Monday, December 7, 2009

The Best of A Bunch of Bad Options

As the Public Option continues to decay in the Senate, I think my preferred alternative would be a triggered public option, with most of the parameters written by mainstream Democrats. But Chris Bowers tells me that ain't gonna happen. So now it looks like folks are dusting off the idea of letting those near retirement age buy into Medicare. This idea, which has been kicking around since at least the Clinton administration, is better than almost anything else being discussed on both politics and policy. After all Republicans have spent the last week claiming to be the champions of Medicare by fighting to preserve every dollar spent on Medicare, showing reckless disregard for the program's solvency and no particular interest in trying to find savings that won't have an impact on health outcomes. I'd love to see the press conference where Mitch McConnell tries to explain why he doesn't want younger than 65 to have access to this lovely government program.

The alternatives are just grim. We're down to some strange idea of a plan being run by the Office of Personnel Management. Except it wouldn't be administered by the government in any real way; it would just be outsourced to a non-profit or a collection of non-profits. It's totally unclear that this would accomplish anything as a cost control measure; it wouldn't do much to improve Americans' confidence in government action; and it would insure even fewer people than the other crippled public option compromises on the table. The trigger alternative, as Bowers suggests, won't lead to a particularly robust public option. But Medicare is a program people like. Giving the people more of it seems worthwhile.
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