A few friends have emailed and asked if I was now fully supporting the Patients' Choice Act. I do support the Health Services Commission and Forum on Quality that I wrote about yesterday that is contained in the Act; I think this is the best way to address cost inflation in Medicare. And it is an area of emerging bipartisan agreement with the President being open to a similar approach (Independent Medicare Advisory Committee). Regarding the full Act, it hasn't been scored by CBO, so it is impossible to make a complete judgment on it.
If I were the king, I would have Medicare for everyone, with persons younger than age 65 having high deductibles (say $10,000 individual/$15,000 family) and a robust private insurance market for the deductible amount. I would have people purchase the 'gap' insurance with after-tax dollars, whether it was arranged by employers or individually arranged. You could certainly have premium support for the gap insurance for low-income groups, and you would need to have an annual physical covered for kids and to cover pre-natal care first dollar. Of course, I am not the king, and we will have to find a compromise that moves us ahead.