Rick Weiland is offering the boldest, clearest policy initiative of any candidate for South Dakota's open U.S. Senate seat. Elaborating on a policy he has advocated throughout his campaign, Weiland is promising that one of his first proposals after taking the Senate oath will be the Medicare Choice Act, a plan to open Medicare to Americans of all ages.
In a conversation with this blog yesterday, Weiland staked out a position that feels radical yet may really be a brilliant compromise, with something to appeal to everyone. On the one hand, Weiland is stating what is obvious to every retiree in America: government can run pretty good health insurance. But he's not going Kucinich/Wellstone and advocating single-payer: Weiland wants competition.
How can government compete with private insurance? Look at the low salaries of Medicare's administrators (Medicare's boss, Marilyn Tavenner, makes $167,000 a year). Look at the pretty typical, not terribly fancy buildings that house Medicare and Medicaid offices. Then look at the salaries of private insurance CEOs (Stephen Hemsley, United Healthcare, $48 million; John Strangfeld, Prudential, $29.9 million...). Look at the fancy steel and glass palaces private health insurance companies build for themselves. The higher overhead of the private health coverage system is as obvious as the statue of T. Denny Sanford out in front of his hospital. Allowing all Americans to enroll in Medicare would give them the choice to see a larger percentage of their health dollars used for health care. Medicare as public option would push private insurers to cut costs and offer competitive value to consumers.
Allowing everyone to enroll in Medicare would be a remarkable expansion of the program. But the Medicare Choice Act wouldn't force big government on anyone. If you want Medicare, you buy in. If you prefer private insurance, you stick with that.
Even folks who wouldn't enroll in Medicare E (Medicare for Everyone!) would benefit, as a larger Medicare market would drive down costs.
Weiland threads another interesting political in positioning the Medicare Choice Act as both an affirmation of and a challenge to the Affordable Care Act. He says his Republican opponents are way off base in wanting to repeal the ACA. Weiland wants to keep all the good consumer protections the ACA offers, like allowing parents to keep their kids on their health policies until age 26 and guaranteeing coverage for folks with pre-existing conditions. But he also says President Obama made the ACA less effective by caving in to Republicans and big money by bending over backward to subsidize the private insurance industry. Harking to his war on plutocracy, Weiland says the ACA protects the overpriced "Greedycare" system. He says making Medicare available to everyone is what President Obama should have done in the first place.
Weiland indicated that he's been brewing the idea of Medicare as a public option for some time. When he was AARP's South Dakota exec, he never heard constitutents suggest they wanted to give up Medicare. Weiland says he's hearing the same pro-Medicare sentiment from people all over South Dakota (including folks in Hetland, town #275 on his statewide tour).
Weiland would allow everyone access to a program that enjoys enormous and well-deserved popularity. He'd fill one of the glaring gaps in the Affordable Care Act, cost control, but do it through competition rather than top-down dictation of prices.
Rick Weiland's main opponent, insurance salesman Marion Michael Rounds, will hate this plan. But Weiland's Medicare Choice Act is the smartest health care policy in South Dakota's U.S. Senate race.