Medicare II, a public entity, but with a whole new private new twist!

Healthcare: Towards a New, New Model


Submitted 2 years ago
Created by
Dave Celone

Why Not Use the Best of Medicare?

Healthcare. Single payer. Private insurers. Affordable Care Act (a/k/a Obamacare). Medicare for All.  Medicaid. HMO's. High Deductible Plans. Point of Service Plans. The list goes on. Can anyone make sense of it?  I can't. However, I do know some things: 1. the cost of healthcare is going through the roof, 2. the cost of healthcare insurance is skyrocketing, 3. my deductibles are also going up, and 4. there has to be a better way. We might need a national discussion. First, though, let's consider something new, just for openers.  Please poke holes in this newly proposed model in the comment section below. I'll read them.  All of them.

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Everyone I know who has Medicare loves it.  They tell me there are no forms to fill out, no payments to be made at the doctor's office, coverage is quite good, and they don't have to worry about the high costs of healthcare. Given this, let's consider Medicare as a healthcare insurer that seems to be doing things right for the end user -- that would be you and me, but only after we reach the age of 65 and have payed into the system through a payroll tax during our working lives.

Medicare also effectively negotiates prices with healthcare providers based on what it deems appropriate for various procedures, tests, and doctor visits. I also know my private healthcare insurance company won't negotiate on my behalf. All it does is pay a pre-set percentage of whatever my healthcare provider bills me, leaving the remainder for me to pay. My insurance company is NOT trying to help drive healthcare costs down. Medicare, on the other hand, does keep costs low by only paying a certain, predetermined amount for each procedure.  

Healthcare providers and insurance companies are large, powerful organizations. They control their own destinies by sheer force of size and the power they wield with politicians and private citizens. If increasing costs will help their bottom lines, thus pleasing stakeholders and shareholders, then costs will increase. If paying lower percentages of my healthcare bills, and yours, will ensure higher profits, then we'll all have to pay more. If increasing premiums and deductibles increase profitability, then increase they will as we continue to pay more. There aren't many governing forces in the marketplace today to prevent healthcare and healthcare insurance costs from climbing endlessly.

Now, let's think about Medicare in a new light. First, it works for the people 65 and older who use it.  Next, it's a large player in the world of healthcare in the U.S. In fact, it's the only effective 1,000 pound gorilla that's not private. It has strength and leverage in our healthcare market. Healthcare providers have little choice but to use set amounts Medicare has pre-defined for procedures and visits. In short, Medicare, with all its infrastructure, policies, and programs already in place today seems to work quite nicely for a subset of Americans. It pays the lowest prices for healthcare to providers. However, it's funded by payroll taxes, thus, it seem an unlikely player to win favor as a healthcare insurer most people would accept.  

BUT, consider this...What if we could access Medicare and its many good programs at any age less than 65, including its costing and pricing mechanisms, simply by paying Medicare premiums to insure us? This is not the "Medicare for All" program some politicians envision. It's a new, new Medicare model, re-envisioned as a player in the open marketplace. Let's call it Medicare II. Medicare II as a private insurer will then become a new market force that would compete with existing private insurance companies, and give us, the insured, another choice in the healthcare insurance marketplace.

My best guess is that, over time, Medicare II will be the lowest-cost insurer. People will prefer to use it rather than private insurers unless they also drive healthcare costs down by negotiating on our behalf with healthcare providers like Medicare already does quite effectively. Injecting a new, Medicare II option into the existing healthcare insurance marketplace will create needed competition from a public entity that already has its foot squarely set and plenty of success with those older than 65. It's a model of "public insurance," funded only if people choose it. Free market forces will govern this government program.

Medicare II, as a privately-funded mechanism to offer us healthcare insurance, in addition to remaining an insurance program as Medicare in its current form for those aged 65 or older, seems to me to be an excellent way to drive down healthcare costs with the kind of oversight only a 1,000 pound gorilla can deliver.

What's your reaction to this healthcare insurance proposal? What are your thoughts? Please add them to the Comments section below.

For my earlier article on rising healthcare costs, "An Rx for Healthcare's Fix: Us!" published here on the dailyuv.com, please see:  https://dailyuv.com/news/865825 for a bit more background on how healthcare costs are spiraling out of control without any governing mechanisms to prevent their alarming rise.

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Dave Celone is NOT this bouquet of hand-made ceramic hearts by Anna Hranovska Vincelette of White River Junction, VT. Your Valentine will absolutely love one or more of these beautifully imagined and sculpted pendants as a gift. They're available at Long River Gallery & Gifts in Lyme, NH and in White River Junction, VT.

Instead, Dave's a writer who likes to share information about his life in the Upper Valley on a host of topics ranging from food and beverage, to art and craft, to politics, healthcare, humor, history, music, and even wood stoves! Dave is a freelance writer, poet, visual artist, art gallery curator, and consultant for the education industry. He co-manages Long River Gallery & Gifts in Lyme, NH and its new gallery space in White River Junction, VT with his wife Lisa, where over 175 local artists and artisans now show their work. The new gallery is at 49 South Main Street in White River Junction between The Junction Frame Shop and The Hotel Coolidge, on the same side of the street as Newberry Market. Dave is also principal of Advancement Consulting Services offering higher education institutions and private secondary schools global best practices and unique ways to increase alumni giving and involvement through programs that develop relationships and value holistically. His "virtuous circle" model on developing fundraising programs, and his strategic program development centered around "treating students like alumnae/i and alumnae/i like students" have gained favor among development industry professionals and higher education leadership on multiple continents. Dave is former director of development at The Tuck School of Business at Dartmouth College in Hanover, NH, and former co-executive director of the Dartmouth College Fund. He may be reached via email at: djcelone@gmail.com. Please feel free to add your comments below. Dave will read them and respond appropriately.

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