Medicare for at least some

Earlier this month, Rep. John Dingell (D-MI) introduced H.R. 2034, which he touted as a Medicare-for-all bill. This bill would allow most people to enroll either in Medicare or the Federal Employees Health Benefit Program, which provides insurance coverage for members of Congress.

Some labor and community activists have praised the proposal's basic concept. Ruben Burks of the Alliance for Retired Americans said, "The legislation is based on the premise that Medicare is a successful program that has saved countless lives, and could help younger Americans in addition to seniors."

Critics of Dingell's plan have pointed to some important flaws. Because the bill preserves a two-tier health coverage system – Medicare and private insurance – healthier and higher-income individuals and families will go to private insurers, while lower-income people as well as those with more chronic or long-term care needs will be enrolled in Medicare.

If this occurs, the financial strain on Medicare without additional investment could help boost pro-privatization critics of Medicare. At the very least, Medicare recipients could see their out-of-pocket expenses grow.

Meanwhile, without proving itself more efficient and less-expensive, the private sector would enjoy continuing double digit inflation on premiums with declining coverage.

Rather than a stepping stone to a single-payer system, the Dingell plan, without the needed political commitment to guaranteeing health care for all, could very well sound the death knell of Medicare.

In addition, the Dingell plan does not mandate coverage for everyone in the US. It excludes undocumented workers and visitors to the country.

Another Medicare-for-all alternative is already on the books. H.R. 676, a national health care, single-payer plan sponsored by Rep. John Conyers (D-MI), would expand Medicare to cover everyone for just about any health care need.

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