We need to expose the fatal flaws in Medicare For Some option as opposed to Medicare For All. The Center on Budget and Policy Priorities has a 2009 article that touches on what is wrong with Biden’s proposal.
It also is essential for an exchange to limit the extent to which healthy and sick people separate into different insurance plans. Such separation —known as “adverse selection” — can cause plans that attract less-healthy enrollees to become increasingly unaffordable over time.
Joe Biden’s plan to have Medicare only as an option violates this need to prevent adverse selection. With Biden’s plan Medicare would be the insurer of only the sickest people. This would guarantee that Medicare would be more costly than private systems that only insured the healthy. This would set up the scenario where rabid capitalists could claim that government programs don’t work, and everything should be privatized. This is no accidental byproduct of Biden’s plan. This is exactly the neoliberal intention of the Obama/Biden/Clinton wing of the Democratic Party.
In the Sep 12, 2019 Democratic Primary Debates, the question was put to Bernie Sanders on why his plan did not allow for people to keep their private insurance plans. He missed a golden opportunity to explain adverse selection. It is not that Biden’s Medicare option is not as good as Sander’s Medicare For All plan. The problem is that Biden’s Medicare option plan is a plan to kill Medicare entirely.
In the debate, Biden went out of his way to describe the free choice in his system. You could choose to keep your private insurance, and at the very moment you discover that it doesn’t cover you for a newly discovered ailment, you can then choose to switch to Medicare. In other words, as long as a cheap policy that covers nothing turned out to be inadequate, you could switch to the more expensive plan that gave you actual coverage. This is plan that enhances adverse selection to its most pernicious level. Biden is not too ignorant to notice this. He must have set up this plan with the intention of destroying a government run plan so that he could tell us that we need to privatize everything the government does.