Tuesday, September 25, 2007

Maybe this is a stupid question, but...

I'm watching Edwards talk about how he would fund his health care plan on C-Span. Here's what I don't get: If we have a truly universal system, where everyone is covered at least by the government health program, doesn't that void out all spending for Medicaid?

I'm just wondering since I'm pretty sure that the current federal spending on Medicaid is greater than the projected expense for Edwards' plan, which is the most expensive of all of them. None of the big 3 even include the word "Medicaid" on their health care issue pages, but they all have detailed estimates of how much their new plans will cost over what we spend right now on health care.

Also, I don't get why candidates don't call for making Medicare an opt-out system so that a few wealthy, virtuous seniors can keep paying for their own health care. Sure, it'll only make a tiny dent in Medicare spending, but it will do a little bit and, more importantly, it's an opportunity for a presidential candidate to talk about civic virtue.


Devin said...

Two things:
1. I´m guessing the plans just assume that medicare costs will stay constant and that all costs directly attributed to the plan just have to do with covering those under retirement age. That would make the most sense because there is some uncertainty as to what full coverage will do to the cost of covering people with medicare. Two effects of full coverage will move the cost of medicare in opposite ways. First, full coverage will mean that people with insurance or medicare won´t have to keep subsidizing the cost of those who are without insurance, causing the cost of healthcare overall (and therefor medicare) to decrease. Second, full coverage will mean that more people will consume regular doctors´visits, causing the costs of those visits to rise. Overall, full coverage should tend to cause medical expenditures to go down, but medicare patients have a lot more office visits than everyone else, so I am completely unsure of what will happen to medicare costs. It probably is easier not to talk about it.
2. They probably don´t talk about opting our of medicaid just becuase they are worried about being laughed at for suggesting that some people are virtuous enough to not use an entitlement. Barack would seem particularly naive.

Alton Brooks Parker said...

Right, but I was asking about Medicaid in the first question and Medicare in the second.

You're right about Barack. I guess Dodd would probably be the only one that could really get away with it.

Alton Brooks Parker said...

Maybe I should clarify my question. If the Edwards-Clinton plans (I'm using these as my reference point because I don't really know anything about Obama's) subsidize the poor so that everyone can afford to buy into at least the government-run program, then why do we need Medicaid? I suppose Medicaid would still pay for non-legal residents, but that still has to amount to a huge decrease in Medicaid spending.

Devin said...

hmmm... I have no idea