Medicare for All 64-Year-Olds

Dean BakerDean Baker is one of my heroes. There are lots of smart economists in the world. A small number of them seem to care about humans. And of them, I only know of one who is really creative. So unlike the vast majority of those in that defiled profession who are only good for telling us what won’t work, Baker is forever coming up with clever policy ideas to improve society.

About a month ago on his Patreon feed, he published a remarkable article, Medicare for All 64-Year-Olds. (The article is now public but you should really consider ponying up a buck or five to support him.) In it, he presents a simple idea to implement Medicare for All.

Full Medicare for All Is a Heavy Lift

As much as I support Medicare for All, I don’t hold out any chance of us getting the policy implemented any time soon. Even if Bernie Sanders becomes president and we have majorities in both houses of Congress and we get rid of the filibuster, there are far too many Blue Dog Democrats to get it passed.

And I’m not sure it is best to do all at once. There will be disruption and conservatives will push the narrative that it isn’t just a temporary problem but one central to “socialized medicine.” And the media will report it like it is a fact. And single-payer will be off the table for a couple more generations.

Expand Medicare Eligibility by One Year

“That gives us a total tab of $13.8 billion, less than 0.3 percent of total spending, or roughly the amount the Pentagon spends in a week.” –Dean Baker

Dean Baker’s idea is also really simple: let’s slowly increase who qualifies for Medicare. Right now you have to be 65-years-old. Baker says, “Let’s reduce it to 64.”

And he runs the numbers. He notes that the headline price for Medicare for All will freak people out. And it really doesn’t matter that people will save more by not having to pay for insurance. People don’t think in this way.

But decreasing the qualifying age for Medicare would be cheap with the “total tab of $13.8 billion, less than 0.3 percent of total spending, or roughly the amount the Pentagon spends in a week. It would be pretty hard to argue that this is not an affordable tab.”

Given that these are people already in the process of retiring, the change should not be difficult. And it would serve as a proof of concept. It would make lowering the Medicare age requirement again that much easier. We might even be able to jump to Medicare for 60-year-olds.

I’m not being glib when I say that I am ready for the revolution today. But since I don’t think the American people are anywhere near revolution, I think it is best to make whatever changes we can that help people today.

It’s possible that we will get Medicare for All right away. But it seems unlikely, given the makeup of the Democratic Party. Dean Baker’s idea not only provides millions of people with tangible benefits, it sets in motion a process that could lead to full Medicare for All in a relatively short period of time.

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About Frank Moraes

Frank Moraes is a freelance writer and editor online and in print. He is educated as a scientist with a PhD in Atmospheric Physics. He has worked in climate science, remote sensing, throughout the computer industry, and as a college physics instructor. Find out more at About Frank Moraes.

17 thoughts on “Medicare for All 64-Year-Olds

  1. Robert Reich is pretty good with ideas to improve society, too. He’s never been a professional economist, but he does understand how economies work better than many of the pros.

    The best thing about Baker’s ideas is they’re all quite easily doable. Converting to green energy is doable and necessary but won’t be easy. Changing patent law? We could do it tomorrow.

    • Reich does have a lot of good ideas — or popularizes a lot of them. But as you note: he isn’t an economist.

      Baker cares about making the world a better place. Someone in the comments said that he was not for increases in taxes. That person clearly hasn’t read much of him. For one thing, he’s been pushing for increasing the payroll tax cap long before anyone else was talking about it.

  2. This is a deeply stupid notion for a whole raft of reasons, some of which can be found in the comments appended to Baker’s article. Like Obamacare, it’s just the sort of scheme one would expect from someone educated as a mainstream economist. Politics is not really driven by macro-economic numbers and accepting that every issue should be reduced to fit right-wing framing like “balanced budgets” and “market-driven solutions” is a large part of how we wound up here. The US should have had a universal healthcare system over a half century ago, but repeated failure never seems to affect some people’s abiding faith in incrementalism.

    • My mom died because of lack of access to health care, so this is pretty much the issue I care about most. Others will have theirs.

      It was quite predictable that the Affordable Care Act would not reduce insurance premiums (it would slow how fast they rose) and that Republicans would launch onto expensive experience premiums as another example of “big government can’t do anything right!” And it would backfire politically, with gigantic consequences. That was not hard to see coming. Except for corporate Democrats, it would appear.

      • So you care about improving the lives of the poor? How does that bring on the glorious revolution?!

        Don’t you know that Obamacare has only hurt the nation’s poor?! If I didn’t now have access to healthcare I’d be on the street dismantling the corporate state!

        Curse you, Obama!

        • This is literally every comment on TruthDig. I still read Chris Hedges, Robert Scheer, and especially Danny Sjursen’s ongoing American history posts (he started before European invasion; he’s all the way up to Vietnam, now, it’ll be a great book when it’s done). But I’ve learned not to read the comments on any of them.

          • Yeah, as you can tell, I’m kind of tired. I try to remain optimistic. I’ve been very happy that so many Democrats are getting onboard for Medicare for All. But I’ve never thought it was a political possibility. I have too much experience with our political system to be optimistic. So when Baker came up with this idea, I suddenly thought it was a possibility. It’s a way of circumventing Americans’ committed ignorance and fear of change. One of the comments on his public post was that we should shoot for 60 rather than 64. That’s probably a better idea.

            But in a broader sense, I’m not that interested in talking in terms of massive changes. I’m glad there are people who do it. I very much want to be proven to be an old pessimistic man. And if there is any light, I’m there. But none of it is going to stop me from pushing marginal change. And I certainly don’t think marginal change inhibits major change.

            • I didn’t take your comment as tired or angry. Key & Peele, right? This is a discussion, and different people can respectfully have different viewpoints. Ideally, that’s how this whole representative democracy thing should work.

              I was always torn on the ACA. I knew it would provide health care to people without employer-provided insurance, like yourself, and that would diminish suffering and unnecessarily early death.

              I also knew it wouldn’t solve the problem of premiums being ridiculously expensive and Republicans would use this to be evil, because that’s how they operate.

              What can you do? If you call for a plan that’s better, and you make Republicans vote against it, you show voters who those assholes are. Meanwhile, people suffer and die. If you do the incremental plan, you alleviate human misery and give Republicans ammo to say “gummint can’t fix anything.”

              I don’t know what the best path should have been. I do know it wasn’t the Bill Clinton hot fucking unholy mess of a plan. That garbage set us back 20 years on this shit. Everything Clinton did set us back 20 years on everything. At least Obama moved us a smidge forward. Could have done more, but at least didn’t move us back.

              • If Republicans hadn’t been quite so incompetent, they would have succeeded at dismantling Obamacare and there would not be any choice but to get single payer. Of course, if Republicans hadn’t be so incompetent, they would have embraced Obamacare for the “free”-market healthcare reform that it was.

                I’m not sure we can blame Clinton on that one. Hillarycare was probably the best thing of his administration. And it was more liberal and expansive than Obamacare. It was never going to fly with the Republicans. But having HRC be behind it certainly doomed it because the Republicans were and still are totally irrational about her.

    • I don’t see how it is muddled nor do I see what your problem is other than that you’d rather have M4A complete now. So would I! I just don’t think there is any way we are going to get that with the Democratic Party as it is now constituted. After the Blue Dogs destroys any hope of full implementation, will it then be okay to implement it year by year?

      As usual, I find your all-or-nothing approach to these things wrong. It’s what’s brought us a conservative federal judiciary for the next generation. I am, however, curious to know how Baker’s idea is “deeply stupid.” I didn’t think the comments were compelling. The main argument is that this makes the program complicated. That’s right up there with “Obamacare is 10,000 pages!” and “I’m for small government!” The truth is that most universal healthcare systems are some kind of pathwork. So I really do want to hear the raft of reasons this is deeply stupid.

      • And reducing Medicare eligibility one year at a time would give insurance companies time to adjust (not like I give a fart if they all go broke immediately, I hate these companies, but reality is they have considerable pull). Let them branch out into other fields of ripping people off. My first guess would be bail bonding, that’s morally right in their wheelhouse. That or debt collection, they already do this anyways.

        • All along, I’ve thought the government should just buy out the industry. It’s not a terribly profitable one. It’s the money that goes to blocking care that costs so much — not the profits. But you are right. And it would also give the workforce time to adjust. Sanders mentions dealing with the workforce problem. But it isn’t in depth and if I know the Democratic Party, it would turn into “job training” — which is useless in almost all cases like this.

          • My old group-home job has a nurse consultant. Somebody who comes in once a month to review the med logs, make sure all the treatments are being administered correctly. On-call in case of panic “what do I do” moments.

            Around 2001 or so, the nurse consultant was this absolutely stunning-looking woman. Not “hot” or “cute.” Elegant. Gorgeous. And a damn good nurse. I was mustering up the nerve to ask her out. (I’m pretty shy.)

            So the next time she came in, I asked what her full-time job was. And she said, without a moment’s hesitation, “I review the insurance claims of customers and find ways to deny them.” Not in a gosh, my job is so awful way. No. She was proud of it.

            Suddenly the normal level of attractiveness graveyard lady I saw on shift changes, who seemed to care about people, looked like a better option to chat up. And this judgment was absolutely correct.

  3. Also, though he is obscure at first, by the end of the article Baker makes clear that he is merely talking about a minor extension of the current Medicare system plus some tinkering around the edges. Fixing its fundamental structural problems is still off the table – so much for getting us to single-payer. Unfortunately, adoption of the “Medicare For All” slogan has made this sort of muddied discussion almost inevitable.

  4. There’s a lot of special interest money backing the idea of increasing the age for Social Security eligibility. The “deficit hawks” and similar professional scaremongers are always giving shorter ETA’s for insolvency of Medicare than of Social Security. Also, even a one-year increment such as Dr. Baker describes is a small change in “market share” in favor of the public sector. Conservatives and centrists alike are absolutely committed to the dogma that the private sector is inherently preferable to the public sector for delivery of virtually anything. The Blue Dog “Democrats” would probably absolutely dig in their heels at even a one-year decrease in Medicare eligibility age.

    There may be cause for optimism, though, as it seems a number of politicians (mostly Republicans) have been electorally punished for trying to reverse Medicaid expansion. Even the commercial media are going with that explanation of those election results, so they must have literally run out of plausible explanations that fit their preferred frames.

    Also, I suspect that there is a growing number of jurisdictions in which being on board with MFA is a de-facto requirement for winning a Democratic primary. My new representative in Congress, Andy Levin, is a charter member of the MFA Caucus, and this is in the infamous Macomb County, Michigan. The district straddles Macomb and Oakland counties, but still…things seem to be moving fast. I look forward to the election cycle in which the “repeat until true, America is a center-right nation” news media don’t know what hit it.

    • Regardless what happens, the Democratic Party’s push for Medicare for All has been heartening. It’s been nice over the last couple of years to see it finally move away from its useless move to the right. (What did we get for that? Criminal punishment “reform”? Welfare “reform”?)

      For about a decade, I’ve been hearing conservatives (And “liberals”!) talking about raising the Social Security eligibility age. And it’s all based on the same misleading statistic: people are living longer! Except that’s only true of richer people. Poorer people aren’t living longer. And the poorest are living shorter. The push for this is an indication that conservatives (largely via the New Democrats) have gotten everything they wanted. So now they are down to trying to repeal the New Deal. It’s shocking.

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