Legal Commentary

Divvying Up the Catfood

By Big Tent Democrat

In a purely Ivory Tower sense, I thought this was an interesting exchange between Yglesias and Atrios. Yglesias initially posited:

Traditionally raising the Medicare eligibility age more than a teensy bit would be unthinkable, since absent Medicare an elderly person would be totally uninsurable. But under ACA that’s not the case. Of course subsidies will be needed for most retirees, but a workable highly progressive system would be in place to ensure that nobody has to go without access to health coverage.

The "workable highly progressive system" Yglesias is talking about are the vaunted exchanges. Representing those of us who disagree with the idea that the exchanges are a "workable highly progressive system" was Atrios:

Saying that "the Affordable Care Act haven’t really sunk in yet" is another way of saying that the assumptions used to calculate cost savings to the government of increasing the Medicare eligibility age are quite wrong. Shifting old people out of an efficient insurance provider into an inefficient one that they pay for with government subsidies isn't sound policy.

Synthesizing these two strands, Yglesias has an update (I do not know if it came after Atrios' post):

Thinking harder about this, the real cost-saver is a twofer. You add a public option with Medicare payment to the ACA exchanges and you raise the Medicare eligibility threshold. Basically we'd transition over time from a single-payer system for seniors and a crap for non-seniors, to a means-tested single-payer system for everyone.

(Emphasis supplied.) Now this is not an original idea. In fact, it was in essence, THE original Hacker idea as I understood it, but expressly using Medicare as opposed to a new public insurance program. And I still like it.

Of course no one in the Beltway will ever agree to this, but it was an interesting exchange nonetheless.

Speaking for me only

Full post as published by TalkLeft on November 15, 2010 (boomark / email).