What Do We Want? Universal Coverage!

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Trump Maladministration

Let’s look at some good news. Paul Waldman writes that Democratic politicians are finally embracing single payer.

While some of us have been predicting for a few months that support for some version of single payer health care would gradually become the default position for those seeking the 2020 presidential nomination — and thus for the party as a whole — it’s happening faster than one might have thought.

A bunch of potential candidates, including Cory Booker, Kirsten Gillibrand, Elizabeth Warren, and Kamala Harris, have moved from their previous position — a somewhat vague support of single payer in the abstract — to becoming co-sponsors of Bernie Sanders’ single payer bill, which is set to be released this week. Today Sen. Tammy Baldwin of Wisconsin, who’s up for reelection next year, added her name to the list, and so did Sen. Richard Blumenthal of Connecticut and Mazie Hirono of Hawaii, joining a number of others. A single payer bill in the House is cosponsored by more than half the Democratic caucus (though Nancy Pelosi is notably holding off).

I know some people will argue that a few of these politicians — Harris and Booker in particular — are just trying to kiss up to the progressive left. And what’s wrong with that, I say? It means they are taking us seriously, instead of brushing us off as unicorn lovers.

For starters, it would be better if we referred not to “single payer” but to “universal coverage,” since the latter is the real goal, while the former is just one way to achieve that goal (see Harold Pollack for more on this). One big question about Sanders’ plan is whether it will be the kind of “Medicare for all” he’s advocated in the past, or something like “Medicare for all who want it,” which would retain a role for private insurance. There are multiple paths to universal coverage, and no one who is serious about the complex policy questions involved believes that a true single payer plan is the only way to get a system that does what we want it to. But that reality may be powerless in the face of the fact that “single payer” is a simple two-word slogan that people are already rallying around.

This is right; we might have to be careful about the “single payer” slogan.  It’s also the case that the same person who might say yes to a program labeled “single payer” might say no to the same program labeled “socialized medicine.” We also will have to fight off the inevitable “but it will raise taxes” arguments and explain that people will end up with more money in their pockets, anyway. We have a lot of educating to do.

One thing we can say, however, is that Democrats probably don’t need to be too paralyzed by fear of the inevitable Republican charge that it would represent big government controlling your life. As Republicans discovered when they tried to kick millions of people off Medicaid and undermine the program, the American public is perfectly fine with the government helping to give people health coverage. Medicare and Medicaid are both extremely popular with their recipients, who in total now number about 130 million….

… But single payer offers Democrats something extremely powerful: an ambitious policy change that will motivate their own voters to haul themselves to the polls.

Wow, actually promising to work for something grand that we’ve wanted for several years, instead of telling us that we’re naive and unpragmatic and believe in fairies and unicorns? What a concept!

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8 Comments

8 Comments

  1. Doug  •  Sep 12, 2017 @7:57 pm

    I am all for universal coverage. But to make it work in the USA we have to confront the elephant in the room. Nobody in the world pays more for less in terms of health care. It’s not inflation or the high cost of labor or any legitimate expense. Business has discovered that people will pay a high price to stay alive which makes health care the most lucrative aspect of business. I think we need to confront the issue – health care can not be a ‘for-profit’ enterprise. The private sector will be the source of medical innovation, true, and profit needs to be an incentive but we have to prohibit every anti-competitive practice which leads to gouging (in the medical supply chains). We have to break up the big pharmaceuticals and other monopolies, ban fo-profit hospitals, etc. Otherwise they free market in the USA will see socialized medicine as the biggest business opportunity in the history of mankind.

  2. Doug  •  Sep 12, 2017 @9:44 pm

    I understand HRC is planning an anti-Bernie tour to promote her book. Some say the timing is deliberately intended to protect medical monopolies & profits and prevent the reform this bil is designed to address.

    IMO, progressives need to turn out in large numbers to protest ANY public appearance by HRC. We nee to associate her with the scourge of money in politics. The argument that democrats must present a untied front has as much merit now as it did when the racist wing of the democratic party opposed civil rights for blacks in the South.

    The government of the US, including the democratic party has embraced a new kind of discrimination – discrimination by economic class. It’s time to call it out for what it is and bury the Clinton dynasty for all time. They are the authors of the democratic party version of the new discrimination.

  3. c u n d gulag  •  Sep 13, 2017 @8:19 am

    Yes, universal coverage is what we liberals/progressives want, not just for us, but for all people in this once great nation..
    It’s the goal. There are a variety of ways of reaching it – just look at the varied forms used around the globe.

    Having said that, “We have a lot of educating to do.”
    You got that right, maha!

    And it will have to be done done while the Reich-Wing Wurlitzer is cranked up to triple digits.
    As we speak, the reich-wing puntwits will be calling their vocal coaches, asking for classes on increasing their volume.
    Cries of the following will be heard:
    SOCIALISAM!
    COMMUNISM!!
    FASCISM!!!
    NIHILISM!!!
    etc…

    They’ll try to drown us out like a weak beer and chili fart leaked out during a Cat 5 hurricane!

    But, we all gotta chip in, and fight on – braving the fetid hot winds that Reich-Wingers love to spew in our direction!
    Wear a mask.

  4. grannyeagle  •  Sep 13, 2017 @5:33 pm

    Gulag: You’ve changed your image, it’s so cute.
    I can’t say that I am expert in the economic issues but I don’t understand why Medicare for all would raise taxes. People enrolled in Medicare now pay for it, the taxpayers don’t.
    Since I have Medicare and am satisfied I think it would be a good idea for everyone. It pays 80% and one can get supplemental if they want. My sister has Medicare and a supplemental program and she tells me she never has to pay anything. She has some serious health issues like rheumatoid arthritis and she recently fell and broke her hip. I don’t have a supplemental but am thinking about it.
    If other countries can provide health care for all, why can’t we?

  5. Bill  •  Sep 13, 2017 @8:44 pm

    The term “medical price gouging” with all the anecdotal evidence needs to be more popularized.

    My own former, big city clinic charged my neighbor $11,000 for a non-diagnosis while a small town clinic charged $900 for a full diagnosis for the very same symptoms. That clinic resorts to kicking patients upstairs to specialists for things their own primary care doctors can easily handle in their own offices (double dipping). Finally they got caught paying an “all-star” surgeon $900,000 a year for doing multiple surgeries at once, meaning his staff was doing all the work while he was doing ‘the supervising’ between operating rooms. Additionally the total year’s billing for those procedures came to $90,000,000, meaning that patients were only paying 1% of their total bill towards “the surgeon” himself.

    This is price gouging as despicable as what some Houston flood victims are seeing. If the official healers of our society are going to be predatory assholes, then this culture would trickle down and our civil society would be fucked. There are economists who espouse this sort of behavior. They need to be discredited and shunned.

  6. Raul  •  Sep 14, 2017 @6:53 am

    But Hillary Clinton said, “SINGLE PAYER IS NEVER GOING TO HAPPEN!”

    And she just published a book! She says it isn’t her fault she lost to the most unpopular and criminal candidate to have ever run for the White House.

    So if Clinton says it…

    CLINTON IN 2020

    /snark

  7. c u n d gulag  •  Sep 14, 2017 @8:36 am

    grannyeagle,
    As far as my image, it depends on which computer I typie a comment:
    On my NOOK, I still have the bemused and perplexed yellow circle.
    On my laptop, for whatever reason, I get this new one.

    My late father had, and my mother currently, has AARP supplemental. It covers pretty much everything. I got the breakdown on my pop’s radiation therapy, and we would have owed almost $50, 000, But AARP covered everything.

    It’s not cheap – she pays about $225 dollars a month. It’s taken out of her checking account a day or two after “the eagle shits” (that’s what my pop called his SD payments – a remnant of the few years he spent in the Army back in the early 50’s).

    There may be cheaper supplemental plans, but this AARP one has done fine by my family, so I’m keeping it.
    YMMV.

  8. bernie  •  Sep 14, 2017 @11:21 am

    We definitely do not want what we (Medicare retired people and some other excepted) what we have now, which is multiple payer.  The reason is simple.  Most payers take 20% off the top for administrative cost.  The governmental cost for Medicare administrative cost is 2%.  That is an 18% difference which gets no one any health services.  It does provide for jobs, but it would be much simpler for all, providers and consumers, to have one standard payment system.  

    If people want more, fine.  They can buy supplemental plans with whistles, bells, and the associated administrative excess costs.  This will provide jobs for those displaced.

    New England Jounal of Medicine 2003
    http://www.nejm.org/doi/full/10.1056/NEJMsa022033



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