Grayson strikes a blow for real Americans

Yesterday, U.S. Representative Alan Grayson introduced a bill that would provide a buy-in option allowing access to Medicare for anybody who wants it.

Read that again, and let it sink in.

It's an amazingly simple bill. Not even four pages long, and the language is so simple that basically anybody can understand it.

The bill is elegantly crafted. In a nutshell, here's what it does:

• Allows Medicare access for all citizens and permanent residents.
• Provides an age-bracket structure for determining premiums. The brackets are: under 19, 19 to 25, 26 to 35, 36 to 45, 46 to 55, and 56 to 64. Beyond that, the existing Medicare age categories apply.

This is brilliant in its simplicity.

The simpler you make an insurance system, the better and more robust it is.

When you accept everyone, regardless of pre-existing conditions, and when your default position is to say 'yes' to coverage rather than bean-counting everything under a default 'no' position, the whole system is much cheaper to administer and operate. Oh, and it manages to provide more actual health care to more people.

Theoretically, the simplest possible system would cover everyone, under a single premium rate. That's unlikely to happen (since, you know, the U.S. isn't actually becoming a socialist nation, despite what tea partiers might like you to think), but Grayson's proposal is still simple enough to be pretty darned good.

But I want to call attention to two other aspects of this bill which are slightly more subtle, but which constitute powerful offense and defense strategies in and of themselves. First, the bill stipulates that none of this would take effect until January 1 of the calendar year following the bill's enactment.

So if we imagine the bill being passed and signed into law, let's say, in July, there would be a five month window in which Americans who hate the present system (*raises hand*) would be champing at the bit to buy into this new system but couldn't do it yet.

This would put unimaginable pressure on the for-profit death mongers in the private insurance industry to change their business practices quickly, or else face a sudden and brutal drop-off in their membership numbers.

If you see Aetna or Regence or any other AHIP members opposing Grayson's bill, this is why. They'll try to convince you that if the bill passes, Satan himself will visit your living room and rip out your intestines.

But what they really mean is "if this bill passes, real Americans will leave so fast their collective wake will rip out our intestines." Cry me a river, AHIP.

Second, the bill's final paragraph states that under-65 participants in the Medicare buy-in (or as the bill itself rightly declares, the Public Option) aren't eligible for financial assistance with their premiums.

This is a powerful defense against the bill's inevitable nay-sayers, because it means that the younger age brackets, the ones who are still of working age and presumably earning a living, would have to pay their fair share.

Retirees, those on fixed incomes, can seek out assistance but everyone else has to pay their fair share. The nay-sayers will want to claim that this bill is just some sneaky way of letting everyone in on government assistance with health care costs - and heck, they'll probably claim it anyway - but this final provision of Grayson's bill is the counter-argument.

We may not get a public option in the massive, 2,500+ page healthcare bill currently being fought over in Congress. But who cares? Go ahead and pass that one under reconciliation. Grayson's four pages of simple brilliance can fix the rest.