If 55-64 are allowed to buy into medicare

[SimpleMom]

Medicare at age 55 would allow baby boomers to retire earlier and reduce unemployment.

Below is what I've been emailing to assorted senators. It won't be popular with folks who aren't earning wages...

Medicare for folks starting at age 55 is a great idea. But let's make sure Medicare is financially sound by making ALL[FONT=&quot] sources of income subject to the 1.45% Medicare tax, not just wages. An employee earning $50,000 pays $725 in Medicare taxes. Their employer also pays $725 in Medicare taxes on those same wages. But a landlord pays $0 Medicare taxes on $100,000 of rental income. A shareholder pays $0 Medicare taxes on $200,000 of dividend income, and a hedge fund manager pays $0 Medicare taxes on $1,000,000 of income treated as capital gains. Why are we only taxing the working class and employers for Medicare and not the investor class? (I’m a landlord and a shareholder so this would raise my taxes, but I’d go along with it because it’s fair.) Maybe we could reduce the Medicare tax rate slightly or increase Medicare's reimbursement rate if the investor class paid its fair share.


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[samclem]

I don't see how this new bill is going to be paid for, and I don't think congress knows or cares.

The Senate is in a giant flail to put together any sort of Frankenbill and get it passed before the public discontent grows even stronger. Over 60% of Americans now oppose this legislation, and opposition is continuing to grow. Despite months of planning and deliberation, the idea of adding millions of people to Medicare wasn't part of any of the proposals before last week, now it's been thrown into the plan as a last-minute sop to keep this bill alive. It's a direct federal takeover of the health care of millions of Americans--it can't be part of a compromise, since it's more radical than the public option that was being hawked originally.

Any thought that the legislature was going to put together a carefully thought-through plan is long gone. It's now just a bunch of disconnected patches and scraps designed to buy off one or two votes here and there.

Here's the new standard for this highly complex issue that seeks to take over 17% of the US GDP, as expressed by Senator Max Baucus:
" If there's 60 Senators who can reach agreement, I'm for it."

Incredible.

I'm surprised the medical professionals in the US aren't quitting the AMA in droves. The organization signed on to support this "reform" in exchange for protection from Medicare cuts. Ha!. The joke is on them! If this thing passes, their members will be treating even more Medicare patients at ridiculously low reimbursement rates, and the number of privately insured (who have traditionally picked up the slack) will significantly decline. Like the lady who thought she could ride the tiger, the AMA ended up inside. Weasels.

 

[mickeyd]

[FONT=&quot]Medicare at age 55 would allow baby boomers to retire earlier and reduce unemployment. [/FONT]

That's ridiculous. Boomers retire for many reasons, but Medicare would not ever be a reason to retire. As for unemployment, the only way to reduce unemployment is to get a job, not get insurance.

 

[SimpleMom]

Eligibility for Medicare does influence baby boomers' decisions as to when they can retire. It certainly will influence mine. And if someone retires, then a job opens up for someone else who is unemployed. Why do you think they invented social security back in the great depression? To get older workers out of the job market.

 

[Rich_by_the_Bay]

I'm surprised the medical professionals in the US aren't quitting the AMA in droves.

Quit them decades ago because of their one-agenda platform of supporting whatever maximized the income of private practice, regardless of the issues of conscience that went along with that stance. I think they have changed little, but now they are not sure which plan supports their perplexing agenda.

Other groups like the American College of Physicians have proposed much more thoughtful positions while avoiding radical solutions.

 

[bbuzzard]

[FONT=&quot]Below is what I've been emailing to assorted senators. It won't be popular with folks who aren't earning wages... [/FONT]

Great question! I have always felt that the middle income w2 earners get shafted with supporting the low income retirees.

 

[teejayevans]

That's ridiculous. Boomers retire for many reasons, but Medicare would not ever be a reason to retire. As for unemployment, the only way to reduce unemployment is to get a job, not get insurance.

Uh? HI is the biggest unknown for an ER, and if HI went away, I would be ER already.
TJ

 

[Rustic23]

Reading the threads here 'Can I retire', or 'I plan on retiring when', one thing always pops up.

Health Cost.

When looking at health cost most here, especially those close to 65, say something like 'until I turn 65 and Medicare kicks in'.

Based on those post I conclude that many in the 55 to 65 catagory would retire if the health care part of their retirement was solidified.

 

[bubba]

I work with a building full of people who would retire if they could get SS before 65. However, I agree with the posts upthread who question how adding all these folks could possibly reduce costs.

 

[samclem]

With Lieberman and Nelson saying they won't go for this Medicare expansion (link), it might be dead.

This would be a good time for Reid to stop the sausage machine. Take a break. Go home and see the constituents. Then in January get back to work on a realistic bipartisan approach that incrementally tackles this problem in a cost-effective way. I think a majority of Americans and legislators see a need to significantly alter and improve how we pay for and deliver health care. Now that everyone has gotten a good scare by seeing how bad the "answer" could be and how close we came to living it, maybe this is a rare window of opportunity to get something done.

 

[teejayevans]

Now that everyone has gotten a good scare by seeing how bad the "answer" could be and how close we came to living it, maybe this is a rare window of opportunity to get something done.

Do you still believe in Santa Claus too?
TJ

 

[burch64]

I must be missing something, I thought early medicare people would pay the entire cost of their medicare premiums, $630 per month per person is the number tossed around.

So how would that hurt medicare?

 

[samclem]

I must be missing something, I thought early medicare people would pay the entire cost of their medicare premiums, $630 per month per person is the number tossed around.

So how would that hurt medicare?

Five reasons:
1) Even if these new enrollees paid the same as other Medicare recipients, Medicare is going broke because the $$ going in to Medicare do not cover the $$ going out.
2)Some (a majority?) of these people are paying Medicare taxes today while they are working. Some of these people will quit working if they qualify for Medicare and no longer need their employer-provided coverage. So, people who used to be paying into Medicare and getting no services (yet) would suddenly become net "takers." That hurts Medicare.
3) Medicare payments to doctors today do not cover the cost of care. The unpaid costs get shifted to other users of the medical care system (primarily private insurers). So, adding more Medicare recipients will drive up costs for everyone else with insurance.
4) Because Medicare doesn't pay the prevailing rate for many services, many medical providers will no longer see Medicare patients. In some areas and in some specialties this has resulted in considerable waiting lists for people on Medicare. Adding more recipients will add to the waiting lists. This helps break Medicare further.
5) All the problems above will be exacerbated when the number of people seeking "in" to Medicare as they reach 55 explodes. This will happen because (as noted above) the cost-shifting to private insurers will drive rates up. Employers will find it much cheaper to pay the fine and drop these workers (or all workers) off their employer-sponsored coverage. So, people who formerly were on private insurance will join the ranks of the Medicare insured, which will continue to drive up private costs, etc. It's the same cycle many believe would have happened when the other "public option" was being considered.

 

[Rustic23]

Sam,
I think you also have to include the 'existing conditions' group in the mix.

 

[lloyds]

I am one of the under 65 crowd that would ER today if I could enroll in medicare. There are thousands, if not millions, of us out there. Someone else could have this job if I didn't have to worry about healthcare. Even if it cost me $600-$700, still better than dying in this office while life passes me by.

 

[huusom]

I am one of the under 65 crowd that would ER today if I could enroll in medicare. There are thousands, if not millions, of us out there. Someone else could have this job if I didn't have to worry about healthcare. Even if it cost me $600-$700, still better than dying in this office while life passes me by.

Well. I'm with you but it lookslike they are going to drop. All because of Lieberman.

 

[ziggy29]

Well. I'm with you but it lookslike they are going to drop. All because of Lieberman.

I didn't know one senator could kill it. I thought it took 41.

Anyway, getting away from the politics, the bottom line from a practical standpoint is that still almost no one is emphasizing cost containment, which is really at the root of much of the health care problem. People may be talking about how much it would cost to provide this today, and even if the costs were fully "paid for" and the adverse selection concerns were addressed, there's little talk about how to stop the endless double-digit cost increases into the future. IMO, that must be the first thing we address. Once we can find a reasonable way to control costs, then it will be a much easier sell to make coverage more universal and portable.

 

[samclem]

Anyway, getting away from the politics, the bottom line from a practical standpoint is that still almost no one is emphasizing cost containment, which is really at the root of much of the health care problem.

That's certainly one of the biggest issues, and the one glossed over the most. And it is huge.

It seems to me that, conceptually, there are two fundamental ways to control costs:
-- A) From the supply side. Limit the procedures patients are allowed to have (effectively limiting the number of procedures), and limit what the insurers/government are allowed to pay for them (the unit price).
-- B) From the demand side. The customer decides which services to buy (which insurance policy to buy and which medical services to buy with his co-pay) and shops for a price.

Our present "system" uses neither of these processes very well. The govt (Medicare) has supply-side cost controls which leads to cost shifting to the private side of the system and leads to the normal resource scarcity that always results when goods or services are priced below demand. The private side has only rudimentary cost controls--there's no efficient market for individual health insurance, there's no way for patients to shop for services by price, and there are few incentives to do so.

All the other cost-saving things being discussed (electronic records, re-importation of pharmaceuticals, reduced overhead and admin, etc) will happen only within one of the two frameworks above.

The current "reform" proposals (House and Senate) concentrate on supply-side controls.

One newly surfaced possible amendment to the current Senate proposal takes a few baby steps toward recognizing the potential of demand-side controls. I can't find the link to the article (apologies!), but a democratic senator has proposed allowing nearly anyone to buy individual insurance from the "insurance exchanges" that would be set up (the present Senate bill only allows these purchases by individuals who work for small employers or who are otherwise not covered by employer-sponsored insurance). In addition, (IIRC) the amendment encourages high-deductible policies (by letting people pocket the money saved) and expands availability of HSAs. The devil is in the details, but this approach, to me, is much more attractive than putting limits on the supply of services. And, if we can cut or weaken the employer-->insurance link, that's even better.