4 ms·

Medicare should cover children. Then we'd be covering children and the elderly. I think that seems fair--children deserve healthcare (just like education) as a

Medicare should cover children. Then we'd be covering children and the elderly. I think that seems fair--children deserve healthcare (just like education) as a fundamental right. It shouldn't be dependent on their parents.

ghaff 11mo ago
Be aware that Medicare is a long way from free. At least if you've had a well-paying job in the past few years, Medicare premiums are pretty similar to exchange costs (or COBRA).
- diogenescynic 11mo ago
  Health insurance isn't free either and it's way more expensive than Medicare. We're all also already paying for Medicare...
  - dmoy 11mo ago
    GP is pointing out that Medicare costs for the individual are about the same as ACA or cobra. It's not cheaper, unless you have the work credits to cut down on part A premiums. So Medicare as-is for kids wouldn't be significantly cheaper than ACA for kids. To make it cheaper, you'd need to either substantially increase the subsidy on Medicare, or decrease US medical costs (administration costs, drug costs, doctor salaries, etc)
  - nradov 11mo ago
    Commercial health insurance is more expensive than Medicare because original Medicare Part A/B doesn't cover prescription drugs, and because commercial plans effectively provide a hidden cross subsidy to Medicare. Under a "Medicare for All" scheme, people would still need to purchase prescription drug coverage (Part D). And because Medicare reimburses providers at very low rates (often below their costs) they have to make up the difference by charging commercial health plans more.
- godelski 11mo ago
  Everyone knows Medicare isn't "free". Medicare and COBRA are not similar costs. My parents pay half what I would pay if I took COBRA and they have a better plan. Neither of them were struggling before they retired and I'll put it this way, they bought a second home in retirement.
  - dmoy 11mo ago
    So if we're doing anecdotes... One of our parents pays about $20k/yr all in for ACA - $12k/yr of premiums and $8k/yr on top of that (all unsubsidized) Her (also unsubsidized) Medicare would be $6.5k/yr partA premium + $1.6k partA deductible+ $2.3k partB + $1k partD + $5k medigap, or about $16.5k total. She has no work credits for Medicare subsidy. If you have subsidy from free partA premiums, then Medicare is about twice as cheap as unsubsidized ACA, yes. If you don't have subsidy for either, it's a little cheaper, but not by a ton. So if you just stuck kids on existing Medicare pricing with no work credit for partA, then it would not be substantially cheaper than unsubsized ACA.
  - ghaff 11mo ago
    >Everyone knows Medicare isn't "free". No they don't. A lot of the "Medicare for All" crowd assumes that "medicare for all"/universal healthcare is free or at least very low cost rather than something that's in the ballpark of unsubsidized individual/family healthcare plans which is the reality at least within a few years of leaving the professional workforce.
999900000999 11mo ago
It should cover everyone. No body goes to the doctor because they want to. I'll dare say it would be a net positive to even expand this to the undocumented. Many of them have dependents, it's not going to be great if your dad can't afford his insulin and is thus unable to work to provide for you. This includes a large percentage of our farm workers who are literally getting sprayed with pesticides all day. That's another issue, but when they get sick they more than deserve treatment. And finally, the vast majority of illnesses can be treated cheaply if irregularly do your checkups. It can cost society $200 today for a doctor visit , or 30k for an ER stay in 3 years. That said, I think this should be handled on a state by state basis. If the people of Alabama don't believe in single-payer healthcare, or they want to forbid using single pair healthcare for contraceptive or something, that shouldn't stop a progressive state from implementing it.
- diogenescynic 11mo ago
  I wholeheartedly agree, but I don't think the national politics would support that at the moment. I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... but they might against 18 or 19 year olds. It's a foot in the door persuasion tactic rather than try to get everything all at once.
  - ryandrake 11mo ago
    > I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... Not sure what gives you this idea. The major political party in power in the US today campaigned in large part on cruelty and removing subsidies and social benefits from people. There are a huge number of people who would bitterly fight against providing health care to children. It's the same mentality that bitterly fights against free school lunch for children.
    - LadyCailin 11mo ago
      [flagged]
not_a_shill 11mo ago
Medicaid does cover children
- nradov 11mo ago
  And in many states there are also CHIP plans for children who don't qualify for Medicaid. https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/ https://www.healthcare.gov/medicaid-chip/childrens-health-in...
godelski 11mo ago
It baffles me that it's so hard to argue for care for children. The response is always "but it's the parents' responsibility". Which, okay, fair, BUT if the parent is failing their responsibility (which can happen for many reasons, many of which don't need maliciousness nor incompetence), then what? We let the child die? We let the child starve? That's what I don't get. A child doesn't have autonomy, so it shouldn't even be a question of helping them out. We can argue about what to do with the parents but in the mean time we're going to let children suffer? That's lunacy. I don't even have children and I'll gladly pay taxes to prevent child suffering. How is anyone against that?
- nradov 11mo ago
  I agree with you. But to steelman the argument on the other side, their concern is that subsidizing care for children creates a moral hazard by encouraging irresponsible people to have even more children. It's a feedback loop which creates an escalating burden on the rest of society. I don't think that denying care to children is effective or morally justified; I'm just trying to explain what seems to be the underlying argument.
  - godelski 11mo ago
    I do understand that argument but 1) doesn't seem to be stopping it now 2) that falls under the "we can argue what to do with the parents". Let's argue about what to do with the parents but not let kids suffer
  - programjames 11mo ago
    I think a solution to fix this moral hazard is to take children away from their parents when the subsidies become too much. But for lots of reasons, society really doesn't want that to happen.
    - godelski 11mo ago
      I think that gets difficult when we talk about incidental causes of needing support. Like let's say there's two parents, the primary income earner dies, there's not enough in savings, so single parent now needs support. I don't think that's anyone's "fault". On the other hand, we could look at a case where there's a family who's never made enough money to support their kids and keeps having more. You can take away the kids and fine the parents for fraud. (Obviously should issue a warning before this) But I think that for some parts of this, tying the benefits to the child just reduces the opportunities for abuse. Medical care for children is a pretty straight forward one. You make it universal and the taxes are progressive such that you make it a wash for middle or upper middle income families and a loss for upper income families. So everyone gets the benefits but that creates an efficient system where we don't really need to do means testing on the child at time of their medical checkup. Same thing for something like food programs. Both of these can even utilize the existing schools so we don't need to build new facilities. For food, you just make it so access to the cafeteria is free. Provide breakfast, lunch, and dinner. Will people abuse the program? Absolutely. Nothing is 100% bulletproof. Will the cost of abuse outweigh the costs needed to avoid the abuse? Probably not. Will the costs of avoiding the abuse outweigh the costs of a child going hungry? Absolutely not. I think this last part is important to note because frequently the complaints about these systems leverage the fact that the system is imperfect. We then spend years arguing about how to make it perfect (which is literally an impossible task) and meanwhile we leave the most important part of the problem unsolved, causing damage. If we are unable to recognize that perfection is impossible then our conversations just become silly as we love to "play devil's advocate" or "steelman" arguments. That adversarial nature is a very helpful tool for refinement, but it also can't serve as a complete blocker either.
osigurdson 11mo ago
I believe children do get healthcare, coverage, insurance or not in the US. The family might take on crushing debt that will never be paid off but the child will be treated. At least, this is my understanding - please correct me if I am wrong.
- trollbridge 11mo ago
  It’s wrong.
toast0 11mo ago
Most children don't have enough credits to qualify for Medicare. OTOH, very few children have enough individual income to be disqualified from Medicaid, but it's based on household income. My handwavey plan for universal federalized healthcare includes using the child's income as a qualifier for Medicaid, phased in so the system will hopefully adjust over time rather than get overloaded to collapse. Also reduce the Medicare eligibility age over time. A solution that takes decades to roll out leaves a lot of unsolved problems, but adding a large number of people to an existing program in one fell swoop feels like it's going to be a negative too.

ghaff 11mo ago

Be aware that Medicare is a long way from free. At least if you've had a well-paying job in the past few years, Medicare premiums are pretty similar to exchange costs (or COBRA).

diogenescynic 11mo ago
Health insurance isn't free either and it's way more expensive than Medicare. We're all also already paying for Medicare...
- dmoy 11mo ago
  GP is pointing out that Medicare costs for the individual are about the same as ACA or cobra. It's not cheaper, unless you have the work credits to cut down on part A premiums. So Medicare as-is for kids wouldn't be significantly cheaper than ACA for kids. To make it cheaper, you'd need to either substantially increase the subsidy on Medicare, or decrease US medical costs (administration costs, drug costs, doctor salaries, etc)
- nradov 11mo ago
  Commercial health insurance is more expensive than Medicare because original Medicare Part A/B doesn't cover prescription drugs, and because commercial plans effectively provide a hidden cross subsidy to Medicare. Under a "Medicare for All" scheme, people would still need to purchase prescription drug coverage (Part D). And because Medicare reimburses providers at very low rates (often below their costs) they have to make up the difference by charging commercial health plans more.
godelski 11mo ago
Everyone knows Medicare isn't "free". Medicare and COBRA are not similar costs. My parents pay half what I would pay if I took COBRA and they have a better plan. Neither of them were struggling before they retired and I'll put it this way, they bought a second home in retirement.
- dmoy 11mo ago
  So if we're doing anecdotes... One of our parents pays about $20k/yr all in for ACA - $12k/yr of premiums and $8k/yr on top of that (all unsubsidized) Her (also unsubsidized) Medicare would be $6.5k/yr partA premium + $1.6k partA deductible+ $2.3k partB + $1k partD + $5k medigap, or about $16.5k total. She has no work credits for Medicare subsidy. If you have subsidy from free partA premiums, then Medicare is about twice as cheap as unsubsidized ACA, yes. If you don't have subsidy for either, it's a little cheaper, but not by a ton. So if you just stuck kids on existing Medicare pricing with no work credit for partA, then it would not be substantially cheaper than unsubsized ACA.
- ghaff 11mo ago
  >Everyone knows Medicare isn't "free". No they don't. A lot of the "Medicare for All" crowd assumes that "medicare for all"/universal healthcare is free or at least very low cost rather than something that's in the ballpark of unsubsidized individual/family healthcare plans which is the reality at least within a few years of leaving the professional workforce.

999900000999 11mo ago

It should cover everyone. No body goes to the doctor because they want to. I'll dare say it would be a net positive to even expand this to the undocumented. Many of them have dependents, it's not going to be great if your dad can't afford his insulin and is thus unable to work to provide for you. This includes a large percentage of our farm workers who are literally getting sprayed with pesticides all day. That's another issue, but when they get sick they more than deserve treatment. And finally, the vast majority of illnesses can be treated cheaply if irregularly do your checkups. It can cost society $200 today for a doctor visit , or 30k for an ER stay in 3 years. That said, I think this should be handled on a state by state basis. If the people of Alabama don't believe in single-payer healthcare, or they want to forbid using single pair healthcare for contraceptive or something, that shouldn't stop a progressive state from implementing it.

diogenescynic 11mo ago
I wholeheartedly agree, but I don't think the national politics would support that at the moment. I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... but they might against 18 or 19 year olds. It's a foot in the door persuasion tactic rather than try to get everything all at once.
- ryandrake 11mo ago
  > I think we have to start somewhere that isn't controversial like extending coverage to kids. I don't think anyone is going to be against covering 8 and 9 year olds... Not sure what gives you this idea. The major political party in power in the US today campaigned in large part on cruelty and removing subsidies and social benefits from people. There are a huge number of people who would bitterly fight against providing health care to children. It's the same mentality that bitterly fights against free school lunch for children.
  - LadyCailin 11mo ago
    [flagged]

not_a_shill 11mo ago

Medicaid does cover children

nradov 11mo ago
And in many states there are also CHIP plans for children who don't qualify for Medicaid. https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/ https://www.healthcare.gov/medicaid-chip/childrens-health-in...

godelski 11mo ago

It baffles me that it's so hard to argue for care for children. The response is always "but it's the parents' responsibility". Which, okay, fair, BUT if the parent is failing their responsibility (which can happen for many reasons, many of which don't need maliciousness nor incompetence), then what? We let the child die? We let the child starve? That's what I don't get. A child doesn't have autonomy, so it shouldn't even be a question of helping them out. We can argue about what to do with the parents but in the mean time we're going to let children suffer? That's lunacy. I don't even have children and I'll gladly pay taxes to prevent child suffering. How is anyone against that?

nradov 11mo ago
I agree with you. But to steelman the argument on the other side, their concern is that subsidizing care for children creates a moral hazard by encouraging irresponsible people to have even more children. It's a feedback loop which creates an escalating burden on the rest of society. I don't think that denying care to children is effective or morally justified; I'm just trying to explain what seems to be the underlying argument.
- godelski 11mo ago
  I do understand that argument but 1) doesn't seem to be stopping it now 2) that falls under the "we can argue what to do with the parents". Let's argue about what to do with the parents but not let kids suffer
- programjames 11mo ago
  I think a solution to fix this moral hazard is to take children away from their parents when the subsidies become too much. But for lots of reasons, society really doesn't want that to happen.
  - godelski 11mo ago
    I think that gets difficult when we talk about incidental causes of needing support. Like let's say there's two parents, the primary income earner dies, there's not enough in savings, so single parent now needs support. I don't think that's anyone's "fault". On the other hand, we could look at a case where there's a family who's never made enough money to support their kids and keeps having more. You can take away the kids and fine the parents for fraud. (Obviously should issue a warning before this) But I think that for some parts of this, tying the benefits to the child just reduces the opportunities for abuse. Medical care for children is a pretty straight forward one. You make it universal and the taxes are progressive such that you make it a wash for middle or upper middle income families and a loss for upper income families. So everyone gets the benefits but that creates an efficient system where we don't really need to do means testing on the child at time of their medical checkup. Same thing for something like food programs. Both of these can even utilize the existing schools so we don't need to build new facilities. For food, you just make it so access to the cafeteria is free. Provide breakfast, lunch, and dinner. Will people abuse the program? Absolutely. Nothing is 100% bulletproof. Will the cost of abuse outweigh the costs needed to avoid the abuse? Probably not. Will the costs of avoiding the abuse outweigh the costs of a child going hungry? Absolutely not. I think this last part is important to note because frequently the complaints about these systems leverage the fact that the system is imperfect. We then spend years arguing about how to make it perfect (which is literally an impossible task) and meanwhile we leave the most important part of the problem unsolved, causing damage. If we are unable to recognize that perfection is impossible then our conversations just become silly as we love to "play devil's advocate" or "steelman" arguments. That adversarial nature is a very helpful tool for refinement, but it also can't serve as a complete blocker either.

osigurdson 11mo ago

I believe children do get healthcare, coverage, insurance or not in the US. The family might take on crushing debt that will never be paid off but the child will be treated. At least, this is my understanding - please correct me if I am wrong.

trollbridge 11mo ago
It’s wrong.

toast0 11mo ago

Most children don't have enough credits to qualify for Medicare. OTOH, very few children have enough individual income to be disqualified from Medicaid, but it's based on household income. My handwavey plan for universal federalized healthcare includes using the child's income as a qualifier for Medicaid, phased in so the system will hopefully adjust over time rather than get overloaded to collapse. Also reduce the Medicare eligibility age over time. A solution that takes decades to roll out leaves a lot of unsolved problems, but adding a large number of people to an existing program in one fell swoop feels like it's going to be a negative too.