Premium-supported health care

As N.C. State University economist Mike Walden gets older, he and his wife, Mary, are paying more attention to Medicare, which helps pay seniors’ medical costs. The program’s expense is rapidly increasing to the point it’s long-run viability is in question. Walden shares some ideas on how to address the issue.

“Well …  this is probably going to be one of the big, big issues that we will ultimately have to confront down the road. There are a couple of ways to address it. One would be to have the government be more restrictive on what kinds of medical care they are willing to pay for through Medicare.

“Another way, and this has been getting increased attention, is to totally change the Medicare program — essentially take it out of the government and have senior citizens like you and me eventually buy private-market insurance that would help pay for our future medical expenses.

“But the government’s role would be to help us do that — that is, to support some of our premiums. And this, indeed, is called premium-supported Medicare. And the support would be on a sliding scale with income so that seniors who have less income would get bigger support — in fact, in some cases 100 percent support for their premiums from the government. Seniors that have more income would get less support.

“And from the government’s point of view, this would help them in a couple of ways: It would make the government’s contribution to paying for senior’s medical care more predictable. It would also make it more controllable in the sense that that sliding scale and the percentages of premium support households will get could be changed as economic conditions warrant it.

“This is an idea that’s getting more attention, so I think our listeners will hear it debated in the coming years.”