‘Medicare for All’ vs. ‘Public Option’: The 2020 Field Is Split, Our Survey Shows

South Hadley Town Meeting recently voted to follow the voters of the this community - both by a two-thirds vote - to recommend that the Massachusetts State Legislature pass single-payer legislation. Those who thought that we were exceeding our purview as elected representatives forgot the words of former Speaker of the United States House of Representatives Tip O'Neill that "all politics is local". The best suggestion I've come across so far is for gradual adoption of full coverage at no charge to every child born each year, phasing out private coverage except for elective procedures. Each year more people at the other end of the age continuum will qualify for a new, single-payer Medicare; correspondingly, private coverage and those who rely upon it for employment until their own retirement, will be phased out as well. This is the right of every CITIZEN. This is the next step in the social protections passed in the administration of Franklin Roosevelt which we take for granted today. Notice that I said "citizen" and this is where the Democrats lose me: undocumented aliens have no right to this benefit. If our immigration laws mean anything at all, every single illegal alien must be returned to his country of origin and "get back in line". That would reduce costs considerably, perhaps to the point where the Republicans would get on board with the program. Let's kill two problems with one solution.

i won't be voting for a Democrat in 2020. Not a chance. And the expansion of government in healthcare and is one big reason. We're already spending almost 20 cents of every dollar on healthcare, and it's only going to go up when every person has access to unlimited taxpayer-funded resources. Very simply, in healthcare, there are three components, and you only get to pick two of the three. Cost, access, and quality. It's clear that the Democrats want access for all, including non-citizens of course, and illegals can already walk into any emergency room and receive the best/most expensive care on the planet. I'm sure they also want top quality. Which means cost will be astronomical. The federal government has not been exceptional with cost-containment. there are too many cute lobbyists persuading them to give exorbitant sums for medications already - despite having the volume to warrant cheaper rates. I am guessing this then becomes a debt-ridden component of our economy, No one talks about debt. It's depressing. Not a great election topic. Someone somewhere needs to think about it. That's me. We can't afford medicare for all. No public option. Medicine can only be fixed by more free-market forces, not the government. In fact a cash-only option may be the most revolutionary and successful model. Old-folks won't let it happen. Much like the old- folks sitting in Congress right now. But if you're 18-50, you're being abused monetarily for the elderly in the country.

Medicare for all sounds great but the public option may be easier to begin with. REMEMBER FIRST we must defeat Trump and the Republicans who hate any working middle class benefit.

It really isn't as split as this article makes it appear, as far as I can see the majority of the candidates (both those listed as favouring a public option and those listed as favouring medicare for all) are of the opinion that a public option is a good first step towards achieving medicare for all. This isn't surprising as it is the most sensible way to do it. I grew up in the UK and now live in Canada, universal single-payer healthcare is absolutely the way to go, but it would be a massive change from the way healthcare currently operates in the US and massive changes inevitably come with hiccups if you try to do them all at once. With a public option as a first step you could manage the transition more gradually. In Canada the transition to universal single-payer was phased in during the '50s and '60s. The UK is different and the NHS was introduced in one go, but that's because the NHS was founded immediately after WW2 when the entire country needed to be rebuilt from ruins.

Among the many reasons for Hillary Clinton's failure to defeat Donald Trump 2016 is that the Democratic Party utterly failed to perceive the extent of the nationwide rage among those "left behind" by the Affordable Care Act. Mistakenly or otherwise, many middle- and working-class Americans in both parties had been expecting something akin to Medicare-for-All, only to find themselves saddled with soaring premiums and deductibles. Ironically, the one unmitigated success story of the ACA is the 36-state expansion of Medicaid -- i.e. the single-payer part of the program!

Obamacare was a step forward but it also further entrenched profit driven insurance companies and the many cottage industries that also profit from every missing link imaginable as well as manufactured needs by convincing the public that they still need more care "or else!" I trust the government's ability to control costs and provide service more than private industry. Any candidate suspicious of our government agencies such as Social Security and Medicare should be thoroughly examined and investigated for their motives. All candidates should reveal how they make their investment income. Who profits from health care? Who profits from agribusiness? Who is invested in long term health care and assisted living industries? The more details candidates can explain, defend and persuade voters that they have enough intelligence and understanding to gain trust will gain real votes. The media and press need to bone up on various incarnations of plans being casually proposed to learn far more than they do right now. Americans--candidates, voters, media, politicians--are extremely ignorant of realistic options that are serving in other parts of the world. There is no good excuse to be living in such extreme ignorance of this issue.

First, the ACA works for many independent people. For every $65K income 55 year old whose ACA premiums soar, there are three $30K income contractors whose plans are 90% subsidized. A gig economy is not a place to get employer-sponsored care. It's youthful. Most qualify for subsidized ACA, but resist paperwork. The ACA bought insurance co. support mandating they buy insurance. It raised their premiums to offset older people costs. Real world premiums rise slowly until 52 or 53, then skyrocket. The cost of 52 to 65 year olds drives overall premium increases. Between 30 and 52, most people have employer sponsored care that takes a bite out of their paycheck but is the devil they know. Medicare costs almost as much as the entire U.S. military. The military's budget is beyond any current accounting system. If Medicare covered everyone, it would be 3X the military budget. It would be by far the largest organization the world has ever seen. Anyone who thinks this is sustainable is a fool. Anyone who thinks there's an easy fix is a liar. The ACA is a start. It's like getting a decent pair of cards. You need more, but you don't fold. Unfortunately, Americans are vulnerably to bluffs, and often fold too fast.

I favor the Public Option, primarily because it has the best chance (though none too good) of evading the massive lobbying efforts that Big Pharma will continue and expand in order to place their greed above effective health care regardless of the cost to Americans. The Perfect is the enemy of the Good.

I'm following the primary campaigns and, honestly, I don't see Bullock, Delany, Moulton, Swalwell and Williamson as showing up in any meaningful way in national polling. On the other side Gilibrand isn't registering either (BTW where's Gabbard).

What do the Medicare for all candidates propose for those of us who work in the insurance industry? Some explicitly want to shut it down and others are happy to let it die. I’m inclined to support one of these candidates and in fact have donated to one already. However I’m now worried that if this policy comes to pass, I’ll end up like the West Virginia coal miners who voted for Trump to try to get their jobs back. These are well-paying, solidly middle class jobs, and they’re all over the country. Some areas like mine will be particularly hard hit. But I guess at least I’ll have govt insurance as I try to get one of the Amazon warehouse jobs that pay a fraction of these white collar careers? Sure some will transition but when you have that many jobs evaporate, most in that position will have a tough time.

It would be great if the media would stop referring to Joe Biden, every time his name is mentioned, as "the front runner". This smacks of the same treatment the Times gave Hillary Clinton, and 16 months before the election it's far too early to be telling people who's "ahead". It sways susceptible minds and casts a cloud over other perfectly legitimate candidates. Let the citizens decide without putting a thumb on the scale.

Start with the public option, then work your way to a national health care system funded by employers.

I'm pleased to see the candidates taking positions, but would prefer to see agreement some minimum level of healthcare for all needs public funding, as in so many other countries. Then let the political debate proceed regarding where to draw the line between public funded vs. privately covered. After implementing, that line will surely be moved as data comes in and political winds shift, but it's existence needs to be the accepted start point.

I was in Spain recently for vacation and fell very ill with tonsillitis. With the trauma of having seen so many astronomical medical bills back home in the States ingrained in me, I begrudgingly held off on seeing a doctor in Spain until I was so sick that I had to go. I went to a public hospital that was a 10 minute walk from my lodging, got an appointment to see a doctor within minutes, received a check-up, a diagnosis, and a prescription for anti-inflammatory meds and antibiotics. You want to know how much I paid for all of that (including the meds) as a non-citizen and visitor? $70! All in all, I thanked my lucky stars that I got sick in Spain and not in America. I'm uninsured back home, and I'd imagine I'd have had to pay several hundreds (at least) to get the same level of treatment that I did in Spain. Not to mention, even if I was insured here, I'd have still had to pay money to receive treatment. It's about time this country looks in the mirror and realizes it's not the greatest in the world (in more ways than one), and I thank progressive candidates for being brave enough to challenge that long-held, flawed view.

Why can't everyone have what we have as retirees; Medicare and supplementary insurance through my former employer? Subsidized medications and ancillary dental. optical and hearing services are also needed; we get them. Much poorer countries do this; the financial arguments do not hold water, in my view and experience. The criticisms of the Affordable Care Act come from those who have never had to use it. It IS inadequate but still a relief to those who had nothing, like a roofer I met in my doctor's office. There is no need to describe adequate health care as a right; it is a NECESSITY for any nation which needs a healthy population able to work, learn and contribute to the general good.

The population have been wanting healthcare coverage for all for decades. They did not get it. Whatever the candidates say in their campaigns. Read the paper by Gillens and Page and Robert Reich's column in Truthdig this morning.

Let's walk before we run. Obamacare, if properly implemented, is a good first step to getting all Americans covered, and we already have experience with it. It should be cost-effective and contain mandated coverage for those not already under an insurance plan. The US should look at other models. There are excellent coverage programs in Europe besides Single Payer plans. In Switzerland, there is government-managed competition among insurance companies to keep costs down. Coverage is REQUIRED for all, with premium assistance provided to those who cannot pay. And the government negotiates with drug companies (of which there are many here) to keep prices low. It works, and there are virtually no complaints, especially since one can change insurance companies if not pleased.

Reasons why Dem candidates need to rally behind Healthcare for All using the public option as the first step to get there: Americans hate to be forced to do anything; pretty much everybody hates their health insurance; people on Medicare are largely elderly and they are terrified of any changes to it such as might be required under Med for All; there will inevitably be problems with a Med for All rollout that will be used to attack Healthcare for All; rally behind EVERYBODY in America gets healthcare no matter what because we are the greatest nation on earth and that is what we do! No more uninsured, no more overloaded ERs, no more sick and dying homeless, no more holding fundraisers in bars and community centers to pay for a neighbor’s cancer treatment because insurance lifetime limits topped out, no more families going broke to pay for catastrophic expenses. Get the public option going immediately, and watch Americans vote with their feet.

Donald Trump was right about one thing in the failed attempt to repeal and replace Obamacare -- medical insurance is more complicated than (almost) anyone thought. But if anything is going to happen to truly improve medical insurance, it is most likely to be either through Medicare/Medicaid or it is not going to happen. As a Medicare recipient myself, and a former member of numerous private plans during my working life, I can say Medicare is terrific, but doesn't do all it could and can leave you with pretty high costs to cover yourself, while private plans are all over the place in terms of adequate care and are outrageously expensive to boot. I've come to believe that a Medicare/Medicaid option on the ACA would be the most practical way to achieve the goal of universal coverage. It would scare the bejeezus out of the existing private insurance carriers, but that's a good thing! They may not directly collude in designing their plans but they all seem to come to similar, way-too-pricy coverage options and arrogantly believe they're due the highest possible profits for their offerings. They need to be reined back! The other choice, in my opinion, is aggressive regulation a la Germany. Complicated? You bet! But if competition in medical insurance has any value at all, it had better start working and soon or none of us will be able to have medical insurance. Medicare could provide the needed competition.

The DNC had better get their act together and present a united front to the public or it'll be a win-win-in 2020 for TRUMP.

Any public option plan needs to be open for those already having a company plane under these two exceptions: First, if the company plan is not a viable option that is not affordable because of high premiums or deductibles or co-insurance or co-pays, two, if the company plan has serious coverage exclusions due to the religious beliefs of the company owners or managers. A strong example of this is, say, the company boss is a Jehovah Witness believer and excludes blood transfusions from the company plan and a worker uses a motorcycle for transportation to work. Another example would be if the company boss is a Scientologist and the employee has a family member with a serious mental illness, or worse yet, the boss is a Christian scientist believer. Unfortunately, that misguided Supreme Court Hobby Lobby decision makes that exception of urgent necessity!

Healthcare cannot be a right as you would be demanding other people take care of you. People have a choice in what they will and won’t do.

If you are unable to buy health insurance in the USA because of a pre-existing condition, the best option is to leave America and move to a country that has socialized health care, as I did fifty-one years ago. But you will have to leave your assault weapons behind.

Though Medicare for All is good policy it is bad politics in the general election. Trump and the Republicans will tell voters that the Democrats want to take away their private insurance, which is true. If the Democratic nominee runs on Medicare for All we will have four more years of Trump.

Our goal needs to be "Affordable Health Care for All."

Radical change is never the best solution to ensuring availability and accessibility for all Americans, so adding the public option to available health care coverage to gain better access at the same time as lowering costs should be best preferred over a Medicare for All plan. The latter is too radical change. Having been called to Congress to advise its Members on the ACA before it was passed in March 2010 and supporting a public option (politically, Obama could not do this then), it is the best reasonable way to inject needed competition into the health care marketplace to. once more, lower costs and increase availability provided by the private health insurance marketplace.

Medicare Part B requires a payment and so does public option. Not really much difference in the two other than how you set them up.

The article says the the two candidates most in favor of single payer Medicare for All (Bernie and Elizabeth Warren) sidestepped the financing question. Not true. It also says Bernie maintained that by wringing out many costs in the current system his plan would actually save money. How is that "sidestepping" the finance question? He is pointing out that we, as a nation, pay much more for healthcare that we need to, because our current fragmented, profit-based system has so much inefficiency and waste. People get all frothed up about the "cost" of the new system, but don't look at the other side of the balance sheet. Remember -- we are already paying for, in fact grossly overpaying for, our health coverage. Those overpayments will be the source of funds to "pay" for the new system. Too many people who write articles about this, and ordinary people who don't have the time or inclination to focus on the problem holistically, talk only about the "cost" of the new system and seem to forget that it will also eliminate the grossly high-cost current system. The end result will be a health insurance system that covers more and costs less. Can it be done? Every other developed country does it. Absolutely no reason we can't. We just have to grow a spine and tell those who are ripping us off with the current system that the jig is up.

The cost to the federal government for Medicare-for-all under the current cost regime (which is absurdly expensive) is easy to calculate: take the average cost per person of the Medicare Advantage Plans (Medicare Part C) which is approximately $800/month or$9,600/year (it varies by location) and multiply it by the number of people you want to cover. Then subtract 15%, which is the average "surcharge" (excess cost for overhead and profit) cost of private sector administration of the Medicare Part C program. It's about $2.7 trillion or about three times the bloated military budget. That is before you extract cost savings from the system. Cheap for civilized people.

The public option makes the most sense. Medicare for all , is possible but the disruption to private insurance and the current practices runs the risk of unemployment going up in those sectors. The public option would be a money shift , instead of premium dollars going to private insurance the money could go into HHS. I say give folks the option public option would cover primary care, emergency care and lifesaving procedures. There should be a co-pay, attached to,every visit and deductions would occur from paychecks. Families could purchase supplemental insurance to cover cost of elective essential procedures that benefits family overall health. If we are truly a conservative country this pathway makes the most sense.

This is really confusing. Why is it either or? Does Medicare for All ban private insurance? Why can't there be Medicare for All but still allow those who prefer it to buy private insurance, or buy some sort of private supplemental coverage? And why all the hissing and moaning about the cost? Mecidare as it is today still costs each of us. We've been paying for it all our working lives and we continue to pay for it even when it becomes age-accessible. If it takes additional funds use the money private businesses formerly spent to buy employee insurance. And if it still takes more, drop the income cap on social security payments (which is a ridiculously unfair tax break to those who are already rich) and split those additional monies between SS and Medicare for All. Remember, every dollar reduction in the cost of insurance is a dollar that gets reinvested in the economy.

Know this: Only Democrats are going to do anything to improve the lives of all Americans. The Republicans are a broken party unable to do much but bluster about Clinton's email, abortion, and socialism. This while driving us into debt to pay for trickle down economics, packing the courts with judges slowing down the progress Americans vote for, and ignoring Trump's ethical, moral, and legal lapses. Medicare for all? Public option? Only Democrats will have this conversation. Republicans are too busy extracting cash from the the system to be bothered to engage in a meaningful conversation.

What each candidate has omitted are the opinions of physicians. You can't just say "Medicare-for-All," there it is, that solves everything. For example, Kamala Harris is fond of saying that 91% of doctors already take Medicare, so what's the problem? The problem is, this statistic is from 7 years ago, before physicians started bailing out due to ACA reductions of income and impositions of mind-numbing bureaucratic box-checking that is destroying the practice of Medicine. What Ms. Harris may also not know is that of those physicians still taking Medicare, many, like myself, restrict our Medicare population to 20% to avoid these hassles. We advocate an employer-funded system based on Medicare as a chargemeaster, which would allow layered plans, which would set doctors free to compete with each other for patients without bureaucratic restrictions, which would reduce costs by eliminating waste, while at the same time raising standards. No copays, no deductibles. In our plan, there are no tax increases and corporations would save $180 billion per year, so it is likely to receive bipartisan support. The US as a whole would save up to $1 trillion per year, and everyone will be insured. Healing American Healthcare. Let doctors be doctors.

The goals of modernizing American health care should be: A) Lower costs - we spend almost double what the rest of the developed world spends - almost 19% of our GDP vs 11% in nations like France, New Zealand. We are on our way to as much as 30% of GDP if we don't reform our system. B) Ease of use - with a single-payer system, paperwork can be reduced dramatically. Our health insurance mess creates huge administrative bureaucracies that eat up budgets of time as well as money. C) Everyone must be covered - we currently cover 90% of the population, leaving over 30 million people uninsured. D) Better results - our life expectancies are already lower than the rest of the developed world and they are falling. We have higher infant mortality and higher rates of serious disease. We could also stand to adopt the French health care ideal of "Solidarity" - which means the sicker you get, the less you pay. I spoke with a French citizen who told me, "We think it is barbaric that Americans lose their houses and life savings because of getting sick." How we get these goals met matters less than getting them. Should progressives care if a conservative idea helps to lower costs, improves quality, ease of use, and includes everyone? Best...H

Medicare for all, march in step with much of rest of globe.

Ms. Warren and Mr Sanders, I am a huge fan of both of you. IMHO this is one of those occasions where half steps are still giant steps. It's really not worth alienating those 10 to 15% of the voters who may want to keep their insurance. And while I am giving you advice, I would strongly suggest that you find some way to form a Progressive coalition. You each have a different demographic and we need reasons to unite all those people. Don't let the Radical Centrists divide you on marginal issues. Thank you for your attention.

We're having the wrong conversation. The priority should be on reducing costs and on eliminating inefficiencies and perverse incentives from the existing system. And Medicare-for-all is a prescription for out-of-control costs and politicalization of healthcare. Two first steps: more transparency in pricing, and higher co-pays.