One policy proposal has defined this Democratic race. It’s time to move on.
By Michelle Cottle
The New York Times, January 8, 2020
With strong support among the Democratic Party’s base, “Medicare for all” has emerged as a test of progressive bona fides in the race for the Democratic presidential nomination.
It has also emerged as something of a political morass into which the candidates keep stumbling.
The American health care system is, no doubt, deeply flawed, and health care was a hot topic in the 2018 midterm elections. But Medicare for all has dominated the Democratic race for too long, serving neither the candidates nor the electorate well.
A plan to blow up that system and throw 149 million people off their private insurance, while embraced by progressives, is viewed more skeptically by moderates and swing voters.
One could argue that it has already proved problematic for Senator Elizabeth Warren, who has been one of Medicare for all’s top champions in this race, along with Senator Bernie Sanders, who has been touting the idea nationally since his 2016 presidential run. Under pressure to explain how she would pay for her proposal, in November Ms. Warren released a detailed accounting of where the estimated $20.5 trillion that her plan would cost over 10 years would come from.
Her financing plan drew heavy fire as misguided and unrealistic, including from some of her Democratic competitors.
Many observers have noted that the Democratic debates — especially the first ones, which felt like a rolling seminar on medical insurance policy — have devoted a disproportionate amount of time to the candidates slashing at each other over who has the political courage — or naïveté — to go big on health care.
It is miring the Democrats in an unnecessary fight over a policy proposal that is divisive and that would require a political miracle to achieve without a progressive takeover of the Senate. And even then, it would most likely be difficult — remember how hard it was to pass Obamacare even with Democrats controlling both chambers?
With the Iowa caucuses less than a month away, Democrats need to move beyond the Medicare for all fixation. Enough time has been spent bickering over the particulars of an electorally risky proposal that is unlikely to come to pass, no matter who wins the White House.
Michelle Cottle is a member of the editorial board.
Comment (NYT Pick):
By Don McCanne, M.D.
An article published this week in the Annals of Internal Medicine confirms that over $600 billion in health care administrative costs is excessive under our uniquely inefficient system of financing health care. Those funds could be recovered by switching to a single payer model of Medicare for All. But they would not be recovered by merely adding a Medicare for All public option.
It is this $600 billion in savings that makes it possible to fill in the costs for the currently uninsured and those with excessive deductibles and other out-of-pocket costs such as surprise medical bills. Also switching from insurance premiums and out-of-pocket costs to equitable taxes would make health care affordable for each of us based on ability to pay, plus guarantee each of us coverage for life.
Maintaining our fragmented system of private plans and various public programs would forgo this $600 billion savings. Those who say that we should be allowed to choose between private plans and a public option have to realize that we each would be paying an average of $1,900 extra for wasteful administrative services that we don’t even want.
This is not just a question of ideological preferences for private insurance versus an improved Medicare program. It’s a matter of pocketbook economics.
Additional Comment:
By Don McCanne, M.D.
Of course, it is not just a matter of pocketbook economics. Much more importantly it is a matter of reducing personal financial hardship, physical suffering and even death.
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