Behind the scenes, Democrats in Washington are trying to think about what they will do if the party wins the White House in 2021 on a Medicare-for-all platform, but still has not made much progress on the critical issue of which taxes You would travel to pay for it.
A natural downturn is trying to find ideas that set the country on the path to single payer vision without requiring nearly as much in the way of immediate tax increases. For many, it means gravitating to an idea that almost happened in the late stages of the original Affordable Care Act debate – opening Medicare to a younger class of elderly people, either by reducing the Medicare qualification age to 55 or at least create a structure for the 55-and-older crowd to "buy in" to Medicare.
However, a much better idea would be to do the reverse and create a universal health insurance program for children. It is much cheaper, which means that it could be paid with relatively modest and politically popular tax increases on the rich and provides a clear and simple benefit to millions of families. New poll shows that it is an extremely popular idea. And most importantly, because the kids would age out of the program instead of ages into it, they and their parents would create a natural constituency for further extensions so that they can hold on to an advantage they currently enjoy and want. fear losing.
Medicare for Kids is Popular
Giving children with health care is quite cheap. The average child's medical needs are mainly focused on routine, low cost. Even better, many of these interventions are basically preventative (vaccines, checkups, etc.) and are very cost effective in the long run.
Because of this nexus, the government has long been more generous ̵
Data for Progress, a progressive policy and opinion research equipment, strongly supported the idea.
Asked "would you (support or oppose / oppose or support) extend universal health care to all American children by giving all Americans under the age of eighteen coverage in a government health plan designed by Medicare, known as & # 39; Medicare For Kids "a solid 54 percent of the public said they supported the idea, with only 27 percent against it. Twenty-three percent of the whites like the idea, and it is overwhelmingly popular with African Americans who support it from 66 to 17.
This is similar to what the Kaiser Family Foundation finds for Medicare-for-all, so it's natural that Progressive Continue to push for their dream resolution. But in the past, well-tuned state-level single-payer's health care has pushed together when the extent of the necessary tax increases becomes clear. It is possible that Medicare-for-all advocates will overcome these obstacles, but if they do not, Medicare for Kids suggests a drastically cheaper decline.
When you break down the problem into smaller parts, it is easy to find items that do not require much in the way of taxes to pay for and sell to the public. But the main reason for thinking Medicare for Kids is a good idea is that the political economy of the approach is much stronger than for other Medicare expansion options.
The Socialism of the Old is a Problem
The United States currently has a rather widespread welfare state for the elderly with a universal basic income called Social Security and a universal health system called Medicare.
For decades, these programs helped persuade older citizens to vote for the Democratic Party as the welfare state party, just as other considerations tend to push in the other direction. However, in recent years, the Republicans have stopped pushing their plan to privatize social security and began carefully structuring plans that would privatize Medicare to exempt everyone at present over 55 years. Then, under Donald Trump's leadership, they completely dismissed the target of cutting programs for the elderly and in fact began to argue that Democrats undermined the welfare state of old people by suggesting to provide health care to younger people.
In an important 2015 document, Vivenkian Ashok, Ilyana Kuziemko and Ebonya Washington indicate that this kind of argument is effective. Their research addresses the issue of why public support for economic redistribution has not increased since 1970 despite the large increase in economic inequality.
They show that the overall flat levels of support for redistribution actually mask significant shifts between different subgroups. In particular, African Americans and the elderly have become significantly less supportive of redistribution, while non-older whites have become moderately more supportive. Looking more closely at African Americans, the biggest driver shows himself to be a fall in support for race-specific forms of redistribution. For seniors, however, the biggest problem is that the elderly "have become increasingly against state health insurance."
The authors say "older Americans worry that redistribution will come at their expense, especially through cuts to Medicare."
This does not describe the structure of current Medicare-for-all proposals (as actually makes Medicare more generous), but it reflects a strong psychological dynamic. The result is that older Americans have become increasingly willing to vote in accordance with their culturally conservative beliefs without fear of consequence for their personal financial well-being. In fact, they have often convinced themselves that voting for the Republicans will help keep America's generous safety net for old people.
In the short term, the expansion of Medicare to cover people aged 55 to 65 should be a winning problem with people of that age group. But if it actually happens, the perverted scenario where the welfare state's recipients come against its further expansion becomes worse. Medicare for Kids solves this problem.
Medicare for Kids has a strong political economy
The great thing from a political economy perspective is that if the beneficiaries of Medicare for Kids liked the program, they would end up having a direct personal incentive in favor of its expansion.
Parents who had loved the fact that they should never worry about their children's insurance would hear plans to extend the program to 25 or 30 years as further reassuring that their children would not end up losing. What's more, if the insurance supply turned out to be good, parents can start to desire something. The basic challenges of expanding the program – it costs money, people don't like paying taxes and special interest groups will complain – will still be there, of course, but the incentives will be adapted to success to stimulate program expansion.
Unfortunately, creating special elderly programs tends to have opposing effects, and accepting a half-way strategy to extend the Medicare coverage to a larger population of elderly people can make it harder to ultimately achieve universal health care.
By contrast, Medicare for Kids is the kind of half measure that would actually keep the country going to ultimately provide a real guarantee of health insurance for everyone.