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Smart Policy: Weiland’s Medicare Choice Act Offers Competition, Cost Control

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.


  1. Wayne B. 2014.02.06

    I grant it an interesting idea, but if we let Medicare compete for taxpayer dollars in insurance markets, it makes sense to allow insurance companies to compete across state borders, doesn't it?

  2. Jerry 2014.02.06

    The big question to me Wayne B is why you would need an insurance company to do anything? To me, that is the big expense we could do without. Healthcare should be about healthcare, simple as that. Cut out all of these special interests and move on. Take a look at how France does there Medicare for all and follow suit.

  3. Anne Beal 2014.02.06

    What I recall from 2009 was the argument that Medicare is unsustainable and Obama's plan was to move people onto Obamacare and phase out Medicare as we know it . Republican legislators who asked Obama what would be done about Medicare were told this by the POTUS himself. Allowing younger uninsured people to buy into Medicare was seen as a common sense solution to both problems, the number if people who were uninsured and the increasing cost of Medicare. But common sense was rejected in 2009.

  4. interested party 2014.02.06

    Hell has iced over: Anne and ip agree on something. Mr. Weiland is a maverick and does not always present the views of our party: one reason i have yet to send him any money.

    Rick's choice to run without our help is his.

  5. Wayne B. 2014.02.06

    Owen, thanks for the read.

    I'm not married to the idea of insurance companies at all, or tying health benefits to businesses. Seems the article didn't pay much attention to the argument that insurance regulations would need to be federally regulated, which makes sense to me, as it's interstate commerce.

  6. owen reitzel 2014.02.06

    Thanks Wayne. I just don't think buying across state lines will help much. Plus it doesn't answer the question of preexsisting conditions

  7. Deb Geelsdottir 2014.02.06

    That was a very informative article Owen. Thanks. The writer makes a good point. Insurance companies will go where they can get the most money out of the people, aka, their 'victims.'

    I support Rick's plan. The greed-driven, sociopaths are not concerned with health, as someone else said. They want more and more Money. Shameful.

  8. Jana 2014.02.06

    Weiland must drive the GOP crazy with his progressive thoughts on expanding medicare and medicaid.

    The last leader that did that effectively was Ronald Reagan.

    So in honor of his birthday, I give you 7 things the wingnuts must be willfully ignorant:

    "Reagan’s health policy previewed Obamacare in three major ways. First, Reagan signed Emergency Medical Treatment and Active Labor Act (EMTALA), the law barring hospitals from turning away patients on grounds of their insurance or citizenship — a preview of Obamacare’s ban on insurance discrimination against individuals with preexisting conditions. Second, Reagan doubled the size of Medicaid over the course of his presidency to pay for all of those new uninsured patients — a huge Obamacare-style Medicaid expansion. Third, Reagan pushed something called Diagnosis Related Groups (DRGs), which essentially had the government set the prices Medicare was willing to pay for each Medicare admission rather than pay for reimburse doctors per cost. DRGs cut Medicare costs by $49 billion by 1986, proving a promising trial for the sorts of Medicare payment reform policies you can find in Obamacare."

    And here's 6 other things that show why St. Ronald is too much like Weiland for the South Dakota GOP.

  9. G-Man 2014.02.06

    Maybe, just maybe it's time South Dakota elect an Independent. Tired of Dems and Repubs. Larry Pressler in the last few years has taken stances that prove he's beholden to NO party. Just thinkin'....

  10. G-Man 2014.02.06

    Dems and Repubs are both owned by the Corporatocracy. Elect more Independents.

  11. G-Man 2014.02.06

    Weiland will just end up being owned by the Dems. He talks the Maverick Game, but, Larry Pressler has proven in the past few years that he's living it. That's the real difference.

  12. Jana 2014.02.07

    It's official. Reagan is no longer a saint.

    Not one GOP/Conservative blog recognized the great one on his birthday. Maybe if he only had a Facebook page, they would have at least given him a like.

  13. Porter Lansing 2014.02.07

    Medicare expansion, being a program already in place, needn't go anywhere near the Supreme Court and could be passed with a simple majority. BRING NOEM Corrina.

  14. Stan Gibilisco 2014.02.07

    If Mr. Weiland cares to contact me, I can tell him what I'd propose, if I were him: Basically, a system like the one they have in Denmark or Sweden.

    By the way, I pitched my notion to one of my most conservative friends some time ago, and she said that it sounded pretty good!

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