I’m for Medicare for All, but not all at once. We should expand Medicare to cover all Americans. But we should do it in steps. Step one: cover the kids.
What is Medicare for All? When I talk about it, I mean the current Medicare system, expanded to cover everyone. People understand the current Medicare, and it was created by our last great President, a Texan. Senator Bernie Sanders (I voted for him and may again.) and some Democrats define Medicare for All to mean a fully comprehensive system that covers all necessary medical costs. That would be great, some day.
Back in 2010, when the so-called “tea party” Republicans were demonstrating against the Affordable Care Act, I went to my Congressman’s town hall meeting carrying a sign that I made. It said:
From my little home-made sign, the idea of expanding Medicare caught fire. (Well, okay, maybe that wasn’t the spark. But the idea did catch fire.)
Universal Medicare should be phased in for three reasons. First, there is not enough support, even in the Democratic Party, to get the expansion done in one time. Second, such a sweeping expansion would be a tremendous shock to the economy. Third, we don’t want another disastrous rollout like we had with Obamacare. The best way to expand Medicare substantially while establishing that it is going to be for everyone eventually, is to extend it to all children under 25.
Start with the kids
We should start with kids for several reasons. First, children are the most vulnerable population. Medicare, like Social Security, was established for the elderly because they are a vulnerable population. Children are also a vulnerable population. Second, covering children will take a lot of financial pressure off families. Third, we are already spending some of the money to cover children, so it’s not as big a budget stretch to bring them under Medicare.
We spend money covering kids now with a program called CHIP. It’s a very limited, means-tested program, so it’s inefficient and unfair. Let’s discontinue CHIP and bring the kids into a solid program.
Forget about expanding Obamacare (Pelosicare, anyone?). It’s a house built on sand. Let’s build our house on rock—Medicare.
The beauty is that, once we have covered both ends of the life span, we will have created a donut hole in the middle that obviously will be closed in time. Just as the donut hole in prescription drug coverage created by the Republicans was inevitably filled… What? The prescription drug donut hole hasn’t been filled? What’s the holdup?
Do you want to lock in the remaining expansion? Sure. Take it in two more steps. Cover 45 to 65 in the thirties. Then cover 25 to 45 in the forties. That’s soon enough to feel definite, but far enough out to feel non-threatening.
Maybe this is our only shot to expand Medicare in this generation. Let’s don’t blow it. Social Security was created in the thirties. Medicare was created in the sixties. If we get this expansion done in the twenties, we may be waiting another generation or two. Let’s make it the most important one.