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With the individual mandate unpopular with even among the minority that actually favors the new health care law, it is no surprise that, according to the Politco Pulse, everyone in Washington is asking the American Academy of Actuaries about possible alternatives:
Members of the American Academy of Actuaries, in town for Hill and agency meetings, tell PULSE that one of the hottest questions they’ve gotten is what can be done if the individual mandate falls. The answer? “There’s no real silver bullet,” says Tom Wildsmith, the group’s vice president for health issues. But the alternative is likely a package of ideas: open enrollments, waiting periods and penalties for late enrollment, or perhaps only allowing non-covered persons to buy bronze plans, versus the gold plans.
To readers of FDL, most of these alternatives should sound familiar.
I do have two small issues with this blurb claiming there is “no silver bullet.” To begin with, the individual mandate in the new law isn’t actually a silver bullet to begin with. The CBO says it will increase overall coverage, but it will still leave us short of universal coverage. They project millions of people will still not buy coverage and just pay the mandate penalty.
There is a silver bullet: Single Payer
Single-payer health care–Medicare for all–actually is a “silver bullet” that would result in more people being covered than in any system relying on an individual mandate.
If people think full single payer is too radical and want to leave the new law relatively unchanged, you can create an extremely bare-bones public program where you automatically enroll anyone who does have other insurance. This “silver bullet” would also result in getting more people covered than a mandate to buy private insurance.
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Doctors, especially primary care doctors will not accept universal medicare. You will see a two tiered primary care system develop with universal medicare. The haves will pay for concierge primary medicical care. The have nots will have to see whoever is willing to accept medicare or continue to get periodic care at walkin clinics or ERs.
Their is already a growing number of top tier doctors that only accept cash and won’t accept any private or public insurance.
While some of that would happen it would be highly limited, in single payer countries the vast majority of doctors accept the single payer insurance, they couldn’t stay in business if they didn’t
Yeah well doctors tend to get paid less in other countries
http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/
Yeah, its basically forcing people to work for the government for lower pay.
Medicare has been functioning for over 40 years, most medical practices accept it now and will continue to accept it in the future. If primary care physicians reimbursement rates have to be raised, swell, then establish higher rates. No one is against those who provide healthcare being paid a fair price.
The issue is why should taxpayers allow private third party payers to take a share of healthcare spending when they provide no added value over and above what the Medicare system can provide itself.
Yeah, well, but, but most of those Drs. live in countries wherein they don’t have to pay for their children’s education and aren’t their retirement needs also taken care of. IOW, how much of what we have to pay for privately for some of the most important things in life are rights of citizenship to share in (they get much more vacation time, from what I’ve heard) in their part of the world?
Yes, and any increase in Medicare reimbursement rates would be more than offset by the savings in overhead and paperwork from eliminating the predatory private health insurance vampires.
There isn’t a free market in Medical Services and hasn’t been for generations. One of the reasons is that the AMA restricts the supply of Doctors through its influence on Medical School education. With supply restricted, higher Doctors fees have basically been forced on the rest of us by the AMA.
Now, why is it right to force all of us to pay much higher fees than we would otherwise have pay, but wrong for us to impose a Government that basically forces the Doctors to deal with a single-payer who will force them to redress the balance to the point where their income is comparable to the incomes that Doctors have in other nations?
Jon, since you (and I) think that Medicare for All is a “silver bullet” for our health care cost problems, will FDL now place it back on the table and begin advocating for it rather than the “public option”?