Is the answer Medicare?

Congressman [Tom] Garrett’s suggestion that 70 year old men should be able to buy health insurance without maternal care coverage missed the whole point of insurance being based on pooling risks across large populations. Should women be able to get health insurance that does not cover erectile dysfunction treatment or prostate cancer? Risk pools across all health conditions reduce overall costs for the participants. Besides, 70 year old men don’t need private insurance — they have Medicare which covers all conditions, male and female, for its served population.

Mr. Garrett’s assertion that “we need to have a safety net because this is America and you shouldn’t be this prosperous and have people slip into the cracks” is highly laudable .

. . but just rhetoric unless you have a viable plan for achieving that. One thing he proposes is to “syllogize the high risk pool” (I think he means split out from the rest) for government subsidies. Again, this means tinkering with the concept of large risk pools where the rest of us who are healthier should not pay into insurance that covers those who are not. What happens when we get less healthy? Or when someone in the healthy risk pool gets really sick? In any case, you then put the government in the position of deciding whom to subsidize and whom not to.

We do have a plan in this country that does not parse out less and more healthy, a plan where folks who make more money pay more and folks who make less money pay less. Of all the segments of our healthcare landscape, it has had over the last twenty years the smallest cost increases and the largest improvement in health outcomes. Hospitals, drug companies, doctors and device makers all profit quite nicely from it. It is called Medicare. Maybe we should address Mr. Garrett’s laudable goal by extending that plan to more people?