Arkansas Democrat-Gazette

Political win-win Medicare buy-in a good solution

- A.J. ZOLTEN A.J. Zolten, Ph.D., is a clinical neuropsych­ologist and a founder of Regnat Populus, a citizen’s action committee.

The end of the individual healthcare insurance mandate is in the cross-hairs of the new administra­tion and Congress.

Ending the Affordable Care Act or modifying it to remove the requiremen­t of individual insurance coverage will contribute to a health-care insurance market that is already spiraling downward with the exit of major private insurers. This could generate a health insurance “death spiral,” with more companies removing themselves from the market, resulting in higher individual costs, which results in fewer participan­ts, further resulting in even higher insurance costs.

The end game would be insurance rates well out of reach of individual­s, many of whom will be the small-business owners and people who have limited incomes.

It is time to revisit the option for a Medicare buy-in.

Allowing individual­s and small businesses to purchase health insurance through Medicare would solve many health-insurance industry problems. It will stabilize the health-care insurance market with an inclusion of the largest health-insurance provider in the U.S. to the market.

Medicare is well-positioned to provide this service, has already modeled costs for a buy-in, and inclusion of this option removes the profit motive from the market, which has been the main reason that private insurers have opted out. Medicare is accepted by more health-care providers and hospitals than any other insurance form, it has set standards for the reimbursem­ent level for care, and settling this issue would allow Congress to move on to more pressing issues like an infrastruc­ture jobs bill.

Health insurance is unlike other insurance policies like homeowner’s insurance and auto insurance. Whether it is a “right” for citizens or not, the availabili­ty of individual insurance is necessary for full participat­ion in today’s society.

Health insurance has its foundation in a shared pool of risk without a profit motive, which only entered the healthcare insurance market in the last 70 years. The profit motive has distorted the fundamenta­l nature of the industry to the point that it is no longer recognizab­le from a historical standpoint. Bringing an option like Medicare back into this market will bring health insurance closer to the original intent. Those who can afford better policies will still be free to purchase what they want. A Medicare buy-in will reset the standard for basic insurance coverage.

The hospital health-care industry is a foundation­al driver of the central Arkansas economy. Stabilizin­g health-care reimbursem­ent will allow large hospital operations to be able to plan their businesses better as the long-term reimbursem­ent issues will be a settled matter. Individual­s will be more secure in that they will have the insurance needed to continue to access the health care.

Thousands of small businesses on both sides of this issue, physicians and other health-care providers, as well as insurance policyhold­ers will benefit from this decision.

This would also be a political “win” for both sides of the political world; it is revenue-neutral, the idea has traditiona­lly been a Democratic proposal, and a pass by a Republican Congress can be seen as a compromise that is in the best interest of the people and an example of our government working together to solve one of the biggest problems we face in the near-term future.

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