Between the Lines Radio, October 23, 2019
Democratic candidates vying for their party’s presidential nomination by and large agree that achieving universal health care in the U.S. is a worthy goal. But the candidates diverge on how to reach that goal. While Vermont Sen. Bernie Sanders and Massachusetts Sen. Elizabeth Warren have championed Medicare For All mandating universal coverage, other candidates including former Vice President Joe Biden, Minnesota Sen. Amy Klobuchar and South Bend Indiana Mayor Pete Buttigieg have attacked Medicare For All as too costly, too complicated and politically unpopular.
In recent Democratic candidate debates, television moderators have posed questions that repeat Republican party, insurance and healthcare industry talking points, maintaining that middle-class Americans will both lose the private health insurance policies they like and will be burdened by steep tax increases.
While Sanders and Warren have done their best to effectively rebut these conservative criticisms, it’s clear that they will need to be more specific about the overall costs of Medicare For All, and who will bear the burden. Between The Lines’ Scott Harris spoke with Dr. Susan Rogers, a board member of the group Physicians for a National Health Program. Here, she responds to some of the often-repeated false claims about Medicare For All, while making the point that every other industrialized nation in the world except for the U.S., has a universal health care system.
DR. SUSAN ROGERS: Well, there is a lot of talk about taxes and people respond almost emotionally to just the word “tax.” But what we’re advocating for is that there would be a small tax that people would pay, but that would be in place of what they’re currently paying as part (what) they pay for part of their cost of their health insurance. And I like to look at this as when you look at your paycheck, you have a gross amount at the top and then you have multiple deductions from that amount. They go to Medicare and their federal tax, state tax, whatever. And there’s also a deduction for your part of the payment for your healthcare, your health insurance that is on there. And what we propose is a tax that would take the place of that deduction for the health insurance, which would likely be smaller than what you’re already paying.
Some people are already paying a couple hundred, several hundred dollars a month for their, you know, family coverage. And so, not only would you be paying less, but you’d also not have to pay any more deductibles, which can sometimes be $5,000 or $6,000 a year. You wouldn’t have any co-pays. We would negotiate to get the costs of drugs decreased so that your total out-of-pocket expenses would be less. And I really believe that the bottom line on your check would be greater. You would be able to deposit more money in the bank because you’re not paying this deduction for your health insurance.
BETWEEN THE LINES: Do you think the candidates advocating Medicare for All have answered the questions effectively to dispel some of the fear-mongering that’s going on, particularly among conservative politicians, but also from the healthcare industry itself, which vast parts of that healthcare industry are opposed to Medicare for All?
DR. SUSAN ROGERS: I don’t think they have. I mean, one of the biggest problems that people face isn’t just what they pay for their health insurance, but the out-of-pocket expenses are just phenomenal, most people cannot afford. And, one of the things that happened with the Affordable Care Act is that clearly the number of people who were uninsured decreased. But what happened was that the number of people who, what we call “underinsured” markedly increased. And by underinsured, we talk about where you pay – it gets tricky depending on income – but up to 5 percent to 10 percent of your income for medical bills. If that’s you, then you are underinsured.
And what happens is that people cannot pay, you know a $1,000, $2,000, $3,000 deductible. So essentially, they are not even able to use their insurance. So people are underinsured. They have an insurance card but they cannot afford to pay for it. And to me that’s just like having a car sitting in your garage. You pay the car note every month, but you don’t have the keys to the car; you can’t drive it. And that’s what’s happened to a lot of people with insurance and you know, they are now underinsured. So I see it a lot. People do not come in for care because they cannot afford to pay down that deductible before their health insurance kicks in.
BETWEEN THE LINES: Doctor, I wanted to mention – in addition to the tax question that comes up quite often in these debates and commentary about Medicare for All, the other question that the candidates running in the Democratic primary are confronted with is “Will you sign on to the plank in the Medicare for All legislation that private insurance will hereby be abolished?” Tell us a little bit about the private insurance industry and what happens to it if Medicare for All gets passed?
DR. SUSAN ROGERS: Well, there would be no role for private insurance with a single-payer program. There’s really only three reasons why other countries have private insurance even though they have a single-payer program or government-funded care. And that’s if you have what we would call supplemental insurance and that’s where it pays for benefits that aren’t already covered. So a single-payer system would really have no need for private insurance because everything would be covered.
And a lot of people talk about “If I like my plan, I should be able to keep it.” But I think that we’re missing the really important piece of that is that people don’t like their plan. They like their doctor. People like their hospital, people like where they go for services. The plan is nothing but a middle man and so there’s no reason to “like the plan.” Plus, you don’t even know if that’s the same plan you’re going to have next year. You don’t know if your employer is going to offer it. You don’t know if you’re still going to be employed there. You don’t want to have to keep that job just to keep that plan when you could get the same and it would be better benefits under a Medicare for All and you wouldn’t have a $5,000 deductible.