Senate Democrats’ Moderate Compromise: Single-Payer Health Care
“To Get Conservative Democrats, We Have to Expand [Government-Run] Medicare…”
“The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”
— Washington Post editorial, December 10, 2009
While Democrats’ latest back-room deal is being reported as a moderate compromise, the amendment to legislation being considered in the Senate (H.R. 3590) would in reality represent a government takeover of health care of a larger magnitude than even most Democrats have previously contemplated:
- Although details of the secret agreement remain sketchy as Democrats continue their behind-the-scenes dealing, most press reports indicate that the “compromise” would allow individuals aged 55 to 64 to participate in the Medicare program. (Subsidy levels for such coverage, if any, have yet to be publicly disclosed.)
- First suggested by Howard Dean—a notable and early supporter of a European-style single-payer health plan—the Medicare buy-in has energized liberal advocates. For instance, Rep. Anthony Weiner observed the buy-in proposal “would be the largest expansion of Medicare in 44 years and would perhaps get us on the path to a single-payer model.” Brookings Institution analyst Henry Aaron noted that the proposal “changes the game completely…it would be far more significant, potentially, than the kinds of [government-run] public options that the two houses have been reduced to.”
- Conversely, organizations like the American Medical Association and American Hospital Association—which heretofore have demonstrated their fervent desire to enact Democrats’ government takeover of health care—oppose the buy-in proposal, on the grounds that Medicare already reimburses doctors and hospitals at below-market rates, and increasing its scope will exacerbate providers’ financial difficulties. For instance, an executive at the Mayo Clinic warned that the buy-in proposal would “push the best providers, hospitals, and physicians closer to the brink of financial ruin.”
- The Medicare buy-in language would resemble a “robust” government-run plan—which even House Democrats rejected before passing Speaker Pelosi’s government takeover of health care (H.R. 3962). The non-partisan Lewin Group found that a “robust” government-run plan would result in up to 114 million individuals losing their current insurance. The Lewin Group also found that such provisions—which link reimbursement to Medicare payment rates that are 20 percent below private payment levels—would result in a net decrease in physician reimbursement levels of $16,207 annually—even after accounting for additional revenue from the newly insured.
“The real problem with our long-term deficit actually has to do with our entitlement obligations…The big problem is Medicare, which is unsustainable.”
—President Obama, Interview with Washington Post editorial board, January 15, 2009
- The Democrat ideological fixation on expanding government-run health plans like Medicare overlooks the fact that according to the latest report issued by the program’s trustees, Medicare itself faces deficits of $37.8 trillion—nearly three times current GDP—over 75 years, and unfunded obligations of $88.9 trillion over the infinite horizon.
Given that numerous leading Democrats have claimed that the so-called “public option” would lead to single-payer health coverage—a system which President Obama himself has endorsed—is there any doubt that a Medicare buy-in mechanism would be used by liberals to ensure the creation of a government-run health plan? If President Obama is willing to ignore his previous comments about the “unsustainable” nature of the Medicare entitlement in order to support a Senate “compromise” that expands the program, is there any action Democrats will not take to expand government so that it consumes the entire health care sector?