Everyone who isn't a highly-paid executive at a health-insurance company believes that health care costs way too much in the US in part because health insurance companies take about 30 cents of every dollar we spend on it. Even people who support Republican politicians know this is true. We have to change how it works here.
The 22 million or so people who work in healthcare and the 167 million people who have private health insurance through their employers have some legitimate concerns about changing the system suddenly. So when they hear "Medicare for All," they worry about their great health plans and their jobs. I think those are fair concerns.
Here's my proposal: starting on an arbitrary date—let's say 1 January 2030—we extend Medicare eligibility by one day for every two days of birthdates. So people born on January 1st and 2nd 1965 get Medicare on 1 January 2030. People born January 3rd and 4th get in on 2 January 2030. And so on. The result looks like this:
The second part of the plan: everyone born on or after the effective date of the legislation is covered immediately. If that seems unfair to babies born in 2029, I agree, but in order for this compormise to work, we have to draw the line somewhere. We could also extend child eligibility backwards at the same rate, which means Medicare for All arrives in 16¼ years (i.e., April 2046) instead of 32½ years (July 2062). That would still give the industry a long time to adjust. And nothing about this plan prevents people from buying private insurance, or takes health insurance off the menu for tax-free benefits to employees.
It looks like this:
| Birthdate | Current eligibility | New eligibility | Age |
|---|---|---|---|
| 1965-01-01 | 2030-01-01 | 2030-01-01 | 65.0 |
| 1965-01-03 | 2030-01-03 | 2030-01-02 | 64.9 |
| 1965-01-05 | 2030-01-05 | 2030-01-03 | 64.9 |
| 1970-01-01 | 2035-01-01 | 2032-07-01 | 62.5 |
| 1980-01-01 | 2045-01-01 | 2037-07-01 | 57.5 |
| 1990-01-01 | 2055-01-01 | 2042-07-01 | 52.5 |
| 1995-01-01 | 2060-01-01 | 2047-07-01 | 47.5 |
| 1997-07-02 | 2067-07-02 | 2046-04-02 | 49.8 |
| 2000-01-01 | 2065-01-01 | 2045-01-01 | 45.0 |
| 2010-01-01 | 2075-01-01 | 2040-01-01 | 30.0 |
| 2020-01-01 | 2085-01-01 | 2035-01-01 | 15.0 |
| 2025-01-01 | 2090-01-01 | 2032-07-01 | 7.5 |
| 2026-07-20 | 2091-07-20 | 2031-09-23 | 5.2 |
| 2029-01-01 | 2094-01-01 | 2030-07-01 | 0.5 |
| 2029-12-28 | 2094-12-28 | 2030-01-03 | 0.0 |
| 2029-12-29 | 2094-12-29 | 2030-01-03 | 0.0 |
| 2029-12-30 | 2094-12-30 | 2030-01-02 | 0.0 |
| 2029-12-31 | 2094-12-31 | 2030-01-02 | 0.0 |
| 2030-01-01 | 2095-01-01 | 2030-01-01 | 0.0 |
As of 1 April 2046, everyone has Medicare, the system doesn't collapse, millions aren't suddenly unemployed, and highly-paid executives can retire.
We could also make people born in or after 2012 wait until the descending dates catch up with them in 2046, but as people in the "gap years" of 1997 to 2012 watch everyone else get it, knowing they'll be last, that might not be as popular.
Where's the flaw?
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