Your idea is a pipe dream.
Biggest reason is that hospitals and other HC providers would take it in the chin. And hospitals/HC is often the largest employer in smaller and mid-sized communities.
What makes you think insures don't have the same economic incentive to negotiate reimbursement rates as govt does? You act as if they are just a price taker, rather than a price setter. Their entire competitive advantage in the employer based insurance market is based upon negotiating the lowest reimbursement rates as they possibly can, to then beat out competitors on rates to employers. And BTW, most insurers do use Medicare reimbursement rates as their benchmark already....paying a certain margin over them.
The entire fixation on the insurance model misses the point of the real problem anyway. An aging population, that lives longer, but has a high rate of ongoing chronic conditions. The payment mechanism used is rather irrelevant. The cost of actual HC is the issue.
you open by saying my plan is no good because it lowers the price healthcare providers currently receive for services, which is bad for HC providers.
then close your argument with the sentence, "The cost of healthcare is the issue".
nice job of tripping over yourself, and 180 degree contradicting your opening statement with your closing statement.
"The cost of healthcare", is exactly what my plan addresses, and addresses in the most efficient way it can be addressed.
as for my idea being a pipe dream. it's half the pipe dream, because it's far far more politically and logistically doable, of going straight to single payer.
having to address blowback from the moneyed interests isn't nearly as tough as facing that blowback, plus the added blowback of people losing employer based healthcare in addition.
what i suggested gives you the cost reduction advantage of single payer, without forcing everyone off whatever plan, private or employer based, they currently have, which is why it's much more politically and logistically doable.
in addition, the cost containment fundamentals of my plan are already in place and currently being implemented, both in Medicare itself, and as you mentioned, in the Medicare benchmark plus X% on top of that, that you acknowledged insurance companies already use to negotiate their payment rates to providers.
the big difference is, instead of the Medicare benchmark rate plus X% on top of that that's negotiated now, we eliminate that negotiation for everybody, and just mandate use of the Medicare benchmark itself, with zero% adder on top, universally, regardless of who you get coverage through.
as for your point that insurers already negotiate the lowest rate they can for competitive reasons, the problem with staying with that strategy, is that HC providers can always play insurance companies against each other, thus insurance companies don't have the negotiating leverage, (or they already would by your own admission), to negotiate everything down to the Medicare benchmark plus zero% that i just negotiated for everyone.
insurers won't even have to negotiate reimbursement any more, as they'll all pay the same reimbursement, (Medicare plus zero), which i'm confident is less than any are now paying.
and having all insurers paying the same reimbursement rates means they'll have to compete on service, margin, and administrative costs, rather than being able to use scale to leverage their market power to negotiate lower reimbursement rates than smaller competitors. (or individuals paying out of pocket, who had zero negotiating leverage till i just gave them equal rates with everyone else).
every argument you made actually reinforces, not refutes, why my plan is sound, and superior to what we have now, or anything you or anyone else has suggested, so what exactly is your or anyone else's issue with it, other than it's source?