The buy-in to Medicare will be very expensive considering how good of an insurance it is. From what I read, those planning to buy in would pay the full premium (a.k.a. without the government subsidizing it). Also the cut off for this will be 133% of the poverty level. Below that you get the subsidized plan starting in 2011 (costing you $95 a month as it is right now). If you are above that you will have to wait for the exchange and then pay the full price.

Here is an interesting tidbit on Medicare you don't hear talked about right now. This year seniors get not cost of living raise on Social Security, yet Medicare co-pays for drugs are going up. Right now it's $5/$10, but next year it will be $6/$10. That doesn't seem like a lot, but when you consider some seniors who take 15-20 drugs per month, then it adds up - especially when those people need every dollar to survive.

@Intoxination: Good points, Jamie. Wouldn't a Medicare-for-All single-payer approach have the same problems?

Keep in mind that this is the SENATE bill and this may be what is needed to get a bill voted on. It could change dramatically when it heads to the conference committee. The bill out of committee will need only 50 votes to pass the full Senate. There are enough people in the House who have pledged to not pass a bill without a public option if the Dems want to accomplish real reform, a PO will be included in the final bill.

Bob, this PO-replacement sounds very much like KerryCare to me. The plan that got Swiftboated in 2004 would supposedly have insured 9 million Americans.

I am hoping the House dems stand firm. Normally I would not be worried about this, but things aren't normal these days.

I don't get the "buy-in" part of Medicare buy-in. Everyone pays for Medicare coverage.

The future success of Medicare expansion will only be as good as the people that run it. Right now there is, of course, the usual fraud and waste. Just like with insurance plans.

The key is to get good managers and keep the lobbyists out of the process. The fund provided by premiums cannot be a trough for use by the providers. Over-testing, over-hospitalization, new equipment for every patient (no reuse), and extremely expensive whirling go-carts ("Scooter Store"). That sort of thing.

Medicare cannot be a "Cadillac Plan".

If this is as you describe it's definitely a step in the right direction! Perhaps a small step but better than nothing.

My best guess is that if this plan gets a fairly good rating from the CBO you'll see a badly needed final "push" from the White House.

@Intoxination: I just got done with the Medicare Part D shopping thing and my co-pays remained almost unchanged, but there's a $63.00 deductible this year that I didn't have last year. The premium for my current plan was nearly doubling but I found a different plan with a slightly lower monthly rate than what I'd paid this year.

So it's not total doom and gloom. There was no increase in Medicare Part B, but my Medigap plan is increasing about $14 a month. I'm sure glad I installed a new heating source last winter, it cut my natural gas usage by about 40%.

According to a CBO analysis of a similar Medicare buy-in for uninsured Americans between 62 and 64 — that group would have to pay a premium plus an administrative fee of 5 percent — “the annual premium for single coverage in 2011 would be about $7,600 (that figure includes the cost of Part D coverage).” The CBO assumed that the Medicare buy-in policy would increase outlays for Social Security retirement benefits “because the availability of the Medicare buy-in program would induce some people to retire sooner than they otherwise would have (because they would no longer need insurance from their employer).” Significantly, the buy-in could also extend the solvency of the Medicare trust fund by bringing in premium dollars from younger beneficiaries and reduce Medicare’s spending for those individuals after they turned 65.

The New ‘Public Option’ Compromise And How To Improve It

Hielo - those under 65 would not get a government subsidy to help pay the cost of Medicare. Therefore, the buy-in is they'd have to pay the full premium.

From what I can tell, there are fewer than ten Douchecrats in the party. So I'm optimistic that if the Senate can pass any kind of bill, there's hope that it can be fixed when merged with the House bill.

Which brings me to my next question. Who does the merging of the two bills?

Howard Dean says the deal needs improvement, particularly with subsidies for the Medicare buy-n, but overall it's a good plan.

@bob - yeah it would unless we do something to contain costs. It appears that through the entire healthcare debate, costs outside of insurance cos. has been overlooked. There was that "deal" with the WH and big pharma, but they showed their backstabbing natures in that by jacking the prices way up before they "cut" them for the deal. That and the fact that the U.S. pays 3-10 times as much per medication as other countries.

Of course pharma is only one portion of costs. Something else that has occurred is the outsourcing of hospital services. You might go to the local no-profit Catholic hospital, but there's a huge chance that things like simple things like blood work is outsourced to a private, for-profit company. Other things like X-Ray readings and MRIs are also common for this. Even here in Cincy, our big Catholic hospital group (Mercy) has outsourced their financial aide stuff to a private, for-profit corporation and people don't get the amount of help they once did.

Another cost that is really crap is the new reporting system doctors have to use. One of my good friends is a cardiologist and has his own practice. It isn't that big of a practice but he still had to fork out $30,000 for the software needed for the new reporting system. I have written similar systems for numerous clients, including the DOD and DOE and the price is never that much - and that's for single client usages. Think of the number of doctors offices around the country having to fork out this kind of money, and the doctors aren't making that much as it is.

If Congress could have come up with a way to reign in all these costs then we would most likely see the price of a single payer plan become a very minor issue. What amazes me is that Congress says they can force people to buy insurance because of the commerce clause of the Constitution, yet somehow they can't force the companies making tons of $$$ in profits per year from healthcare to reign in their costs.

So if Cody's link is correct, if you're 62 and have no medical insurance, you can buy into Medicare for $7600 annually & get no subsidies or tax credits to help pay for it & this is a good deal...how?? If they have an extra $633/mo lying around, chances are they can already afford insurance, so they're not eligible anyway.

something's wrong with this picture...

@ ceu

We are all thinking the same way. So is Howard Dean according to Cody's link.

Right now I have to be thinking about a perfect world with a Congress that was not infiltrated by greed and God and just general douchyness. They sit down and actually think. Suddenly, someone slaps his or her forehead and says "I've got it!. Let's offerMedicare to everybody so the bigger pool will make it affordable".

How can the process go forward without considering this obvious scenario?

Oh wait. The voters are stupid. The MSM knows this.

Are young people with almost no need for health insurance going to be forced to buy insurance?

Are pre-existing conditions going to be priced as if they don't exist for private insurance? Is rescission going to be outlawed for all private policies? Will pregnancy coverage stop being a rider and start becoming a standard provision of every state's policies? (There is your abortion coverage, Liberals)

Will smoking cessation and drug rehab services become a standard provision of all policies? Will ridiculously high deductible plans be outlawed? You know the kind, where the small business owner pays $12k a year premiums with a $5k deductible for husband, wife, and child?

Will small business owners get the same price breaks that large groups get? If we fuck this up for our small business owners, the American economy is fucked.

Is there some provision in the bill to at least try and limit medical malpractice suits? Doctors are human, too, and shouldn't be forced into bankruptcy because they made a mistake. Besides which, everybody pays for every malpractice suit in one way or another. It's time to see whether Democrats are willing to stand up to America's trial lawyers.

I am sure I have missed something important, but the point is this:

If the answer to any of these questions is "no", then this plan blows.

Hielo,
The voters are stupid and the politicians are corrupt. That's just the way it is. So unfortunately a plan like this is what we're left with. All things considered, it could be worse. And it has been worse. Like it or not, this is an improvement.

"We are all thinking the same way. So is Howard Dean according to Cody's link"

Should be "Matt's Link"

@ eljefejeff

Oh, I agree. I actually like the way things are going with HCR right now. We may get a way forward yet.

That doesn't stop me from just bullshitting about "what if?" type things.

Teh Rep. Weiner likes it.... http://is.gd/5h2wi

"So if Cody's link is correct, if you're 62 and have no medical insurance, you can buy into Medicare for $7600 annually & get no subsidies or tax credits to help pay for it & this is a good deal...how?? If they have an extra $633/mo lying around, chances are they can already afford insurance, so they're not eligible anyway."

I'm 57 and have no health problems and I cannot get health insurance that does everything that medicare does for that price. It would cost me far more than that. The health insurance I have covers very little (example - no doctor visits paid for) and I have a $10,000 deductible. Basically I have it in case husband or I have a heart attack or get cancer. BUT there is no assurance we won't be canceled if we do become ill.

ANOTHER important point is that lots of people over 55 can't get insurance at ANY price because no one will insure them. AT ANY PRICE.

So I think this is a great start at reform.

I would be thrilled just to know I cannot be canceled for needing my health insurance.

The thing is, tho, Eve, that you do have health insurance and even if it's expensive & sucky, you wouldn't be able to buy in to Medicare. The pieces I've read about it say "uninsured people between 55 & 65".
And it would be great for people like you who are getting reamed for insurance IF you could buy in. For the hypothetical me of a year ago, (if I didn't have insurance thru one of my employers which I didn't until last Feb) this plan would be awful - no way could I afford $7600 a year (even with 3 jobs) and if there were no tax credits or subsides?...forget it. I'd still be uninsured.

I could buy in. All I'd have to do to become uninsurable is drop my present coverage and get a prescription for anything. Zoloft for instance. I wouldn't be able to buy any insurance in my state if I am taking any kind of prescription medication.

And I do think we have a long way to go in making sure EVERYONE gets health coverage. But we have to at least start somewhere.

Even if I can buy in to medicare -- it won't be for 4 years. But I would rather start with some changes and then keep going. If we pass nothing if will be another 10 years before we do anything.

ALSO -- if the Senate passes a bill there is a chance that the reconciliation of the House and Senate version is even better than what either one of them passed.

ceu, eve: The way I'm hearing it, 55-64 would be able to buy into Medicare at $7600 starting in 2011. But once you get to 2014, they will be able to use the federal subsidy from the exchange to pay for/supplement their buy-in. (Assuming you meet the financial requirements.)

Overall, I hesitate to call this good news. Anything we like will probably be dropped before Noon.

Well then Bob, what else can we say??

This is excellent news for John McCain!

thanks, Bull