Jay Ackroyd laughs when I state that there is serious path dependency issues on transitioning the US health finance and health care providing systems from the current set of kludges that are based on heavy but hidden governmental involvement in both for most working age adults, and then single payer systems for the elderly, the disabled and the poor.
He thinks that path dependency can be waived away by changing the eligibility age for Medicare.
The US has a single payer system in place already. Just change the Medicare eligibility age. Set premiums. Compete!
If my memory serves me correctly, there was a recent proposal to do just that and it failed.
The group of 10 senators put forward a plan to set aside the public option in favor creating at least two national health plans modeled after those offered to federal workers and allowing some people to buy coverage through Medicare beginning at age 55.
Mr. Lieberman had supported the Medicare buy-in proposal in the past — both as the Democrats’ vice presidential nominee in 2000 and in more recent discussions about the health care system. In an interview this year, he reiterated his support for the concept.
But in the interview, Mr. Lieberman said that he grew apprehensive when a formal proposal began to take shape. He said he worried that the program would lead to financial trouble and contribute to the instability of the existing Medicare program.
And he said he was particularly troubled by the overly enthusiastic reaction to the proposal by some liberals, including Representative Anthony Weiner, Democrat of New York, who champions a fully government-run health care system….
Yes, I believe Jay will agree with me that Sen. Lieberman is a douchnozzle extraordinaire, but he was not and is not categorically unique within any Democratic caucus of the past thirty years, nor is his behavioral pattern and being in-hoc to insurance and other FIRE interests unique to Democrats who represent certain states and are sponsored by certain groups.
The minimal coalition for single payer or even a break-even self-funding Medicare buy-in proposal is 218 Democratic representatives, a Democratic vice president, a friendly Senate parliamentarian and 50 Democrats. All of the Democrats who would need to vote yes need not to be scared of being defeated by a combination of Tea baggers, insurance industry flacks and hacks and Wall Street cash.
The actual probable minimal coalition is 230 or so Democrats in the House willing to vote yes, sixty Democratic senators, and five Supreme Court justices who don’t want to invent new legal doctrine for shits and giggles.
Again, in an ideal world, a Medicare buy-in at 55 or even better, full Medicare expansion to 55 would be a significant improvement over putting the 55 to 64.999 age cohort on exchanges. But just believing that there is an easy way to get there is Green Lanternism or belief in the power of the Bully Pulpit ™.