When social evolution goes astray very outlandish things occur. In this essay I would like to touch on one, the evolution of Medicare and why this has to do with anything.
Antagonists of this program claim that Medicare is a social one and therefore evil. Well, the only social aspect of Medicare is that premiums are subsidized by the US government.
First, Medicare is administered by the Social Security Administration. The SSA goes County by County across the country enlisting qualified private insurance companies to bid for the right to underwrite Medicare in that County. It is so amazing to hear candidates for the Presidency of the United States show complete ignorance about how Medicare even works. But it is even more absurd to hear their antagonists complain that these same candidates want the government to socialize health care. As I said, the only socialist aspect of Medicare is that premiums are subsidized.
When Medicare first began it was a terrible plan, severely flawed and subject to fraudulent claims. But over the years Medicare has evolved.
When Senator Bernie Sanders mentions the single-payer system what is he talking about? The CMS or Center for Medicare services is the single payer for Medicare.
I believe the CMS, I would have to check this, is a private organization hired by the Social Security Administration to pay as little as possible to only those service providers who deserve to be paid without losing good doctors who may opt not to provide services for Medicare. This is not socialism. It is a market driven system, capitalism it is sometimes referred to, to get more bang for the buck for the end insured.
Nor is it a way to cheat medical providers from getting their just due. It is more like game theory, as expounded by Dr. Nash who won the Nobel Prize for this work. When things are argued respectfully amongst opposing parties eventually a good solution will emerge, or things are said to just settle out. This is how the single provider system works. This dialectical process is how Congress is supposed to function this way, but it isn’t currently.
The single-payer system has evolved so well that private insurance companies, capitalists, want to use the CMS as the single-payer for the insurance that these private companies would love to sell. This is called a Medicare Advantage Plan. Those private insurance companies that underwrite Medicare in each County are allowed to offer their own Medicare Advantage insurance in lieu of standard Medicare. The stipulation is that this advantage plan must be at least as good as Medicare in every single respect.
The collaboration between private insurance companies and the CMS single payer system has improved access to Medical Advantage plans, providing excellent coverage. And all this without any additional cost. In fact, it is a no-brainer. Just as soon as one is eligible for Medicare, get that Advantage plan at the first open enrollment.
This all begs the question of what would happen if we expanded Medicare to cover everybody except that citizens under a certain age would have to pay the premium?
Well first, younger people do not get as sick as older people, nor do they get sick for such long durations as old people, and this would benefit the Medicare actuarial very well. Putting young people with old people under the same medical insurance is a synergy that private insurance companies would want to insure. However, such a plan would need to make that mandate that everyone must participate. The Supreme Court has already decided that it is constitutional to do so. Chief Justice Roberts stated that the universal mandate is permitted because it is tax. So granted there is an element of socialism here.
But what is socialism? If you believe that government is at least to some degree fiduciary to its citizens, then activity in such regard would be socialistic.
I do not want my government to bear all responsibility of taking care of me. BUT if the government can make it easier for me to afford the premium of a good medical plan, then I believe that’s exactly what the government should do!