Gingerly, Democrats Give ‘Medicare for All’ an Official Moment

Apr 30, 2019 · 39 comments
Andrew (Forest Hills, NY)
MfA has 1 critical problem: it puts the government in charge of running it. Every 2 years, we risk Republicans taking over and overhauling it. Even if it set up with the right policies, government employees (appointed or civil servants) will be running day to day operations. Services and contracts will be outsourced to the usual groups, who have high overhead. Just stop. We need a public option, your USPS equivalent to UPS and FedEx. We need proper policies encoded in law that makes prices more transparent. What we don't need is another monolithic government agency that will do an OK job at best.
Bill (NC)
What could go wrong... put the government in charge of your healthcare. The government has proven incapable of managing everything they have been given responsibility for. Enough of this liberal idiocy.
metamorphys (Boulder, CO)
@Bill What a tired trope you trot out. Take a look around the rest of the developed world and you can't logically defend what we have going on here re: healthcare access and management. Were it not for Medicare, my dad's fatal illness would have bankrupted our family. He died from ALS. Ask all the mining families who benefit from the federally insured pension and health care that is taking up the slack for the mining companies that are reneging on their promises to provide those benefits, even though there are far fewer employees to keep their promises with. Even with its issues and flaws, the VA serves millions of veterans. For every "incompetent" governmental program, there is a privately run program that fails its customers through incompetence, short sightedness, and greed.
Melbourne Des (Melbourne Australia)
I live on Australia were we have a universal health care policy my mum asks me when I will i move back yo the Stated and I say never I just had a day surgery at a public hospital Walked in showed my card was well attended by all the health carers and at the end of the day walked out with smiles goodbyes and nothing to sign or pay granted I had to wait but if you have something serious there is no wait or Chest pains free ambulance takes to best cardio center 8 hours of observations and a follow up cost me a taxi ride home I am bemused by the health debate in states and saddened as the politicians here are trying to erode a good system into a state system If the corporations would pay their taxes like i a humble teacher pay mine think if the amazing universal health system Australia and the States could have By the way for more comparisons Ventolin over the counter here 5 dollars Benefits of PBS in states do for appointment and 35 dollars I will not come home as it doesn't make economic sense Cheers From down under
s.whether (mont)
"When I argued that we should freeze federal spending, I meant Social Security as well; I meant Medicare and Medicaid; I meant veterans' benefits; I meant every single, solitary thing in the government." (J. Biden, Jan., 1995) He was defending the proposed GOP balanced budget amendment at the time and his argument was clear. At other times in his career we have seen the same capitulation that might have been in the service of political expediency and/or a 'higher ideal'. But, sadly, the politicians that do this only delay necessary change like Single-payer health care, living wages, addressing clear taxation inequality that benefits, disproportionately, the wealthiest corporations and citizens etc. The fact is National single-payer healthcare is approximately 2-3x 'less expensive' and it results in better outcomes, preventive care saves business(es) and patients 10s and 10s of billions annually, and it's more humane and moral. These are all facts. And yet, too many candidates for POTUS are hedging their bet on this subject. Why? The majority of Americans are for it, it's less expensive, more 'christ-like',etc. The 'why' is because of one thing and one thing only: Profit. Insurance Company Profits. Pharmaceutical Company Profits. Lobbyist Profits Profiting off of pain & suffering is immoral and wrong. And only politicians seeking lobbying money & insurance company propheteers will tell a different narrative. This battle has nothing to do with free enterprise. Nothing.
Roberto (San Francisco)
It's idiotic that there is debate on this issue. Just look around the world and one can see so many successful healthcare systems that provide worry-free, cradle-to-grave care. It's embarrassing that our once-great empire is #37 on the list of countries' healthcare quality. Our infant mortality rate is about the same as Cuba, the poorest country in North America. We pay twice as much, per capita, as France, the #1 rated system in the world. The opposition? The highly-profitable private health insurance industry, pharma companies afraid of price regulations, some compromised democrats, and all republicans, of course. Money truly is the root of all evil.
Silvana (Cincinnati)
If people like their private insurance so much, why don't they continue with their private insurance when they retire or when they reach 65? Most people I know in my age group who are between 55 and 64, can't wait to get their Medicare benefits. I wonder how many people who "love" their private insurance are willing to forgo their Medicare option when it becomes available to them. People who crow about how great their employer provided insurance is, are deluding themselves because they don't know how much their medical care is actually costing them or could potentially cost them if they got really sick. Private insurance raises costs because of so many factors. People have to have insurance, so they pay outrageous prices often with blinders on because no one, not even the doctors providing their care knows what the prices are! Wake up people and realize that you are being scammed to death.
AACNY (New York)
Americans will never accept health insurance that doesn't have a private component. They like their freedom to choose and to have options. Obamacare's unpopularity was its restrictiveness and high costs. A dead end for American consumers.
Lg (Sf)
@AACNY. Not sure what you mean about restrictiveness. In California we are offered Blue Shield, Kaiser, Anthem Blue Cross, and a local option, with multiple choices of plans per company offered. We chose a high deductible plan and our premium is $4 per month. We are a retired couple, not quite old enough for Medicare, with a history of cancer and heart disease
Richard Winchell (New Hope, PA)
Some version of Medicare for All may be good policy and certainly better than our current for profit catastrophe. But if the proposal requires that 175 million people give up their private insurance it will never see the light of day. Americans like their freedom and their ability to choose; it would be political suicide to eliminate private health insurance and promise something better. Allow Medicare, with its dramatically lower administrative costs, compete with private insurance and consumers will flock to it.
James Wallis Martin (Christchurch, New Zealand)
If the Democrats don't whole-heartedly get behind healthcare as a basic human right and that the health of the nation should not be a for-profit business, but rather a better regulated and fairer system then they will only be seen as Republican-lite and still beholden to Wall Street. Without a clear difference, the Republicans will hold on to the Senate and Presidency because short of the economy tanking before the election, unemployment skyrocketing toward double-digits or the Electoral College being abolished, healthcare is the only area where Trump's base might be willing to change sides.
kknight (portland)
Those who have listened to the new regs regarding monitoring of health care in religious-based systems must be appalled. I am - ISIS of health care does not acknowledge indications of patients about their desire for abortion, end-of-life care, medical agreements with family, etc. Instead, it prioritizes the religious beliefs of providers. This proposal is unacceptable, discounts the expressed needs of patients and is yet another step in the disintegration of democratic values.
Jon (Danville, CA)
I think we should every year lower the Medicare eligibility age by one year. Eventually we would have Medicare for all, but in a gradual fashion that would allow for payroll taxes to be adjusted slowly. We cannot predict the results of a rapid change to our health care system. And allowing people to buy into Medicare would select for the sickest and eliminate the broad membership needed for lower premiums. Remember that Medicare pays 80%, not 100%. Supplement premiums are the same regardless of income, unlike premiums and copays under Obamacare.
Connecticut Yankee (Middlesex County, CT)
There are two types of voters in America. Those who vote with their hearts and those who vote with their heads. No one who votes with their head supports Single Payer.
Larry (Somers, NY)
@Connecticut Yankee. Dear Yankee: Please drive a few hours north to Canada. Stay there long enough to have a few dozen relaxed conversations with ordinary Canadians about their national health insurance (insurance - not delivery). I did this when my truck driving job took me to Canada many times. Most Canadians are as committed to it as most American seniors are to Medicare. They will say it is a good foundation that can be improved. A morsel for our heads, not our hearts: Canada spends $6,000 per person for its total health care. We spend $10,000.The big result? Canadians live three years longer than we do. I am serious. Take that trip and listen to our friendly neighbors. Find out why so many of them feel sorry for us with our endless frustrations about health care.
Anthony (Tacoma WA)
@Connecticut Yankee: My take, and I work in the healthcare industry, is that support for the true single-payer plans, i.e. the Jayapal or Sanders proposals, is the "climate change" of the left. People who have absolutely no idea what they are talking about, haven't studied the issue or spent any time reading or thinking about it, are 100% convinced that they are correct; that people who disagree with them are greedy, immoral, unjust and even "evil". It's mindless proselytizing, sanctimonious ignorance. Of course the truth and correct path are somewhere down the middle.
Penny (FL)
I totally disagree. I vote with my head and my money sense. MfA is the best option out there
Dr. D (Virginia)
Medicare at 55. We have too many people at 65 who put a drain on Medicare since that have put off treatment for chronic conditions for many years due to no health insurance, or lousy health insurance. Get them in the system and under treatment.
DataDrivenFP (California)
Since the Republicans in the Senate will kill any attempt to expand or improve US health care, while they're trying to eliminate coverage for more people, this discussion is really about considering plans, mapping out battle lines, and choosing sides. Politics is like driving: use "D" to go forward, "R" to go backward.
Elizabeth (Minnesota)
Medicare for all will keep in place our high quality hospitals and health systems, but will allow universal access and decrease costs overall. it is time to give it a try.
Mon Ray (KS)
There are many millions of Americans, many of them voters, who like their current health plans and will strenuously object to having to give them up and to lose control of the doctors and treatments they have access to.
Snowman (Larkspur, Co.)
@Mon Ray Although I support something analogous to Medicare for All, I believe that those wishing to keep their current plans, as well as the premiums they will pay to keep them, may help expedite implementation of Medicare for All.
Whiteylockmandoubled (Connecticut)
@Mon Ray: Actually, 2 million workers lose their job-based coverage every month by changing jobs, retiring or getting laid off. That's 24 million people a year losing employer sponsored coverage, without counting the millions who change plans because their employer changes what's offered. People on employer coverage have little control over which doctors they can see. Employers and insurers are constantly shrinking provider networks to control costs. Polls show as many as 14% of Americans lose access to a provider each year due to network changes. Medicare for All? See any doctor you choose. So, would you prefer a system in which your employer lets you choose an insurance company to tell you which doctors you can't see, or one where you can just go to any doctor you want?
Lynn (Greenville, SC)
@Mon Ray "millions ... who like their current health plans " Who are these people? I for one am sick of co-pays, exclusions, rising premiums, indecipherable bills, refusals to pay for the cheap med with no real side effects and insistence that I accept one with serious side effects etc. The last time I called my insurance company to complain about a clear instance of fraud, the person who answered wanted to talk about nothing but my feelings as in "You feel the creation of a fictional dependent on your bill was intentional." I won't miss talking to that nitwit at all. My insurance is with one of the largest employers in the state and I'd drop it in a heartbeat for Medicare for All.
Paul (Brooklyn)
Be careful here. Universal, quality, affordable health care should be our number one goal here in America and join the rest of our peer civilized countries. What not to do? What Hillary did in the 1990, ie pigeon hole the answer into a total socialist program like in Great Britain. Yes, as mentioned in the first paragraph but don't obsess over a single problem like medicare for all or what Hillary did. Any program our peer countries have or any combo of them is better than our current (per ACA) de facto criminal republican plan of don't get sick, be rich and/or don't have a bad life event. Comprise it with moderates of both sides and avoid the extremists on the left and right.
Henry VIII (Montclair)
For the 11 millionth time, we are NOT talking about overhauling the health care system. WE ARE TALKING ABOUT HOW WE PAY FOR IT. We are NOT talking about eliminating doctors. We are talking about eliminating insurance companies. We are NOT going to ration healthcare. We are going to EXPAND IT. We are NOT talking about putting government in charge. We are talking putting doctors in charge. The people who oppose MFA are either greedy insurance executives who profit off of death. Or tragically stupid people who are terrified that the government might help "those people."
H (NYC)
Balderdash. Every single payer system in existence has healthcare rationing, waiting lists, and a laundry list of medications and treatments that are not covered. The UK does cost analysis with every prescription drug. Canadian hospitals receive an annual budgeted amount. The unhinged screeds about greedy insurers are comical. The Blue Cross insurers were all nonprofit once but were converted to for-profit with the aid of states governments who received a large payout for their acquiescence. Just recently, nonprofit Fidelis was sold to Centene when the Archdiocese decided to cash out. But there’s still Kaiser Permanente and several other large nonprofit insurers out there. And don’t forget about Union healthcare plans. What you also fail to acknowledge is that insurers both nonprofit and for profit currently manage Medicare Advantage and Medicaid patients. States and CMS have contracts with private insurers to manage public healthcare programs. Some actually do a good job at preventing repeated hospitalizations. There is so much wrong with the Bernie Sanders Medicare for All, I don’t have the space. But it’s fiercest proponents are frequently the most uneducated on the US healthcare system. Obviously reforms need to be made to reduce costs, increase coverage, and improve outcomes. But single payer that bans private insurance is just insane.
Rhsmd1 (Central FL)
@Henry VIII of course there will be rationing of healthcare. do you think 85y/o should be on dialysis?. do we want to have annual tax hikes to pay for care that will be futile? get real.
ARL (New York)
@Rhsmd1 You are going to pay one way or another. If you don't want to treat mom's breast cancer, you will be paying SSDI for her children, or maybe foster care. I'm happy to pay for care for genetic issues that extend life to a normal life. Its no one's fault they were born with MS, type 1 diabetes, sickle cell anemia etc and these people can live a full life for a small amount rather than dying of lack of care. Yes, its futile..they will die sooner or later, but the price for later is small.
ann (Seattle)
To avoid undermining their national health care system, Canada manages to have few illegal immigrants and accepts most of its legal immigrants on a point-based merit system. Those who could help Canada’s economy by bringing a special skill and educational background are given high points. Those who are fluent in English and/or French, and those who could easily assimilate are also rewarded with points. (While already having a relative in Canada might help a migrant assimilate, this is but one small consideration.) Thus, Canadian immigrants get high paying jobs which allow them to pay high taxes that help support the national health care system. We have what might be described as the opposite of the Canadian immigration system. We have millions of poorly educated, non-English speaking illegal immigrants. (The PEW Trust estimates the number at around 11 million. A Yale - MIT study found the number to be between 16 and 29 million.) We award almost 2/3’s of our green cards solely on kinship. It does not matter if an applicant is educated, has any skills, knows any English, or would be able to easily assimilate, beyond that of having a relative already living here. The only thing that matters is having that relative. Thus, many, if not most, of our legal immigrants have low paying jobs. If we want Medicare for all, we must change our immigration system.
Sarah99 (Richmond)
@ann Thank you! I have pointing this out for years. We can't have open borders, "free" insurance - we will be bankrupt.
AACNY (New York)
@ann Maybe democrats would accept more stringent immigration policies as part of the deal.
pedro (Carmel)
start taxing these corporations that are paying zero taxes and put that to pay for health care,it is a start
caveman007 (Grants Pass, OR)
The poor and the unemployed have Medicaid. The Democrats should defend their base by proposing Medicare for everyone who works for a living. What are we, chopped meat?
Susan Ahern (Richmond, Virginia)
The least disruptive way to move toward a single-payer system would be to start out w/ Medicare X, a public option that could be offered on ACA Exchanges. Medicare X is co-sponsored by Va Senator (former VP candidate) Tim Kaine. Medicare X would NOT touch the Medicare Trust Fund, as consumers would pay premiums for health policies. “Well baby” and obstetrics would be offered, unlike W/ traditional Medicare. There would be no deductibles and premiums would be cheaper, because like w/ traditional Medicare, Medicare X would NOT have to pay fat CEO bonuses, shareholder profits, or pay for fancy TV ads/expensive P.R. Medicare X also doesn’t pay CPAs to devise clever ways to deny care. (private insurers pay ALL these costs) Medicare X would force private insurers to lower overhead to compete. There is very little real competition in healthcare and that’s one reason prices are so high. Unfortunately, the kind of free-market, “less-government intervention” policies Republicans pushed in the past saw private insurers merge and jack up rates. This hurt consumers. Another important point is that in an eventual single-payer health system, ONE big “insurance risk pool” would include the whole country. This would bring premiums down, as a favorite way for private insurers to raise premiums is to create tiny risk pools and then raise premiums because of “bad experiences” the year before. Common illnesses are treated as shameful liabilities. Not so w/ Medicare X.
Mannyv (Portland)
As long as MfA doesn't restrict private insurance it should be great for America. The problem is that "the movement" will always object to the idea that the wealthy can pay for better care. They need to let that idea go and just be happy that everyone can get basic care for free.
kim (nyc)
@Mannyv This doesn't sound true to what I've heard from those arguing for single payer health care. It would be folly to believe wealthy people who can afford premium healthcare can and should be stopped because of, I'm assuming you're suggesting, jealousy on the part of the rest of us. The thing I admire most about "the movement" is their commitment to the working poor and middle classes, the 99%. I honestly don't think they care or think about the 1% as long as they're paying their fair share like the rest of us.
Kenneth Fulford (Asheville nc)
@Mannyv I agree. I read today about the massive effort Steve Jobs went through with teams of specialists and perhaps two medical universities trying everything they could including untested drugs to save him to no avail. Not letting the rich and powerful have their own insurance will be a scab on the MfA that its opponents will pick at to the distraction of the whole plan.
Dejah (Williamsburg, VA)
@Kenneth Fulford Steve Jobs died because he didn't take the regular care that was advised to him in the VERY beginning right after his cancer diagnosis. He had the VERY simply, VERY easily curable form of pancreatic cancer. He INSISTED on trying "alternative" quackery instead of taking chemo... until it was WAY too late. He admitted this right before his death. Then he died. Had he not been a total idiot who "knew everything" and thought his money could buy him "something better" than the same medicine that we ALL get, Steve Jobs would be alive today. On plain old Chemo. Narcissism killed Steve Jobs. The rich will always buy "better medical care." The UK has a rather good system where the NHS provides darn good, worry free health services to everyone. The rich have private health services, private doctors and private hospitals, and private insurance if they want to pay for them. People like me who are rather ill and very fragile don't have to be concerned that abusers like my narc husband will up and leave me in my 40s, or that I'll be too sick to work and maintain insurance, or that Obama care policies will beggar me. There is basic care. The rich will always have a parallel system that they can pay more for. SHOCKER.