I got to thinking this morning after hearing Chelsea’s criticism of Bernie’s single-payer health care program — when I hadn’t yet seen the details (Thank you Chaoslillith).
A single-payer plan is absolutely the best way to go, as demonstrated by a bunch of other countries. I’ve never doubted it, but I haven’t given a lot of thought to how we actually get to single payer. There’s been a lot of talk of “Medicare for all” and the only more specific suggestion I’ve heard has been to gradually lower the age for Medicare. On the surface lowering the Medicare age makes sense, but it's clear with a little bit of thought that it would be a mess. We’d need parallel infrastructures for the whole transition time, and private insurance — or exchange insurance would gradually fall apart as it becomes less relevant.
So I got to thinking about how Bernie might structure a single payer plan with state participation. One problem with Medicare for all is the need to transform a country full of health care contractors into a single monolithic organization providing Medicare management services. But what if states could contract with private healthcare management companies? It might be a way to create a single payer system with a role for HMOs and Insurance administrators. All the money would still be funneled through the federal government — so it’s still single payer. And it’s single payer with a minimum amount of disruption.
And sure enough that’s what Bernie proposed. (With appropriate safeguards to ensure that we all get (more or less) the same level of care.)
What’s most impressive about Bernie Sanders is his ability to find practical ways to move forward. Bernie is calling for a revolution, and he’s also quietly ready to lead a movement forward one significant practical step at a time.
Bernie Sanders is Amazing.