the arthritis were classics exposure symptoms. I begged them regularly because by now I was literally an invalid and I was suffering 24/7. The pain was like someone was twisting my arm as hard as they could all day long. I was so weak I couldn't change my clothes, bath, or leave the house except to drag myself to see them. i would become so distraught I would call almost every day and come in over and over in tears. They simply said I had arthritis and sent me for physical therapy which I tried to do but couldn't because it was so painful. They changed my primary care doctor over and over, at least 10 times. Each doctor would do nothing. They refused to test or anything. Did I say I was 43. The last time I saw them I said I was going to kill myself and I really was but had kids so hung on. I lost my insurance very soon after I got this ill. They never checked up on me or even seemed to care. I was home in bed filthy and dying for sure. I was this sick for about 18 months at this point.

When I begged for these tests the doctors would turn away from me and act like I wasn't talking. They would cut me off and leave. Over and over again this happened. I became mad and said why won't you just give me the tests so I won't worry about it any more. No they wouldn't even acknowledge what I said.

I was talking to a friend of mine who is older and she said oh Group health is never going to help you document exposure to toxins because they are Kaiser as in Kaiser mining which we have right in my town. I was freaked out and didn't believe her. i searched the net to find the connection and I could find nothing for a very long time. Finally I found all the info on Wikipedia about Henry J. Kaiser. I was really scared at this point.

Just as a matter of coincidence my father used to be a Workman's comp judge in the seventies. He heard exclusively Black Lung Cases. We moved to Evansville Indiana for that job. He said the mining industry was so ruthless that when miners started coughing in the days before Black Lung legislation that miners would be shoved down mine shafts and killed. The mining industry is beyond heartless and those are just a few examples.

It also was very unnerving to me that I saw that Kaiser designed legislation for the creation of HMOs at the same time the Black Lung Legislation had forced oversight on the mines.

Since then I do research all the time on Kaiser mining and their pollution which is extensive around the country and they are being sued by many thousands of people for callous indifference to the people they poison. They have left properties here in the Spokane area to be developed into neighborhood while knowing they were contaminated. The law suits are still going on years and years later.

How you can hold up Kaiser P as a good example of a good company is beyond me and really makes me mad. It is also a concern that the oil industry is contributing millions to stop health care reform. i got a chart from Huff post showing they were major funders of these groups against health care reform. I beg you to explain to me how this doesn't concern you in the least because I for one have no doubt that they went into the medical business to control documentation against them and others like themselves. Just like PG&E did in the Erin Brockovich story. I would like to know why this seems okay to you. I can't hardly bare it when you hold up Kaiser as a good example of health care because the whole thing is worse than a nightmare to me.

PS I am much better now but my life has been on hold for about 6 years. Every day away from the contaminated site has helped me heal. it took me years and I swore to God if I ever got well enough to expose this story I would do so. Not to sound aggressive but I really demand that you explain this to me if you are going to promote Kaiser.

David (not verified) 13 years 36 weeks ago

I'm a Republican and have been trying to follow this debate and read to become better informed. I appreciate Thom's liberal but mostly centrist positions and analysis skills.

I think everybody sees this as a moral issue - and so there's broad consensus that we need reform. Nobody wants to hear of anybody going bankrupt or dying because they don't have are.

Problem with what's posed above is it's going to break the bank. (Go to YouTube or your favorite website and look up GAO or Peterman Foundation on Healthcare). Medicare is already broke actuarially and isn't getting any better.
Putting 40 million more people on an "all you can eat" buffet is not going to work. Seniors won't like it - but their care will most likely get rationed in future - or they'll pay more (hopefully born by those who can afford it).

Both parties have been fiscally wreckless over the last 50 years and we are on the verge of bankruptcy. (Foreign buyers will not buy our debt and our own people are getting to the point they won't either. If you can't sell the debt, you can't deficit spend). If the ship goes down, we all lose most if not all of what we have.

So, let's agree that what we're trying to do is:
1. Something we can afford to do now and in future (this was one of Obama's conditions). Everybody into the same risk pool (only way you can pay for this). Ugly fact is any insurance scheme only works because more healthy people are paying in than sick people.
2.Get rid of the bankruptcies and needless deaths but retain some incentive for folks to take care of their health. Offer everybody at least catastrophic protection, routine checkups and preventive care. You may need to add folks with chronic conditions (cases of general welfare). If you want full fledged health care - buy a private policy (this can also be regulated. Government lays out plans. Dictates everybody pays same price.). High risk cases and pre-existing conditions go into pool that all companies pay into (to prevent gaming the system - which is what's going on now. Only way to generate more proftis).
2. Fix the rules. The left seems to have an agenda against the insurers. Nobody defends anybody's criminal behavior. But the reality is, the insurers have their infrastructure in place. I don't want to replace it. I want to regulate it.
FIx the rules (portability, must take everybody, must pay all claims, limit executive pay like a public utility, etc).
3. Fix the defensive medicine problem with medical arbitration boards.
(see France's example). Legal costs aren't a huge problem - it's all the hidden cost around defensive medecine. It's also discouraging people from practicing medicine. I don't have anything against lawyers - but the system is also out of whack here as well.
4. Implement all efficiency measures. Comparative medicine. IT Infrastructure and common paperwork systems for claims and payments, etc, etc.

Folks on the left side of this issue need to understand that there's large percentage of folks out there who do no t trust the government to run anything.
But, those same folks do no believe that companies should run wild either.
Government is perceived as a good referee but a terrible player. Agree or not, this is the problem with Medicare Part E or the Government taking direct control.

I stil don't see why this compromise won't work and it's what we can afford.
But, both sides have dug in and won't budge. I'd rather see this done than nothing pass. It can improved upon later (you can squeeze the insurers out of business). Baccuses plan with the non-profit coops would work (I think). But it really comes down to how it's executed.

The real problem here is that the Insurance industry has bought both parties. We really need campaign finance reform - bad. And/or term limits.

Sorry for the book. Let's hope something gets done.

wrenfoto's picture
wrenfoto 11 years 34 weeks ago
#11!/petition/medicare-part-e-everybody/62ZRcP2W Come on and sign it. If you want the White House to do something.

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