Economic and Social Research Institute
November 2002
Covering America: Real Remedies for the Uninsured
Volume II
Medicare for All
James A. Morone has proposed a single-payer approach to provide universal coverage with the following elements:
* The Medicare program with expanded benefits, including no cost sharing, would provide automatic coverage for all legal residents of every age.
* Funding would come solely from revenues raised by a new federal value-added tax.
* States could opt out (for residents under age 65) by proposing a program that meets federal guidelines and by paying 25 percent of the cost.
* Employers could offer coverage for additional benefits, with the employer-paid premium not subject to income tax.
http://www.esresearch.org/newsletter/booktwo/CovAm2.htm
Comment: Three new proposals for comprehensive health care reform have been added to the ten proposals presented last year by the Economic and Social Research Institute. Of great significance is the fact that this single payer, Medicare for All proposal has helped to place this concept back into the national debate over the various options for reform. This is another crucial breakthrough since the single payer option has often been explicitly excluded from the forums on reform (as it was in the ESRI report last year).
Some single payer advocates might be concerned about a few of the features of Professor Morone’s proposal, such as the value added tax (VAT) and an employer option for supplementary insurance. He ameliorates, to some degree, the regressive nature of the VAT by exempting food, medicine and shelter, and by expanding the earned income credit to families with incomes up to $45,000. Also he limits the employer supplement to extra benefits such as hospital amenities.
But rather than diverting attention to various details of his proposal, we should direct our efforts to being certain that the fundamental single payer message is included in all forums, discussions and deliberations. America can only benefit by making health care reform a fully informed process.