Liberal Leader Backs Health Deal

Expanding Medicare enrollment has its consequences. It can be viewed as a "public option". Increasing Medicare's enrollment with a younger population, on its face, would have a favorable underwriting impact on an unsustainable Medicare program. It allows more people to have access to deeply discounted provider prices (at someone else's expense); it provides seamless access to public subsidy of underwriting losses; it positions policy makers with the ability to price according to personal income (similar to Medicare Part B), or political whim independent of cost; and to ration services at some point. Whether I am responsible or totally irresponsible will have no bearing on my economic interests. The new Medicare can take "all comers" at anytime because deficits do not matter and ultimately will be fixed by either subsidy from some other public sector's interests or higher out of pockets charged to everyone. The policy maker's threat will be "pay our price now" or face egregious penalties later. Private insurance will suffer a premium tax to subsidize the public sector, regulated benefit obligations, and an expectation to be the source of necessary profit to keep providers in business. The new expanded Medicare program will be more politically powerful and unassailable than the current program. The "centrist authority" governing Medicare will be unable or unwilling to cut its costs unless it has a vehicle to shift those costs to a declining alternative source of funding. There will be a "new game in town". The "solution" will be rationalized as "very popular".

Will be interesting how the next generation manages this "inheritance".