Medicare Buy-in. Good for those 55 and over, but what about everyone else?

[Kitsune]

Please don't get me wrong - I think expanding Medicare is a great idea, but I'm pissed off that it's essentially coming at the expense of everyone under 55. If you're opening Medicare up to people who are going to have a higher cost of coverage due to a higher likelihood of developing medical problems, why not expand it to people who aren't going to have such a high risk? It'd only increase the fiscal solvency of Medicare. In the meantime you're giving the insurance mafia a way to foist off the sick onto the government - supposedly (or so I hear) there'll be safeguards to prevent them from simply kicking people off at 55, but come on, these slimeballs will exploit every loophole and we all know it.

Overall, this is better than what we were probably going to get stuck with assuming last week's completely gutted public option, but not by much, because it's going to reinforce the message to young people that Obama and the Democrats really don't give a flying tinker's hoot about the people who gave them their jobs. I know that's certainly the message I've been getting, and I'm not alone, not by a longshot. Young people put Obama over the top in 2008. We busted our asses for him and the Democrats. What are we now, chopped liver? We're still stuck with the health insurance mafia leeches, paying premiums we can't afford and insane deductibles on top of it, in the middle of the worst job market in decades - and thanks to the individual mandate we don't even have the option to tell them to stick their extortion where the sun don't shine! Leaving aside debates over the efficacy of single-payer vs other forms of coverage, because I'm fairly certain almost everyone here agrees that single-payer is the only way to fix this mess completely and we sure aren't getting it any time soon, how the hell is this in any way a good move politically? Do they want young people to not vote in 2010?

tl;dr The Dems after 2008 should be the last people falling for the "young people don't vote" canard.

[yourguide]

1. Finally some fair criticism...

much different than some of the crazy train posts I've seen today.

Thank you.

[Kitsune]

2. I've been pretty ticked at the whole process recently, so I'm glad you at least don't think I'm nuts

Mostly I'm just annoyed that basic freaking logic apparently takes a vacation whenever Congress is in session. Even the conservaDems should be able to add 2 and 2 to get 4.

[DrDan]

3. support for this is not necessarily going to fall along age lines - there are plenty of us

that are over 55 and feel screwn.

Because - we have children who have just been screwed-over, and grandchildren. And by our own party. You expect it from the R's - it is just in their nature. But the D's. . . . .

And that does not feel good.

[harkadog]

4. No one knows if the buy-in is good or not for 55+.

There have been no details on the cost of the buy-in just speculation. Plus none of us knows what the final bill will look like after it gets through the Senate and then the Senate-House conference.

[Kitsune]

5. This is true. I'm assuming it's a fair buy-in, since that age group stereotypically votes often

and votes are a politician's lifeblood. I've never seen a politician intentionally go after the 50+ set, at least not openly (see Medicare Part D on the GOP end of things, and look where it got them), so I'm assuming that the program, while probably not as good as just being on Medicare by dint of being 65+, will still be a lot better than private insurance (I fail to see how it could be worse).

[levander]

18. I'm tired of details not being released yet...

they just do it so they can get a vote in as fast as possible before the public can decide if the details are any good or not.

[ChiciB1]

39. The Drum Roll On This HCR Has Got To Be the LONGEST ONE EVER!!!

And in the end, I'm betting that there will be a BIG BUNCH OF FINE PRINT and most of it won't get read until... well you know... It's Too Late!!

Too many questions, not enough answers and I'm just one of those liberal lefties who doesn't know squat! So there, I said it before I got jumped! But jump anyway if you want, my skin gets thicker every day!

My brain on the other hand has been doing some SERIOUS RE-THINKING!

[dmallind]

6. IIRC that's only part of it.

Doesn't the plan also extend Medicaid to families making up to 3X poverty - so about $65K annually for a family of four. That will capture a lot of the working poor, including many younger workers.

[glinda]

9. I think all the deals in the end should help those from $75 thousand on down.

Most people do not realize that weather you are a "family" or not, that financial level has been gouged in just about every way and I feel it is that group all the way to the poorest that need help.

[Kitsune]

10. I don't know where you're getting those numbers

I looked it up on wikipedia and while the article agreed with your number, the link itself didn't.

http://www.census.gov/hhes/www/poverty/threshld/thresh08.html for reference

I don't see 60k+ anywhere on that chart. In any case I don't think most young people have a family of four to look out for, and this OP was sort of intended to be about that particular age group and the political wisdom of ignoring them, without discounting that others may accrue some benefits from this plan aside from the lower Medicare buy-in age.

[dmallind]

11. Just a guess from memory really - point was mostly that Medicare is not only thing in plan. NT

[dmallind]

14. On review the numbers do agree - it's 3X poverty. Poverty is 21.9 => 65.7K NT

[Kitsune]

22. Can we tell I'm a humanities major? ;)

That said, that's for a family of four. My concern was mostly for young singles, especially in urban areas where the cost of living is much higher.

[dmallind]

30. Sure thing. Young singles unlikely to qualify BUT

They are also the least likely to need care. Remember that most Americans will continue to be covered by employers for forseeable future (not my preference, but inertia's a bitch) and that Medicaid exists for the truly very poor.

So yes underemployed non-poverty young folks with jobs offering no benefits will still have problems with this deal. The way I see it is that perfect is the ideal, but better is OK for now. This is better.

[Kitsune]

32. On the policy end of things it will (hopefully) be an improvement

My concern is with the political end of the matter. I'm trying to think of anyone I know that isn't in the category of "underemployed non-poverty young folks." That's pretty much everyone in my age group, everyone that busted their ass for Obama in 2008. If they don't see significant improvement coming down the pike, I'm worried that a lot of us may well stay home, and that'll sink the Dems faster than anything else.

[levander]

29. Young people are going to lose... it's only natual.

Obama has an unfortunate habit of making grandiose promises that can't be filled. "My stimulus bill will mean that unemployment will not rise above 8%!". "If you like the health insurance you currently have, you can keep it!"

Look, this is a 2,000 page bill. Health insurance is going to change in huge ways, and because the bill is so complicated, we're not going to understand all of them.

But, young people are the largest benefactors of the current system. I saw somewhere that currently insurance companies typically charge someone in their 60's 6 times what they charge someone in their 20's. And, any time there are seismic changes to a system, some people are going to win and some people are going to lose. With young people being such enormous profiters of the current system, it's just not very likely young people are going to come out ahead in any health reform plan that looks at whose paying what premiums.

[Kitsune]

31. I'm 'profiting' from the current system?

I don't see the doctor for anything short of a gaping wound or debilitating pain because my deductibles are through the roof. NOBODY profits from the current system except the leeches on top of the racket. Everyone else is getting screwed. Some may be screwed more than others, but that is a far cry from saying that the ones being screwed slightly less are making out like bandits.

[stopbush]

7. It's good politically because it is far easier to get a toe into the political door

than it is to get in the entire body politic.

You're making the mistake of considering this in a vacuum. Yes, it's no big thing if this is the end of it. But the fact is that this is only the beginning. Medicare is a program that works right now and people who are on it are happy with it. It will work for more people when the eligibility age drops to 55. That "new" success will engage people's thoughts about Medicare across the board. Medicare is a program that people don't even bother thinking about until they're 64 or so. Be honest, have you at your tender age spent any time thinking about health care for the older set in this country? Would you have thought of expanding Medicare to everyone if the Senate wasn't looking to extend it to those 55-and-older?

The added success of Medicare will make it more likely that it will be extended to even younger groups, and those extensions will not need to happen as part of a world war over health insurance like we're engaged in today. They will be extended by simple acts of Congress expanding the program. In addition, the Ds will gain considerably in a voting block that does vote in elections.

You're hoping to win the health care war in the first large-scale battle we've had in years. The smart people know to gain as much territory as possible in this major battle, and to come back later and get the rest in smaller battles and skirmishes. Patience is a virtue. Strategy is a necessity.

I'm 55, and the health insurance industry has been gouging me for decades. I could use the break that this proposal promises. You, on the other hand, are a youngster, perhaps in your 20s. If this Medicare proposal goes through, my insurance premiums may finally drop to something manageable. If I'm lucky, I'll live another 20-25 years. If it takes 10 years for Medicare to be extended to people in their 30s and 40s, well, at least you will personally need only pay high premiums for the next ten years or so, high premiums that us old codgers have been paying for 30-40 years. Once Medicare extends to 30-40 year olds, you'll be saving $ for the remaining 30-50 years of your life.

And you want to bitch about that?

[Kitsune]

20. There's a couple problems with this.

I get that this isn't the entire war, only the first battle. However, past experience leads me to believe that, even if we do get this totally awesome foot in the door, it'll be years at best before anything else is considered by way of expanding it.

The other problem is with the political dimension, which is sort of what I was trying to address more than the policy aspect. Young people busted their ass for Obama. That much we know. Now, I say this as a young person myself: we are a generation raised on the concept of instantaneous satisfaction. If I want the answer to just about any factual question, odds on I can have it within 15 seconds thanks to Google and Wikipedia. Blog posts of more than 168 characters seem excessive in the light of Twitter. We are not a group of people geared for long-term waits, especially when we are being kerfucked so soundly as we are by the economy and especially the health insurance mafia.

Patience is not a virtue we have, as a generation, cultivated - quite the opposite. And I'm worried that this is going to be the downfall of the Dems in 2010. This is leaving aside all the other "...duh?" issues, such as GLBT rights, which have been largely ignored save for a very nice hate crimes bill - how about ENDA? DADT? DOMA? Things that matter before we get beaten to a pulp, and that would not take nearly so long as this healthcare bill.

(I have a whole other rant about that but I think I'd better stop before I hijack my own thread. XD )

[Tom Rinaldo]

40. You are right

I'm 60 and uninsured so maybe this will help me IF I can afford to pay the unsubsidized rates but I agree with you completely. You are right to be upset. I also agree with you that this scheme PROBABLY overall is better than the completely shredded debased public option they were planning because this may actually help large numbers of people and it does expand the U.S. single payer health care system, perhaps significantly.

But it is a sad state of affairs that this is the best that can be done. Private insurers do not want to give up an inch of the market for younger generally healthier people, nor have to compete for their business in any way.

[DeschutesRiver]

53. I think there might just be two choices, then

You either decide to fight to win, no matter how convoluted or long the process is, or you stay the way you are, demanding instantaneous political satisfaction while life moves on without you guys, as others shape your future.

Your generation may decide that there is no need to cultivate patience & persistance despite all the odds, and that is your right, but I assure you that once you guys reach my age, you will find that others, mostly those whose values you abhor (and rightly so) will already decided your future for you, and that is how you will live out the rest of your days. The universe doesn't care about the quality of your life, or my life in particular; if you cry that you don't have the skills to get what you want (lack patience, need things NOW, blah blah), then others will fill in the void left by your unwillingness to participate. If you don't vote, it won't matter to those on the other side - you will just make it easier for them to create the life they want, at the expense of the life you wanted.

You know, the way I read the change deal from Obama was that we were going to make the change happen ourselves, with his leadership as guidance and support; not that we were voting for him in exchange for him doing all the heavy lifting on multiple issues and causing said change to happen instantaneously. Which brings me to a question - when you say your generation is used to having instant satisfaction, what exactly does that mean?

Since we've had repubs in office for the last 8 years, I don't think that experience gave you the idea that you could have instantaneous political satisfaction. So do you feel you are now entitled to having instantaneous satisfaction on the complex political front due to the fact that on a more simplistic, more process oriented level you can twitter-type shit fast, play computer games fast, buy cheap consumer crap fast, get thousands of trival things found on google fast and the like?

Why would you think that our technological ability to achieve instant gratification of personal needs would also mean that deep social change could be achieved just as quickly?

I should add that I sounded just like you at your age, so I do understand a bit of where you are coming from - I didn't even have an instant gratification mentality, but patience was a dirty word. Now having reached the age of 51, I'd say the other thing I learned was that a lot of the shit I wanted and got didn't come without a fight.

[Kitsune]

54. I'm not defending my generation's lack of patience

Rather, I'm laying out exactly how this situation is going to bite the Democrats in the ass if they aren't careful and keep ignoring the young demographic. This is a purely political consideration I'm making.

The problem is that your reading of "change" being grassroots is that, as far as I can tell, the Democrats are trying as hard as they can to ignore their grassroots. Otherwise they'd be pushing for single-payer and trying to wrestle the conservaDems into doing the right thing rather than trying to placate them by watering down compromise measures even further. Grassroots organizing in the modern era appears to be good for one thing: getting people elected who will proceed to ignore you in favor of the industry lobbies.

Another problem with this is that civics hasn't been a requirement in education since Reagan did his best to dismantle the public school system. You had a civics class when you were in school, I'm sure. I didn't. The closest I had was a totally awesome history teacher pitching a copy of Newsweek at my head every week during the 1996 election season and quizzing us on the contents. My generation is, aside from the odd nerd here and there (such as myself) not nearly aware enough of the mechanisms of government and politics as they should be.

I make these arguments not to excuse these phenomena but to warn others who may not be as in tune with the younger generation. I really think this is going to be a problem for the Democrats in 2010 and 2012.

[DeschutesRiver]

56. The only way your generation will be ignored by the democratic party

is if your generation makes it easy for them to do so.

What I hear you describing is a generation that is unwilling to do anything more than walk out of their house to plug in a vote that is supposed to immediately deliver everything they demand, and if it doesn't happen, they won't participate any further. If your assessment is accurate, then yep, democrats might lose big in the near term. And frankly not care a whit, because end of the day the party will continue to be a multi-generational beast that will see another rise to power. They won't be hurt nearly as much as you, who only have a single generation to live on this earth before you hand things down to your kids, and it will either be what you make it, or what you decide by default that it is to be. I understand that you aren't necessarily defending your generation, but just telling it like you see it. The way I see it is that you won't get any more out of the process than you put into it, and if all you wanted to do is cast a single ballot, then don't be surprised if all you get is some peanuts tossed your way.

Yeah, we had civics classes in my day, but I don't think that is critical to making change happen - now you could google enough to figure out the nuts and bolts. What your generation needs is a fire lit under their ass in order to focus their impatience into a lethal weapon that cannot be shoved aside after the election is over, and the ability to play some chess. What this sorry state of affairs of late should be showing your generation is that the threat of not getting votes from you in the future is not troubling to the democrats long term at all. Grassroots change should be about what you want it to be about, not what some thing called a democratic party is willing to use it for, like just getting votes to get into power without keeping the rest of their bargain.

I am flat out discouraged by quite a few things I've come to realize even this late in my life about power, politics, wealth and bad actors. I realize that it must be doubly discouraging to today's kids with their particular outlook on things. OTOH, every generation gets stuck with some bad mojo, and they figure out a way to deal with it or not.

P.S. sometimes when I said "you", I meant your generation, not you personally.

[BeyondGeography]

8. Y'all will be 55 sooner than you think

[vaberella]

12. Well currently we haves superficial information as of yet.

I'd await until we get the details and full information before I come in with BUTs and speculations. We really haven't heard a thing yet.

[Kitsune]

23. This is true, but I still think it bears some discussion.

Even after the details are released, it's going to be some labyrinthine multi-thousand-word bill, with loopholes all over it and the like, so what we're hearing now is probably what it'll boil down to in the end. I'm mostly talking about politics and in politics the message is what matters more than substance, sad though that is.

I hate car commercials for the same reason.

[Oregone]

13. Was the old alternative better for younger people?

It really wasn't at all, despite the magic words of the "public option". There will still be a subsidized exchange, but now it will be regulated to spend even more premiums on health costs (90%). It will remove some of the most expensive from private rolls and the insurers will be forced to pass those savings onto the younger consumers.

This could be good for everyone. The devil is in the details.

[cadmium]

17. That's the truth. Devil always in details nt

[cadmium]

15. good points. Here is my perspective why this could be better than PO

The public option was never going to be universal. In both HELP committee and Congress bills it was limited. A public option that was essentially letting everyone pick Medicare could be great but was never close to happening at this stage. . Here is a scenario that I think is realistic and seriously good progress:

#1 Expanded SCHIP 400% poverty level. That covers a lot of people up to age 18

#2 Allowing offspring to stay on parent's insurance through age 26 (admittedly this is not everyone but it is a large group)

#3 People Age 55 and above have option of Medicare.

#4 People can buy insurance through the exchange if not offered by employer. Younger people can buy lower cost catastrophic plans. People with low incomes can get on Medicaid.

This is a major increase in coverage availability. Most everyone could get coverage under these conditions. By lowering the age of Medicare 10 yrs below the retirement age paves the way for Medicare for All much more than a new agency Public Option could. There is the added mandate of ending lifetime caps and denials for pre-existing conditions. I would be very pleased if this actually happened and I think all these features are still on the table.

I'm not saying that this is how it will go, but I am speculating on a rosy scenario that is still in play

[levander]

16. Obamacare is such a complex solution

I think expanding Medicare is a great idea, but I'm pissed off that it's essentially coming at the expense of everyone under 55. If you're opening Medicare up to people who are going to have a higher cost of coverage due to a higher likelihood of developing medical problems, why not expand it to people who aren't going to have such a high risk?

People over 55 are one of the groups that are having the most problems being uninsured. Pre-existing conditions keeping them off the roles and even without that, insurance companies charge so much more for older people. But, that's what this whole Obamacare bill seems to do to me. It takes this giant morass of our health care system, pushes the problems in a little here and so the problems pop out a little more there. Then, they go and try to push whats popped back out in somehow else. The whole time, Harry Reid is in constant contact with the CBO learning how to massage their economic model so the system looks as good as possible on paper. The process completes once they have a 2,000 page bill that's more complicated than the CBO's economic model, thereby having outwitted it! But, you can't just continually massage economic models until they tell you what you want to hear, they're not that reliable.

[BeyondGeography]

19. Obamacare?

[levander]

21. Whatever the latest version of it is officially named...

Obamacare is just the only all-ecompassing name I've heard of all these drastic variations of the same basic idea.

What do you call it?

[Oregone]

24. This label actually feels very apt today

Krugman just wrote an article, about economic policy and Obama, which described him as the best tight-rope walking president in recent history (but thats not necessarily what is needed). I can't help but feel Obama has taken some of these same attributes in the health care debate

Perhaps the term "ObamaCare" accurately describes some politically amorphous health care reform which attempts to please everyone at once (which is impossible) while meeting a few ambiguous objectives (but not really solving the main problems).

I'm not really sure what to call this stab at reform. If the situation wasn't so dire, it would be entertaining and amusing to watch. But this label perhaps is accurate to not describe a specific flavor of health reform, but rather a specific approach being used to arrive at health care reform.

[BeyondGeography]

26. It's a wingnut term

Come back from the edge.

[Oregone]

27. Im well aware

(though its ridiculous that such a term has an instant negative conotation).

Anyway, I can still just label the reform approach as "Third Way".

[ChiciB1]

45. Well That Makes At Least Three Of Us Out Here On The Same Cloud...

And it's not even a full moon! My mind keeps thinking of strange phrases that have been made throughout the years that could apply, but seem silly too!

Yeah, I think I'm on some kind of cloud, pretty foggy and not seeing well!

[vaberella]

33. Obamacare? How is this allowed?! nt

[slipslidingaway]

59. That is what Jacob Hacker called it in 2007 ...

Obamacare: Clearing Away The Fog
Jacob S. Hacker
June 04, 2007

http://www.tompaine.com/articles/2007/06/04/obamacare_clearing_away_the_fog.php

:shrug:

[PHIMG]

25. And why is it a buy-in ?

And if it's a buy-in it had better be subsidized just like the private plans under the "Insurance Company Profit Preservation Act" of 2009.

Medicare should be for everyone and cover everything. Every American deserves Cadillac care.

One nation, one plan: MEDICARE.

[Oregone]

28. Because shifting more people on Medicare would increase payroll taxes

Buying in doesn't disrupt the current funding model for Medicare. EARLY rumors suggest that when the subsidies kick in, people can use them to pay for their buy-in. I think.

[PHIMG]

36. What's wrong with raising the payroll tax?

Give me medicare and raise my payroll tax...most people support this idea.

[Oregone]

38. Quite a bit if not everyone gets Medicare

This only allows 55 to 65 in additionally. If they aren't buying into Medicare, 90% of their health costs will be shifted on the workers to pay for it.

[maryf]

42. So lets give it †o Everyone!!

see my post above, please!

[Oregone]

43. Sure, with, eh, what Democratic Congress?

:)

[PHIMG]

46. The world does not revolve around *THIS* congress

I'm glad you weren't around to tell MLK that the currently sitting congress will never pass a civil rights act so don't bother to organize that boycott, sit in, or march on washington.

So sick of people pimping pessimism.

[maryf]

47. Make your congress work for you...

Use your voice, join the movement! PHIMG (public health insurance must go) is a great place to start (both the poster and the outfit). They have made a difference. Be part of the solution! Healthcare-Now is another great outfit. Physicians for a National Health Plan is a great site to learn! Lots more, Join us!!

[Oregone]

48. They work for money and bribes

They don't know I exist. Thats fine. Im all set for what I need without them now.

[maryf]

49. Make them know you...

Nancy Pelosi caved when there was a sit-in in her office because she wouldn't allow Weiner's amendment to be presented...She did fold later, but she was scared. Think of it, which has more power? 90 percent of the people, or 90 percent of the money??? The Bastille wasn't stormed with money...

And you're all set for now, what about nearly 50 million Americans??? or do you care? do you pass by the other side?

[Oregone]

51. Seriously, my situation sort of dictates I take an observer roll

:)

Without a clear moral conscious, I could not allow my children to be enlisted in this perpetual battle and have my tax monies diverted to buy bullets for war; the only clear solution was moving to a single-payer country that had significant social benefits and a high rate of intergenerational mobility. They don't know I exist, and thats fine with me now. Of course I care about people Ive left behind, but I care about the entire world. I'm in no more of a position now to do a sit-in in the US as I am to do a sit in over in Honduras.

This battle, I perceive, to be perpetual and un-ending. It serves some as gratification to participate, but I would only grow frustrated and feel guilty for not removing my children from the situation. I will still educate others, offer perspective, and learn myself, but thats all I got. Good luck

[maryf]

55. Thanks, education is critical...

any contribution is good, :)

[maryf]

37. Might increase payroll taxes, but

Medicare for all would reduce the amount of administrative costs by 400 billion a year, conservatively. It would also save on municipal costs (much cheaper to cover public municipal workers), public school costs, (thus reducing school taxes), and would remove health care from many unions' negotiations, thus allowing things like working conditions and salary to take precedence during contract negotiations. The cost would be an increase in the medicare tax all workers already pay, but the premiums many pay now are much higher than this increase, plus, no copays, no deductibles, no limits...and with HR676, you and your doctor decide, not the government, or, as with private insurance, someone who's main concern is profit, not your health.

[Oregone]

41. Of course it would, but this isn't Medicare for All...Its Medicare for a few more

And asking everyone to increase payroll taxes to cover another 10 years doesn't seem incredibly fair. I don't know.

Id rather see Medicare for all. Its not what is being discussed here though (and this may lead there one day)

[maryf]

44. Yes, yes, yes, Medicare for All

That is what hr676 is, Single payer Medicare for all! Healthcare for People not for profit!!!

[maryf]

35. I recommend this post, and your outfit!

Did you see this article today??? One of our major activists, and leading educators on single payer:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7187382

[LovinLife]

34. THis would be change I could believe in if they just allowed everyone who WANTED to buy into it.

That's a true public option. I don't get these people. This country is so screwed up.

[Garam_Masala]

50. I am on Medicare and the biggest problem I have is....

80% of doctors in my area do not accept new Medicare patients!
Probably this situation manifests in most communities.

The good thing is I have been with the same doctor's office for many years,
even before I went on Medicare so I am OK. I see my bills and am amazed
how much lower Medicare approved rates are over non-Medicare rates. I am
surprised the doctor has'nt kicked me out!

But we are due for a move in 18 months and then I will be faced
with the problem of finding a doctor of my liking within reasonable commuting distance.
With 40 Million more patients, I wonder if the situation could get worse.

[KrR]

57. So lets get rid of Medicare? Is that what you are saying? n/t

[Garam_Masala]

58. Did you even read my post?

I am just wondering if doctors are reluctant to accept
Medicare patients now, what happens when more millions are
made eligible? The HCR bill will need a clause to require
doctors to accept a certain percentage of Medicare patients
is what I was implying.

I love MY Medicare....I get to pay lower fees for medical
services than people under 65 age.

[Rosa Luxemburg]

52. Medicare for everyone!

except rich people that make millions

or the gov could take a wee bit out of our salaries