One problem with current health care reform proposals has been the burden that expanded Medicaid coverage would place on the states, which have a cost-sharing agreement worked out with the federal government. Raising the eligibility level to 150% of the federal poverty level would expand the program’s rolls significantly – the Heritage Foundation has a great chart that documents what percentage of the various states’ populations would join Medicaid.
Rep. Tom Harkin (D-IA) has a solution to that, however: put children on the federal tab, by moving them to Medicare (the program for the elderly) rather than keeping them on the State Children’s Health Insurance Program (SCHIP) which is currently administered through Medicaid. And it serves a dual purpose: the Des Moines Register reports that Harkin said “I also thought about it in terms of bridging the generation gap,” because “Young people are more likely to be supportive of Medicare if it’s not a benefit only for retirees.”
Aside from selfishly shifting Iowa’s health care costs to the federal government, there’s another big problem with Harkin’s proposal: Medicare is TERRIBLE. Costs are out of control; its unfunded liabilities pose a very real threat to the financial health of the country; it provides subpar coverage, forcing patients to seek Medigap coverage to pay for services the program itself will not; it’s a racket that the elderly are forced to use, lest they forfeit their Social Security; it hides its costs by passing the buck to other government agencies. Those low overhead costs they brag about? Partially due to the fact that they barely check claims (turns out just writing checks and not reading bills takes a lot less time – who’d have thought? Eureka!!!)
Efficient? Yes. Good business? Hardly. Even 60 Minutes did a segment on the waste, fraud, and abuse in Medicare – talk about jumping the shark. The Mafia has turned to it as their next big moneymaking venture (less penalties than the drug trade, and far more lucrative!)
Conclusion: expanding a failed program is pretty insane (see also: Department of Education, federal.) There are better ways to address the problem of Medicare and SCHIP: I recommend checking out the Cato Institute’s excellent resource page on the subject.