I have become intrigued with a talking point or framework that has cropped up recently, namely, the notion that we should pass something related to healthcare reform so we have a bill. Once we have a bill, then at some time in the future, we can ‘fix’ that bill, make it better, improve it.
That makes a lot of sense to me. Except for one bit.
We already have a major insurance bill. In fact, some of us have been proposing that we improve that bill from the beginning. It’s a bill that’s been worked on, improved, amended, updated, and otherwise ‘fixed’ for almost three quarters of a century.
What is this magical bill?
It’s what we call the Social Security Act.
Tonight, I’m not going to address a detailed policy analysis. I understand there is much specific work to do in drafting the language of legislation.
I just want to point out that fixing a bill is precisely the framework I advocate. We don’t need another bill to fix. Let’s work on one we’ve got.
There are two main ways to ‘fix’ Social Security with regards to health insurance.
One approach is the ‘Medicare for all’ kind of strategy. Change Title XVIII to cover all Americans. I mean, if we want simple, if we want easy to explain, if we want easy to sell politically, it’s hard to beat that.
A second approach, which I personally advocate, is being a little more bold. It’s to suggest that we create another insurance product line within SSA. We can call it a Health Insurance trust fund, just like the Old Age and Survivors Insurance (OASI) trust fund and the Disability Insurance (DI) trust fund (often combined to ‘OASDI’). This trust fund, rather than being Medicare for All, would replace the whole Medicare/Medicaid/SCHIP/Hospital Insurance trust fund system. This, in short, is a single payer system; private healthcare providers streamlining all billings through one government insurance agency, SSA.
The Social Security Administration is the most efficient insurance provider in the country. It already provides multiple product lines to millions of Americans.
Let’s improve that Act by using it to cover the physical and mental healthcare needs of all Americans.
Crossposted at Daily Kos.