Mr. Reid's buy-in simply cuts out the middle man. Why go to thetrouble of creating a new plan like Medicare when Medicare itself isalready handy? A buy-in is an old chestnut of single-payer advocatePete Stark, and it's the political strategy liberals have tried sincethe Great Society: Ratchet down the enrollment age for Medicare, boostthe income limits to qualify for Medicaid, and soon health care for theentire middle class becomes a taxpayer commitment.
In the case of Medicare, this meansexpanding a program that is already going broke. Medicare reimbursesdoctors and hospitals at rates 70% to 80% below those of privateinsurers, which means below the actual treatment costs in many citiesand regions. Providers either eat these losses—about half of U.S.hospitals are running a deficit or close to it—or they raise prices forprivate payers.