Rather than proposing some unknown public health care option, Obama should have offered the opportunity to sign up for Medicare to anyone who wanted it.
Here's some commentary.
Medicare, most opinion surveys show, is either the most popular government program or close to it.
It's easy to criticize an unknown unformed possible plan as the Devil, it's hard to criticize a popular program or to say it's okay for me, but you don't deserve it.
Go into any doctor's office, and you will see at least one person, usually several more, who spend their days on the phone arguing with private insurance companies about covering claims and procedures. Medicare works like an indemnity program. If the doctor-or other health care provider-prescribes a procedure, it Medicare will pay for it. When it comes to dealing with Medicare, most health care providers, myself included, find it no muss, no fuss. We submit a claim and it's paid.
There are no panels or networks. If you are a licensed health care professional, you're in.
Many people have signed up for what are called private Medicare carve out plans. These plans offer more benefits than Medicare alone. But they also offer more aggravation and are a mistake, as far as I'm concerned. In the carve out plans, you have panels and networks and clerks deciding which procedures will be covered.
And they are not all covered. In my experience, in my state of Connecticut, for example, if I see a resident of a nursing home with Medicare, no problem. But if I want to see a person with one of the Medicare carve-out plans, there's inordinate paperwork and delay before they might approve the service. My company has decided it's not worth the trouble, and there's more than enough Medicare and Medicare patients to go around. The decision was made above my pay grade, but it's effect: If you don't have Medicare, then no psychologists for you.
So think before you sign up for a Medicare alternative.
Among my fellow providers, the main complaint about Medicare is that because of its economy of scale, i.e., its huge buying volume, it can negotiate (dictate, some would call it) reimbursements that are lower than offered by private insurance. In other words, it's less expensive than private insurance from which a proportion of your money goes to stockholders. With Medicare, there are no stockholders, so it just pays out the discounted amount-take it or leave it. Most providers decide to take it because they realize it's a huge source of income, even at the so-called discounted rate.
Some people say that Medicare is broken because down the road the money we pay in will not equal the money it pays out. There's an easy answer for that. We should pay in more money. It's easy to be against higher taxes, but people don't see paying higher insurance premiums as de facto higher taxes. If everyone were in Medicare-those who would use it often, and those who would seldom use it-it would be quite solvent.
But something rational like a single payer system, which socializes insurance but not the medical industry-is far too rational for our country in which the survey says only 15 percent of us believe in evolution.
It would have been better for Obama simply to have proposed that Medicare would be available for anyone who wanted it. All the folks who are attacking an unknown public option would have been put in the position of attacking Medicare, the preeminently popular government program-saying, in effect, "It's good enough for Grandma, but not her grandson."
Instead he has proposed the devil we don't know, and who doesn't want to criticize that?
I'm afraid we will get a system that will simply put more money in the pockets of the insurance companies, with no public option to rain on theirmoney parade.
Or as H.L. Mencken said, "Democracy is the theory that the common people know what they want, and deserve to get it good and hard."
Not that I'm against democracy. I'd just like it to be composed of citizens who believed in evolution. But that would require a public option, namely, a good, strong public education. A public education system in which the same people who say, "Keep the government off my Medicare," won't be insisting that intelligent design, is a scientific theory on an equal footing with an actual scientific theory, natural selection.
Keep your hands off my science.
When I'm feeling Menckensian, I'm happy there is the consolation of science-where it's not a democracy, nothing is a matter of opinion, and nobody votes.
