Nothing demonstrates the lack of vision among the center/right of the Democratic Party like the jumble of names they’ve concocted for their healthcare proposals. Medicare for America or Medicare X, Choose Medicare, Medicare at 50 and Medicare for Anyone who wants it. Lacking their own ideas and vision, center/right candidates have tried to bottle some of the popularity of Medicare For All with their proposals.
Bernie showed them that it was politically astute to lead with Medicare, which enjoys enormous support, and they have responded with the political equivalent of a company releasing a cheap knock off. The thing is, why would you go with a knock off when you can have the real thing?
Since John Conyers first introduced HR 676 in 2003, Medicare For All has had the following essential features:
- universal coverage, i.e. it covers everyone in the US
- it covers all medically necessary procedures (including dental and vision)
- free at the point of service
- private insurance that replicates it is banned
The 2003 bill Conyers introduced was a few lines, but it included this:
Prohibits a private health insurer from selling health insurance coverage that duplicates the benefits provided under this Act. — www.congress.gov/...
That provision is key. Without it, we end up with a two-tiered system where those who can afford a small amount more for additional payment/insurance pay a premium and get exclusive access to providers. With the provision in place, providers who refuse to accept Medicare-For-All will be limited to patients who can pay for all care out of pocket.
The insurance and pharmaceutical lobbies have never liked M4A. They know M4A ends rent-seeking and obscene compensation for executives by exploiting sick Americans. Their lobbyists have been tasked with playing defense. Center/right Democrats, associated think tanks and paid spokespeople are more than happy to oblige by proposing or supporting watered-down knock-offs of progressive policy proposals. Some of them believe it’s politically advantageous, others simply can’t stomach bold proposals because they’ve spent their whole life afraid that Republicans might call them socialists (which they will anyway). They all know that passing a policy with health insurance and pharmaceutical industry support guarantees a lifetime of gratitude in the form of future lobbying contracts, jobs for friends and staffers, invitations to deliver speeches, etc.
Over the summer, leading pharmaceutical, insurance, and hospital lobbyists formed the Partnership for America’s Health Care Future, an ad hoc alliance of private health interests, to curb support for expanding Medicare.
The campaign, according to one planning document, is designed to “change the conversation around Medicare for All,” then “minimize the potential for this option in health care from becoming part of a national political party’s platform in 2020.” — theintercept.com/...
Health insurers thrive on complexity and on exploiting the power disparity between them and patients. That is why they are lobbying for less simple, more complex solutions. Senator Harris has released a plan she calls Medicare For All. I’ll let the person who wrote the current Medicare For All bill in the House say the needful:
Senator Harris is trying to thread the needle here, seeing whether she can create a private/public combination that satisfies everyone. The problem is, this is a Sisyphean task and we know it. The moment you roll a complex health-care boulder (like Obamacare) up the hill, the Republicans will immediately start trying to roll it down the hill.
Best case, Sen. Harris gets the bill passed in year one. By the time her two terms are up (if she wins re-election), her absurdly long ten year phase in still won’t be complete, and Republicans will have demonized the plan a million ways to Sunday. The economy might have stumbled, American’s might get distracted by the antics of a YouTube rat dragging pizza down the subway steps. It’s far more stable if you have a simple solution that people can understand in simple terms.
Patients and doctors want good, convenient care, as Physicians for a National Health Program explain here. Even the conservative AMA came close to endorsing M4A. Insurance companies are not interested in care, they merely want to make a buck out of patients, often by creating nightmarish barriers to care. That is why you see the industry presenting disingenuous arguments against M4A, though studies find it will save Americans trillions of dollars while providing better care, coverage for all and healthier outcomes.
The mere act of trying to reconcile fundamentally irreconcilable actors is so difficult that it seems to be tripping up even someone as astute and sharp as Senator Harris, who found herself struggling to defend her own policy proposal during the second debate.
Some of the confusion stems from the confusing patchwork nature of all such center/right responses to Medicare For All. By trying to be all things to all people they create complexity, which makes the proposals unintelligible and weak.
That’s not as bad as candidates who kept peddling the idea that Americans like their health insurance, rather than their care providers. They’re also trying to scare union workers.
But union members know better. They know M4A offers better coverage than private insurers, and they know that employers have gone bust or reneged on promises to workers.
If Democrats want to learn how to effectively sell a healthcare proposal to the American populace, they should look to Bernie.
— @subirgrewal