Freedom to Choose Medicare

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As Republicans flail about trying to find a magic solution to healthcare, they refer constantly to the importance of “freedom” as the key criterion by which their proposal must be judged. Freedom to choose healthcare plans, or none at all, is more important to them than coverage. They then invest this “freedom” with all kinds of wonderful benefits until the CBO informs them, “nyet” (a language they seem to speak well), it rips coverage away from millions of people and premiums will go up.

Republicans seem to ignore that illness itself is enslaving. Think of how a serious illness compromises one’s choices in life. Even more enslaving than illness, is illness that could have been prevented or treated if proper coverage, at reasonable cost, were available. How much freedom do people thrown into personal bankruptcy due to illness have?

It is why the Affordable Care Act was the greatest advancement in freedom in generations.

Ok, now, so what about the freedom for each and every American to choose Medicare? While 55-65 year-olds are the most expensive patients for private insurers, they would be the least expensive for Medicare. Hence, it would likely extend the solvency of Medicare even further than the Affordable Care Act did (an oft-forgotten fact, before the ACA, Medicare was slated to go insolvent in 2016).

A “freedom agenda” that was more than empty jargon would provide everyone the freedom to choose Medicare for coverage. It would be good for people, good for patients, good for the economy, and good for freedom.

Indeed, even among the current Medicare population, just 5% of people covered by Medicare account for 50% of its annual costs; 10% account for about 61%. Generally, these are people with multiple chronic diseases, with each illness adding substantially to their overall costs of care. . Such “accumulation” of chronic diseases increases with age.

Hence, providing everyone the freedom to choose Medicare would extend its longevity beyond the additional ~14 years Obamacare achieved. Details would have to be calculated regarding premiums since part A (Hospital care coverage) costs nothing for those who have paid Medicare taxes for 10 years, that a 30 year-old would not have had time to do. Part B is $134 monthly plus additional amounts based upon income. Should Part D (drug coverage) be mandatory for under 65’s?

Some system of covering reproductive health would have to be built in so that women were not negatively impacted. But, since women at reproductive age are likely to be otherwise healthy compared to the elderly, the costs should be more than outweighed by their premiums.

All that said, it is a favorable actuarial picture for the program and the people.

Fulfill the “freedom agenda”. Freedom to choose Medicare.

Embrace it. Repeat it. Pass it.