Medicare Direct, A Blueprint For Public Option Waivers, Part 1: Introduction, Administration, And Financing

There is a reason that Medicare for All has captured the enthusiastic support of a large majority of the public: The status quo for our health care system is unsustainable economically and unforgiveable morally. An honest assessment of the probability of Congress enacting Medicare for All–related legislation, however, demonstrates it is highly unlikely in the foreseeable future.

In the absence of federal legislative action, states have an opportunity to advance the concept’s core principles—lower-cost, higher-quality coverage delivered via a trustworthy, public-interested platform—using a unique combination of waiver authorities permitted under current law. I suggest such a program be titled Medicare Direct.

This proposal represents an evolution from my original investigation of “Medicare Advantage for All” (with traditional...