PROPOSAL IN BRIEF:

Enroll all eligible Americans under the age of 65 in the existing Medicare program but with high deductibles ($10,000-$20,000). Individuals may opt to:

1. Self-insure up to the national deductible amount

2. Purchase private insurance to cover costs up to when Medicare would be the insurer or  

3. Receive vouchers for the equivalent Medicare high deductible value to purchase comprehensive private insurance and/or enroll in a health maintenance organization (HMO) providing comprehensive care.

BENEFITS:

1. Preserves Medicare’s solvency by enrolling healthier and younger individuals.

2. Removes excess financial burden on employers who currently pay higher premiums with less coverage for their employees.  Removes incentives for employers to hire part time employees rather than full time employees in order to avoid providing mandated employer sponsored health coverage.

3. No need for mandated insurance coverage and no penalties for not purchasing insurance.  Coverage for major medical problems would be guaranteed, and more common, but less expensive medical care can be covered by private insurance or at the individual’s expense.

4. No exclusion for pre-existing problems after initial Medicare deductible has been met for those not choosing to purchase private insurance.

5. Provides a role for private insurance companies to provide coverage up to the national catastrophic deductible amount with limits on their exposure or to provide comprehensive coverage through vouchers similar to the current Medicare Advantage programs.

6. Reduces financial burden on state Medicaid budgets but allows flexibility to use vouchers for comprehensive coverage or provide first dollar coverage prior to Medicare deductible being met.

7. Eliminates cost shifting by hospitals which currently provide uncompensated care at the expense of those with ability to pay.

8. No need for thousands of pages of new rules and regulations regarding coverage since  Medicare already has existing rules in place.

9. Politically feasible since coverage is flexible, allows patients to chose the medical providers of their choice, provides a role for private/commercial insurance companies, and reduces financial burdens on businesses and state budgets.  Existing taxing structure to fund coverage is already in place.

10. No new taxes though Medicare taxes would go up. Medicare taxes are currently paid by younger working individuals who may otherwise not have any benefit in the future for the taxes they are currently paying. They now would have the safety net of coverage for major medical problems or pay less for first dollar coverage by private insurance com.