So why has it not occurred to the champions of reform that instead of telling people that the public option is "like Medicare," we might simply let the public option be Medicare? That would reduce all the complexities to one clear-cut public-option solution: Amend Medicare so that it will be available to everyone regardless of age.
Since 1951, the self-employed have been able to buy into Social Security; currently about 9 million of them are in the system. Why not remove the age restriction on Medicare and let everybody buy in who wants to buy in? Medicare provides a very elusive target for right-wing vilification or for those who seek to make reform look so complex that we must wait an additional 20 years to change the system. It is a time-tested program that people know and trust. It has an exemplary track record for low-overhead administration. Medicare is already the most successful cost-control program we have, and it can be made more effective still. (There are estimates that fraud in the system costs over $60 billion a year -- a serious but fixable flaw that accounts for enough money to keep the system solvent.)
Above all, it's here. Its administrative procedures and personnel are in place. Unlike health co-ops -- which remain a mystery to most of us -- Medicare needs only to be expanded, which has to be cheaper than starting from square one.
Read it all at latimes.com