By John Tozzi
Bloomberg, November 7, 2018
Obamacare repeal is officially dead. On to the battle over Medicare for All.
Tuesday’s midterm victories by Democrats mean that Republicans no longer have a path to make major changes to the Affordable Care Act. It also sets up a debate between Democrats’ liberal and moderate wings over whether to embrace a broad expansion of insurance to all Americans as they prepare to challenge President Donald Trump for the presidency in 2020.
Tuesday’s midterm victories by Democrats mean that Republicans no longer have a path to make major changes to the Affordable Care Act. It also sets up a debate between Democrats’ liberal and moderate wings over whether to embrace a broad expansion of insurance to all Americans as they prepare to challenge President Donald Trump for the presidency in 2020.
Once considered an outlier position, Medicare for All has gained substantial support among Democrats thanks to midterm primary victories by progressives who embraced it.
In its broadest terms, the proposal would expand benefits in Medicare — which covers more than 50 million elderly or disabled Americans — and offer it to working age people. It would be a radical change to U.S. health care, potentially dismantling much of an existing system where people get health benefits through work. It would also shift trillions of dollars that the country currently spends on private insurance.
“Medicare for All has really been a slogan that has not been well-defined, and it was weaponized by the Republican party as some kind of an attempt to socialize the medical system,” said Dan Mendelson, founder of the consulting group Avalere Health.
“It’s really going to be important for anyone running for president to define what they mean by Medicare for All,” he said.
Quick: What’s The Difference Between Medicare-For-All and Single-Payer?
By Samantha Young
Kaiser Health News, November 5, 2018
Across the country, catchphrases such as “Medicare-for-all,” “single-payer,” “public option” and “universal health care” are sweeping state and federal political races as Democrats tap into voter anger about GOP efforts to kill the Affordable Care Act and erode protections for people with preexisting conditions.
Voters have become casualties as candidates toss around these catchphrases — sometimes vaguely and inaccurately. The sound bites often come across as “quick answers without a lot of detail,” said Gerard Anderson, a professor of public health at the Johns Hopkins University Bloomberg School Public Health.
“It’s quite understandable people don’t understand the terms,” Anderson added.
For example, U.S. Sen. Bernie Sanders (I-Vt.) advocates a single-payer national health care program that he calls Medicare-for-all, an idea that caught fire during his 2016 presidential bid.
But Sanders’ labels are misleading, health experts agree, because Medicare isn’t actually a single-payer system. Medicare allows private insurance companies to manage care in the program, which means the government is not the only payer of claims.
What Sanders wants is a federally run program charged with providing health coverage to everyone. Private insurance companies wouldn’t participate.
In other words: single-payer, with the federal government at the helm.
Comment:
By Don McCanne, M.D.
The concept of Medicare for all has grown in popularity to the extent that many of the pundits have stated it was a significant driving force in the midterm election. But the media reports suggest that there is confusion as to just what Medicare for all means.
“Medicare for all” for many years has referred rigidly to a single payer national health program – an improved and expanded version of Medicare that includes everyone. Because of the popularity of the term, many politicians latched onto it, suggesting that the ultimate goal was to make health care coverage universal but without defining what that coverage would be, while, in the meantime, they suggest perhaps Medicare could be offered as another option in the health insurance marketplace. They then use the Medicare for all label to refer to this strategy. Of course, when it has already been defined as a single payer system, this is a clear misuse of the Medicare for all label.
Now this mislabeling is getting worse, further confusing the general public. The very reliable Kaiser Health News says that Bernie Sanders’ use of Medicare for All is misleading because his is not a single payer system since Medicare allows the option of selecting private Medicare Advantage plans, even though the intent of single payer is to eliminate private plans. The Bloomberg article says that, in its broadest terms, Medicare for all would be offered to working age people – not exactly a broad definition.
Little does it matter that the improved version of Medicare that is called Medicare for all would be a true single payer system. Not only have the incrementalists lifted the Medicare for all label, they now seem to want to deny its use for the single payer model that not only was the original model for that label but is also the model for which the label is actually descriptive – Medicare for all.
We need to keep the Medicare for all label to be used to describe the real thing, perhaps making it clear by calling it “Single Payer Medicare for All,” as mentioned in in prior commentary. And what should we call those models such as the Medicare public option that leaves much of the dysfunctional system in place? In this age of Trump rhetoric, perhaps we should label those alternate proposals “Fake Medicare for Some.”
(Thanks to John Walsh for the suggestion of the “Fake” label.)
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