An unusual health care argument

I like Drum's 'medicare from the bottom up' approach very much. It is so sensible that only 'look over there' distraction will be the response. The problem with Drum's approach is that the Medicare Part A funding (hospitalization costs) are prepaid already by deductions over the life of the individual by payroll taxes as they work (like social security), so any hospitalizaton costs of young folks would be additive (or substitutive) to the costs of old folks. Part B of Medicare (doctor fees and misc. expenses like tests) are paid by the individual annually in Part B premiums. Adding young folks to this Part B pool would result in average premiums being lower (a good thing), or the savings could be directed into covering Part A costs for young folks.

The split between Part A and Part B may have made sense at one time, but no longer seems appropriate - so blurring or removing this distinction seems like good policy. A combined Part A and Part B will still have to be paid partly by a combination of payroll taxes as you work over your lifetime and partly by annual premiums. But Part B is relatively inexpensive, so it shouldn't be a financial burden on the young - but if they are not working, some collection/enforcement mechanism would have to be put in place.

Bottom Line: Kevin hasn't thought through the financial side of things with his short proposal, but someone will have to do that.