Undernews is the online report of the Progressive Review, edited by Sam Smith, who covered Washington during all or part of one quarter of America's presidencies and edited alternative journals since 1964. The Review has been on the web since 1995. See main page for full contents

August 28, 2009


Marshall Auerbach, Counterpunch - Since its inception in 1965, Medicare has covered almost all citizens over age 65, and it is one of the most popular government programs existing today. Individual state-managed health programs with low reimbursement to caregivers cover additionally most children with congenital malformations and children with many other disorders. For low-income families, the combined federal and state-managed Medicaid program is available for the majority of medical disorders that are not primarily cosmetic. Why not expand its role to incorporate citizens not covered in any of the existing private health insurance plans? Why not, in fact, allow Medicare to compete against private health insurance companies in order to keep them honest?. . .

Few Americans rail against Medicare or characterize it as a nefarious "socialistic" takeover of the health care system. As a program, it has great political legitimacy and is as strongly entrenched in the American political landscape as our Social Security system. . .

Today, 43 million of Americans are covered by the program, yet seldom does one hear a senior citizen complain about struggling under the burden of "socialistic health care". . . . At 4% per annum its administrative costs less than half of most private insurance companies and polls consistently show very high satisfaction among its participants. . .

Most advanced countries have dealt with the defects of private health insurance in a straightforward way, by making health insurance a government service. Through Medicare, the United States has in effect done the same thing for its seniors. There are a number of incrementalist ways this could be expanded . . . One suggestion by Rick Fonkalsrud, M.D., and economist Michael Intriligator of UCLA proposes "Medicare Expansion," would build a national care system by expanding on the existing Medicare program for citizens over the age of 65 years, with a gradual phasing out of the very uneven and underfunded state-administered Medicaid programs:

"The first step in the Medicare Expansion program would be to enroll children under 5 years of age, pregnant women and those with lifelong illnesses by the end of 2010. The remainder of the population would be phased in gradually, taking the most needy age groups first, until all persons are covered within five years. In 2011, those between 55 and 65 would be enrolled, and in 2012 those from 5 to 15 and those from 45 to 55 would be included. Those between 15 and 25 as well as those from 40 to 45 would be added in 2013. Finally, by the end of 2014, by adding the remaining population between 25 and 40 the entire U.S. population would be covered: There would be Medicare for all in a single-payer system. There would be no limitations based on pre-existing conditions, as is common in private insurance plans."


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