Public Option Finale?

| Mon Dec. 7, 2009 1:57 PM EST

Healthcare reform took a fairly unexpected detour this weekend.  A consensus seems to be developing, even among liberal senators, that the public option just isn't going to happen, so now a whole bunch of alternatives are being discussed to make up for its loss.  Including this:

Sources who have been briefed on the negotiations say that Medicare buy-in is attracting the most interest. Expanding Medicaid is running into more problems, though there's some appeal because, unlike increasing subsidies, expanding Medicaid actually saves you money. There's also ongoing discussion about tightening regulations on insurers, but I don't know the precise menu of options being considered.

The idea here is that you could buy into Medicare if you're between the age of 55 and 65.  It's the ultimate public option, but only for a subset of the population.  On the bright side, it's a pretty big demographic, and it's also the demographic that, on average, has the most health issues.  On the less bright side, I also imagine that it's a demographic that's pretty well covered by employer insurance already.

In any case, I think it's a great idea, though I have a hard time believing it's going to be suddenly resurrected at the 11th hour like this.  Still — and with the caveat that I'm a lukewarm supporter of the public option in the first place — I'd probably take this over the public option as a straight-up trade any time.  Not only does it do a lot of good, but it sets the stage for possible future age reductions.  Ezra Klein runs down the rest of the possible compromises here.