Lefty Henry Aaron Proposes Folding "Private" Medigap into "Public" Medicare

Henry Aaron, the lefty revolving-door think tanker who the left-wing press claims first¹ brought us the "premium support" idea, is out recently with what looks like a new idea to me. (But -- with Medicare reform -- there are really no new ideas.) Aaron suggests folding Medigap -- particularly first-dollar-coverage Medigap -- into Original Medicare as an option offered by the Medicare bureaucracy rather than it being a separate insurance service from dreaded "private insurers." 

The benefit -- with which I agree -- would be to eliminate a layer of complexity (see chart above from "Medicare and You") in beneficiaries' Medicare decision tree. Or at least it would move the box on the lower left up into the heart of the flow chart and position Medigap and Medicare Advantage equally on the flow chart as the real options they have always been:

• Uncoordinated fee-for-service network-free health care for which you usually pay more for the network-free choice of providers (Medigap)
• Vs.
• Coordinated capitated networked health care for which you usually pay less for provider-network restrictions (Part C Medicare Advantage)

I like it because it would end the useless and intelletually dishonest private vs. public debate about Medicare typically used by lefty academics and think tankers like Aaron to attack those of us who freely choose the "public" coordinated networked health care of Medicare Part C. If Aaron's suggestion were adopted, all Parts of Medicare purchased individually would then be "public." (And all Parts would presumably still be administered by private insurance companies as they are now, which is why the current debate is intellectually dishonest.).

I guess a plurality of seniors could still get their supplemental Medicare insurance through groups the way they currently do but Aaron does not appear to address that issue in his 10,000-word dirge. That length is the bad news. Aaron's good idea is buried at about the 7,000-word point in his 10,000-word snooze about all the things wrong about Republicans and non-enrolled voters (and the few remaining neanderthal Democrats, I guess). 

One of the oddities of this article is Aaron's multiple reference to Medicare Supplementary Insurance (SMI). What he's talking about is Medicare Part B; almost no one uses the SMI term because it gets confused with Medigap. I can only assume that Aaron is trying to confuse readers on purpose but I can't figure out why (unless he doesn't want to tell the nurses and firefighters on good government retiree plans that he wants them to pay a lot more for their Medicare Part B than the rest of us non-governmental retirees?).

¹ To the best of my knowledge, or at least for the 45 years off and on that I bought employer-sponsored healthcare insurance, there has always been premium support.  Aaron might be able to lay claim to first suggesting it for Medicae however; I don't know. Not surprisingly, througout his 10,000-word article, Aaron calls the concept "premium support" when he talks about Democratic-party ideas or positions and calls exactly the same concept "a voucher system" when knocking a Republican-party position or idea. It is hard to keep changing hats like that.