Institute for Public Accuracy, March 16, 2020
Biden claimed at last night’s debate: “With all due respect to Medicare for All, you have a single-payer system in Italy. It doesn’t work there. It has nothing to do with Medicare for All. That would not solve the problem at all.” Sanders responded: “What the experts tell us, is that one of the reasons that we are unprepared and have been unprepared is we don’t have a system. We’ve got thousands of private insurance plans. That is not a system that is prepared to provide healthcare to all people.”
Biden claimed: “The national crisis says we’re responding. It’s all free. You don’t have to pay for a thing. That has nothing to do with whether or not you have an insurance policy. This is a crisis. We’re at war with the virus. We’re at war with the virus. It has nothing to do with copays or anything.”
DAVID HIMMELSTEIN, M.D.
Himmelstein is a distinguished professor of public health at the City University of New York at Hunter College. He said today: “Biden lied about coverage, and also distorted the Italian situation. Italians will not face medical bills, or be reticent to seek care for fear of costs. The problem in Italy is a huge number of terribly sick people who are overwhelming hospitals and doctors. That’s a problem pretty much every nation will face.”
JAMES G. KAHN, M.D., M.P.H.
Dr. Kahn is emeritus professor at the Philip R. Lee Institute for Health Policy Studies, the Department of Epidemiology and Biostatistics, and the Institute for Global Health Sciences in the School of Medicine, University of California San Francisco. He said today: “Biden, abetted by moderator questions focused on immediate action, claimed that he had short-term solutions, whereas Sanders wanted a revolution. Indeed, Sanders proposes both immediate solutions and long-overdue structural reforms to properly address serious long-term problems.
“Once again, Biden falsely equated his health care solution (a public option) and Bernie’s comprehensive reform Medicare for All. Biden’s approach would cost more — much more — and leave 100 million people seriously underinsured, facing large financial barriers, and limit doctor choice. Medicare for All would shift waste in our current system into giving everyone comprehensive first-dollar coverage, with free choice of doctor.”
In an accuracy.org released Sunday and challenging CNN to finally “get it” about Medicare for All, Himmelstein and Kahn anticipated Biden’s arguments about Italy. Said Himmelstein: “Our fragmented system leaves public health separate and disconnected from medical care, and provides no mechanism to appropriately balance funding priorities. Kahn noted that without a Medicare for All system, “we’re handicapping ourselves. In other words, Medicare for All is necessary but not sufficient.”
By Don McCanne, M.D.
Facts about health policy are important. The way those facts are communicated is also important since they can influence the future of our health care.
Two issues were appropriately conflated during the Biden/Sanders debate. One is that nations must be prepared at all times to address current and future public health crises, and the other is that the United States needs to reform its health care financing infrastructure to make it work well for everyone. Bernie Sanders made both those points whereas Joe Biden dismissed the need for financing system reform (“It has nothing to do with Medicare for All”) while discussing the more limited topic of management of a pandemic. This led to his outrageous statement that single payer doesn’t work (in Italy).
The urgency of addressing the Covid-19 crisis aside, the most important long-term health policy debate today is whether we are going to enact and implement a single payer model of an improved Medicare that includes everyone, or if we are going to continue to try to improve the Affordable Care Act plus add a Medicare-like public option. The facts are that the two approaches are a world apart.
Merely making modifications to our current financing infrastructure is the most expensive model of reforming health care and yet it achieves none of the goals of true universality, efficiency, equity, affordability for all individuals and families, free choice of health care professionals and institutions, and other important goals of reform. Yet single payer Medicare for All achieves those goals and more and does so at a cost less than our current national health expenditures, not to mention avoiding the extra cost of trying to stoke our current dysfunctional system.
Bernie Sanders has been consistent in his efforts to accurately describe the Medicare for All model and its clear benefits over our current fragmented financing system. Unfortunately, Joe Biden has been dismissive of the single payer model, making untrue claims about the supposed deficiencies of single payer while also making untrue claims about the benefits of building on Obamacare. Just his claim alone that Medicare for All “would cost more than the entire federal budget” is emphatically untrue (Politifact: “False” 2/13/20).
The distortions and lies about single payer are rampant, and yet much of the media has been remiss in not challenging them. The debates have shown that members of the media have often used these false rhetorical depictions of single payer in the questions they ask, perhaps innocently so, although they are guilty of failing to adequately research these false claims.
Fortunately we have policy experts such as David Himmelstein and James Kahn who are meticulous with the truth and can be an invaluable resource for setting the facts straight. But we need the politicians and the media on board as well. Until they start demanding rigid adherence to the truth, the general public is apt to remain confused and then rely on the spinmeisters for their information. These spinmeisters gladly accept the generous financial support of the health insurance industry, pharmaceutical firms and others who are served so well by our current health care financing system. Should the medical-industrial complex fail in controlling the rhetorical debate, they would find themselves in need of establishing legitimacy should we enact and implement single payer Medicare for All.
PNHP does not support any political candidates for office, but we do encourage all candidates to be thoroughly and accurately informed on health policy so that they will support health care measures that are truly in the best interests of all of us.
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