The Hillary Clinton campaign appears to be trying to erode Bernie Sanders’ support in the liberal base by being less than truthful about his healthcare reform proposals. It's a baffling and short-sighted position for her to be taking, and a strange place to try to create contrast in the base, since it's been clamoring for some kind of single payer option for years now. The latest broadside from the Clinton campaign came from daughter Chelsea, who gave a frightening—and incomplete—picture of Sanders' single-payer approach.
Chelsea […] argued that Sanders would dismantle Medicare and Medicaid—and "strip millions and millions and millions of people of their health insurance." […]
"Sen. Sanders wants to dismantle Obamacare, dismantle the [Children's Health Insurance Program], dismantle Medicare, and dismantle private insurance," she said, according to an account from NBC News. "I worry if we give Republicans Democratic permission to do that, we'll go back to an era—before we had the Affordable Care Act—that would strip millions and millions and millions of people off their health insurance."
What's left out, of course, is that these programs would be replaced and healthcare would become universal. The argument that this could undermine Obamacare, well, Republicans sure as hell don't need Democratic permission to try to destroy that. It's ridiculous to suggest that Sanders wants to destroy government health care programs, when he's actually advocating for government-provided health insurance for everyone.
There is, however, some valid criticism of Sanders' plan, based on the 2013 legislation he introduced, and how it would get paid for. All things being equal—meaning it needs new pay-fors—it could mean higher taxes on the middle class, and those taxes would not necessarily be offset by the savings this group will see in their health insurance plans. It doesn't have to, because there are certainly sources apart from payroll taxes to pay for healthcare. The Sanders' campaign, though, needs to make good on his promise to deliver those funding ideas.
In the meantime, Clinton could do herself some good, and more importantly help advance healthcare policy, by doing something the progressive and liberal base is fully behind by not rejecting out of hand an expansion of public healthcare. She's right to defend Obamacare, but wrong not to see that there are looming problems in our system that threaten its long-term viability—problems that aren't even directly related to it. Namely, how being insured is increasingly not necessarily enough to help you avoid financial catastrophe because of a health issue. Saving Obamacare is going to mean building on it and fixing the stuff it doesn't address.
At the moment, she's trying to walk a line between flat-out opposing single payer, which she knows is not a good thing to do in a tight primary, and finding things to criticize in Sanders' plan. Here's the answer, and one that Sanders could be promoting too, via digby and Brian Beutler: Resurrect the public option.
For Sanders, this is how you transition from Obamacare to single payer. For Clinton, it's retaining Obamacare and building on it. For the country, it gives people under 65 a solid system to buy into, one that happens to be doing a pretty damned good job at saving the country money right now. As Beutler says, it "addresses all of the issues at the heart of the Clinton/Sanders dispute":
1. It can be administered by the feds.
2. It would reduce federal and individual health expenditures.
3. It can serve as a default plan for the uninsured.
4. It’s an ideal vehicle for migrating toward a single-payer system over time, while mitigating disruption.
It's also popular with the base. We still need a Sanders—and as many policy-makers as he can recruit to his side—to be taking the left flank on full single-payer. But there are some realities to face about how we're going to get there. We need a serious discussion and a serious plan on how to do that to both save and build on Obamacare. Here's the answer—if the candidates will take it up.
