The Washington Post‘s editors argue that Harry Reid’s “11th hour compromise” is actually a very old idea going back decades and “a far more dramatic step toward a single-payer system than lawmakers on either side realize.” Actually, I think Senate leaders on one side realize exactly what is afoot here and are daring moderates and conservatives in their party to cry foul. There is plenty to cry foul about. The editors reel off a list of queries and issues:
Currently, Medicare benefits are less generous in significant ways than the plans to be offered on the [bill's planned insurance] exchanges. For instance, there is no cap on out-of-pocket expenses. So would near-seniors who buy in to Medicare get Medicare-level benefits? If so, who would tend to purchase that coverage? Sicker near-seniors might be better off purchasing private insurance on the an exchange. But the educated guessing — and that’s a generous description — is that sicker near-seniors might tend to place more trust in a government-run program; they might assume, with good reason, that the government will be more accommodating in approving treatments, and they might flock to Medicare. That would raise premium costs and, correspondingly, the pressure to dip into federal funds for extra help. …
Will providers cut costs — or will they shift them to private insurers, driving up premiums? Will they stop taking Medicare patients or go to Congress demanding higher rates? Once 55-year-olds are in, they are not likely to be kicked out, and the pressure will be on to expand the program to make more people eligible.
Reid and the White House, in the guise of taking out the public option to allay centrists’ concerns, are setting up a financially reckless but very obvious gateway to a single-payer system. The purported moderate and conservative Democratic senators who objected to the public option because it would crowd out private insurers, do nothing to reduce costs, and insert the heavy hand of government into personal medical decisions should be doubly alarmed by this scheme. We’re going to herd millions of new, more sickly patients into a system that’s already facing financial strain — and then cut hundreds of billions in funding from that same system. Whoever thinks this can be done without severely impacting care and/or knocking a jumbo hole in the deficit raise your hand. No hands, I see.
Yes, it’s actually a worse plan than PelosiCare. That’s why Reid is so desperate to do this very, very fast. If it took only a day for the Post to figure this out, the rest of the Senate will certainly clue in by the end of the month. And once they do, it will become increasingly hard for conscientious senators to go along with this spasm of irresponsibility.