General Discussion
In reply to the discussion: Bernie Sanders talks universal Medicare, and 1.1 million people click to watch him [View all]ehrnst
(32,640 posts)And one of the things is what you pointed out - "Medicare for All" as proposed by Sanders is way more comprehensive, and therefore more expensive than actual Medicare, and even what Canada has.
A gradual expansion, such as allowing people to buy in at 55 at a higher premium than they would pay at 65 would be a start. After a few years of people being happy with it, and letting the CMS and the health care system absorb, adapt and retool for the larger Medicare numbers enrolled - and work out the kinks, then CHIP could be extended to cover all kids up to 18.
Those are much harder targets for the GOP, because they're not going to affect the insurance of people who have it, and want to keep it. It's not a HUGE overhaul that will panick people with insurance. Older people and kids are going to be a much easier sell to the public - look at the success of getting CHIP re-authorized for 6 years under Republican majorities in House and Senate.
People get word about how they're working, and if it goes smoothly, people aren't going to be supportive of GOP efforts to torpedo them. This will require expertise in defending it from under the table defunding and publicized stories of people who had a negative experience with it - health care policy analysts will be VITAL - and should not be hammered at now for fact checking inaccurate claims about Single Payer
Once that has been in place for a few years, you lower the buy-in age of Medicare to 50, and expand CHIP to cover up to 21. By that point a public option might be politically feasible.
Let those show that they will go unmolested by the GOP, then Medicaid gets expanded to cover those who got shafted by the GOP when they challenged the ACA.
This will not be accomplished in 8 years, as the Sanders plan states Medicare for All would be. But it would be cheaper, more politically durable, and would not disrupt health care delivery as much.
Remember - Social Security didn't start out being available to kids when their parents died. It expanded over the decades. It may not have passed in that form, because that would have created huge expenses at the beginning.