Vermont Sen. Bernie Sanders is once again pushing his version of single-payer health care as Republican efforts in Congress to repeal Obamacare run into serious obstacles.
And Sanders’ “Medicare for All” proposal offers a road map for how single-payer health care could be rolled out gradually in a way that would avoid major disruptions, notes Katharine London, MS, a top health care policy expert at UMass Medical School.
Under the Sanders plan, Medicare, the government health insurance program for the elderly, would gradually lower its age limit for eligibility down from 65 to the point where eventually everyone is covered.
The former Democratic presidential primary contender has suggested an initial drop in the signup age to 55 as a first step, with those eligible having the option to stick with their private health insurance plans or switch to Medicare.
“If you had a choice, you can choose the plan option your employer gave you, or you could choose Medicare,” said London, principal associate of the Center for Health Law and Economics. “In that way, you could phase it in.”
Eventually, as more and more people dropped their private coverage to sign up with Medicare, employers would begin to take notice.
“If you could get to the point where most people are choosing the public option, employers could just say OK, we are going to go with that plan because it works better for everybody,” London said.
This gradual approach, in turn, would work far better than trying to switch everyone overnight from private insurance to an expanded Medicare plan.
“You could just get there a little bit over time without having as much disruption and make it responsive to people’s needs,” she said.