Conservatives Want To Raise the Medicare Eligibility Threshold To Make It Easier To End Medicare

[eridani]

http://www.slate.com/blogs/moneybox/2012/12/12/medicare_eligibility_age_conservatives_want_to_raise_it_in_order_to_make.html

Something that's been puzzling me about the debate over raising the Medicare eligibility age is whether this is something conservatives even really want to do. It's a pretty terrible idea on the merits and my understanding of the conservative position on Medicare is that the program needs "structural reforms" (i.e., privatization) not a minor tweak in the number of people who qualify for it. But Peter Suderman at Reason has a good account of why conservatives might think a minor tweak in the number of people who qualify for Medicare is a helpful step on the road to privatization:

The most important likely effect is political. Reforming Medicare is difficult in part because of resistance by beneficiaries, who hold a lot of political influence; indeed, the fact that some beneficiaries might have to pay more for their insurance (CBO estimates that nearly all would still end up insured) is the primary argument cited by opponents of raising the eligibility age object to the change. That people who benefit from a program like it and/or get financial rewards from it, however, is not much of an argument for refusing to accept reforms, especially with an obviously unsustainable entitlement like Medicare. Diminishing the size of the beneficiary class is likely to diminish resistance to further change, and while it's not enough, it might ultimately make reform easier.

Basically the idea is that if we reduce the number of people who get Medicare we leave the remaining Medicare with a smaller coalition behind it. Basically you've got a new version of Newt Gingrich's old concept that instead of repealing Medicare outright you create a situation in which "it's going to wither on the vine" and die.

[exboyfil]

1. One way to think about this

Germany spends 12% of GDP on healthcare. The U.S. spends 18%. Virtually of Germany could be considered a single payer public system. The public portion of our system pays 50% through a variety of funding vehicles including Medicare withholding, Medicare premiums, federal worker and retiree payment of premiums, general tax revenue (state and federal), and borrowing. So right now if our costs equalled Germany we would be sitting at 9% of public sector payments for healthcare without a dollar more in additional revenue (still have to address the borrowing though). Most private company provided healthplans are subsidized by the tax code. How much additional revenue would that represent? Could we get to a 8%/8% of all income to support a single payer system? Would employers be willing to pass along the savings from not providing healthcare to their employees?

Germany is at 15% approximately split between employer and employee.

[eridani]

2. I'd call Germany more of a single buyer system--and that has all the benefits of single payer

In single payer (monopoly), the government is the sole payer. With single buyer (monopsomy), the government does a large share of the buying, and thus sets the prices for every other buyer.