Meet Medicare Part E

by Gillian Hubble

categories: Medicare and Medicaid, Obama and Congress, Public Plan

Published October 23, 2009 @ 06:00AM PT

How much time-consuming bluster did it take to get to this simple and obvious option? Open up Medicare to everybody, like Ted Kennedy originally proposed in the Senate HELP bill. Part E does stand for “Everybody.” While it’s only one of the three public options being considered by the House, it’s the strongest. Keith Olbermann gives us a great introduction to the concept in the video clip above. Meet Medicare Part E.

First, some caveats. This proposal wouldn’t cover everybody exactly. It would, according to HR 3200 as currently written, only be available to the currently uninsured and the smallest businesses during the first year. In subsequent years it would open up to larger and larger employers. This is not robust coverage in the accessibility sense. “If you like what you have, you can keep it” still really means “If you don’t like what you have, tough.” But Medicare Part E is better than any other public option under consideration (state-based opt-outs, anyone?)

According to Jeff Goldsmith, leveraging Medicare solves numerous reform problems: speed to results, reducing disruption to markets, affordability, and bending the Medicare cost curve downwards when boomers flood the program over the next decade. Why the last one? Because a 2007 study showed that uninsured people with previous chronic conditions who enroll in Medicare have higher medical costs as long as seven years after enrollment. Basically, early Medicare is proactive Medicare.

All right, so what’s the low-down on Medicare Part E? It’s cost-effective, covering the balance of 97% of Americans for under $9 billion, and it is deficit neutral over 10 years. It’s Medicare – the program that seniors are so vigorously defending against the Sarah Palins of the world. Physician reimbursement would be tied to Medicare rates, so Nancy Pelosi had better address the “doctor fix”, as the Senate failed. Physician support will depend on it. But with reassuring Medicare Part E on the table instead of a terrifyingly fuzzy public option, I look forward to next month’s poll gauging public support. Especially with videos like the one from Healthcare For America Now, below, from their protest outside AHIP's annual meeting in D.C.