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Opinion: Joe Lieberman, Medicare expansion and healthcare reform

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Journalists covering the healthcare reform debate have focused their fire on Sen. Joe Lieberman (I-Conn.) today for (gasp!) favoring Medicare expansion a few months before he opposed it. Well, it looks like Lieberman’s going to win this debate anyway -- Politico and other outlets are reporting that Senate Democrats are prepared to drop the idea in order to get Lieberman’s vote for cloture.

Making Medicare available to a few million uninsured people between the ages of 55 and 64 was an iffy proposition to begin with, given the potential cost and distorting effect on the rest of the market. (Even the Mayo Clinic was down on the idea.) Hospitals and doctors argued that Medicare underpays them, forcing providers either to stop seeing Medicare patients or to recoup their costs by overcharging other customers. And the folks most likely to need policies are those who private insurers considered too risky, which means they’d probably be expensive for Medicare to cover. On the other hand, getting those folks into preventative care before they hit retirement age could conceivably lower Medicare’s costs over the long term.

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Anyway, the debate appears to be moot. Medicare expansion struck Lieberman as the first step toward a single-payer system, which he simply couldn’t abide. But what do you think? Should Senate Democratic leaders stick to their guns and try to pass the Medicare expansion proposal with 51 votes, using the budget-reconciliation process to eliminate the filibuster? If they’re going the reconciliation route, should they go back to a more robust public option? Or is Lieberman doing the right thing and saving the country from an ill-conceived compromise among Democrats? Take our poll, leave a comment or both!

-- Jon Healey

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