No Warren Did Not Abandon Medicare for All

This post is a follow up to one I wrote a couple of weeks ago, on Liz Warren’s Health Care Hurdles. Warren has been pressured from Left and Right more than any other candidate to take a firm stand on health care and how she might pay for a Medicare for All plan without raising taxes on the middle class.

So just over two weeks ago she brought out a proposal for paying for Medicare for All without a middle class tax hike. In spite of a few serious people (like Paul Krugman) saying that it was a reasonable effort, the plan has mostly gotten beaten up, rather brutally, in news media.

Further, since mid-October or so her poll numbers have sagged as the “centrist” candidates, especially Biden and Buttigieg, have gone on the attack against Medicare for All. According to Monmouth, Pete Buttigieg just took the lead in Iowa away from Warren. Polls have warned that Medicare for All is massively unpopular in the “swing” states that will determine which candidate wins the Electoral College.

So now, Warren has moved to supporting a transition period before full implementation of Medicare for All.

Warren on Friday proposed a series of steps she said would gradually move the country towards “Medicare for All” over the course of three years….

…While the final version of Medicare for All will eliminate private insurance coverage, the first stage will preserve it, while still giving people the option of joining an expanded Medicare-type plan.

After three years, Warren argued, people will be able to see the full benefits of her Medicare for All system.

“By this point, the American people will have experienced the full benefits of a true Medicare for All option, and they can see for themselves how that experience stacks up against high-priced care that requires them to fight tooth-and-nail against their insurance company,” Warren wrote.

This seems to me to be a good idea. Naturally, today a large part of the Left on social media is throwing fits and sliming Warren with everything they’ve got, calling her a liar and a sellout and nothing but Hillary Clinton 2.0.

So lefties will destroy the best chance we’ve had in years to elect a genuinely progressive president, just as the plutocrats planned it, and assuming Trump isn’t re-elected we’ll end up with Biden or a facsimile thereof.There’s still Bernie Sanders, of course, but I think he’s got a steeper hill to climb for the nomination.

This is why we can’t have nice things.

Update: See also Dylan Scott, Elizabeth Warren’s new Medicare-for-all plan starts out with a public option.

As Warren competes with not only Sanders on the left but Joe Biden and Pete Buttigieg toward the center for the Democratic nomination, the plan seems like a bit of triangulation on her part. She isn’t backing off her commitment to Medicare-for-all single-payer. But she is putting out a plan that she will argue is more likely to actually pass 18 months from now.

Either bill in Warren’s two-step plan would face serious challenges: The first requires 50 or so Senate Democrats to agree on a health care plan in early 2021 and then the second even more audaciously needs a Senate supermajority to approve single-payer health care (or an end to the Senate filibuster).

This won’t win over many Sanders supporters, who see an unnecessary focus on tactics over strategy. The moderates will still assail her plan as unrealistic and politically toxic. Warren, meanwhile, will make the case she has a plan to both pay for and pass Medicare-for-all.

15 thoughts on “No Warren Did Not Abandon Medicare for All

  1. I don't get why people like their "private" insurance. 

    Not even union members, who have fought for health care longer than I've been alive – and I'll be turning 62 in early March.  The money they pay for coverage could go in their pockets instead.

    Every company I ever worker for took a portion of the health care coverage out of my salary.  And the amount increased EVERY year, and almost always cost more than any raise or COLA increase!

    Due to my disabilities, about 5years ago I became eligible for Medicare.  And for the same reason, I became eligible for NY's Medicaid.  I LOVE IT!!!!!!  I PAY NOTHING!!!!!!!!!!!!!!

    So please, someone explain to me why you'd want some profit-motivated private company handling YOUR health care?

    Are American's REALLY that stupi…

    Never mind.

    Of course they are.

    • Yeah, I was on New York’s Medicaid for a while, too. That was a huge help. Then I was on a “Medicaid plus” plan that cost something like $40 a month and included dental and vision. None of that is available in Missouri, of course, but I moved back here just as I became eligible for Medicare.

  2. Obama has also weighed in. There are a lot of political calculations going on. What Liz says about her plan only requires wide approximations. No matter the specifics, the president can't wave a wand and change the health care and tax systems. A lot of other forces are involved, as we witnessed in the ACA negotiations.

    Warren is walking a line trying to be practical as well as inspirational. That strikes me as smart. I'm also convinced "centrists" are just as big a threat to progress as the right. It's harder to argue with Obama's "third way" approach. No matter, we'll get more of what we need if we can get a landslide election in 2020, and that doesn't seem impossible.


  3. My concern for months has been that Bernie and Liz are splitting the progressive segment. There are valid arguments for both of them but if the objective calculation is that together they open a path for Biden to take the nomination, they have to flip a coin or something and combine to a Warren-Sanders or Sanders-Warren ticket. Together they would be invincible in the primaries and devastating in the general because they both have star power to turn out people in rallies. 

  4. I think Medicare is misunderstood.  One does not have to sign up for Medicare, it is a choice.  Also, it is not free, there is a monthly premium.  So, it makes sense to make it available to everyone regardless of age.  Just give people a choice.

  5. Just like with the ACA, there's a failure to communicate when it comes to Medicare in general.  The average person hears "Medicare" and think its something that won't provide them the level of "care" they get from private insurance.  That's the message, that's been resonating, for the most part.  I don't believe it but many people, not hearing anything else, do.  It would help tremendously if people already on Medicare would speak more about it in more detail than just saying "its great."  

    • How much does Medicare cost in premiums per month?
    • Are there copays?
    • Do you pay additional for tests and procedures resulting from visits?
    • Is there a deductible, and if so how much?
    • Am I limited to doctors and hospitals?

    Just like the media goes into these damned diners to talk to the Trump lovers, why not go where the Medicare recipients are, and have them talk specifics about it?

    As a customer of private insurance, I keep being told that "I love it" and that I would not want to give it up for "anything" let alone M4A.

    I am at the mercy of the private private health insurance, which:

    • Costs me about $600 in premiums a month; my employer pays even more
    • $30 – $50 in copays for each visit (which for the wife and are more frequent as we get older
    • I get bills all the time for the portion of tests and procedures and things the insurance didn't pay for.
    • If I lose my job I have nothing but COBRA which is unaffordable (and makes no sense.  Why is it "reasonable" to assume an unemployed person could pay upwards of $1500 a month (what COBRA estimate was for me a few years ago) more than twice what they currently pay, without a job??)

    And you're at the mercy of private insurance because they do run "death panels" and always have, in the sense they decide over the doctors what care you will get, not for medical reasons but for profit reasons. 

    If I had the option of paying more in taxes to have a health care plan that not only cost me, net, far less out of pocket over what I pay today for private insurance, AND, I am covered even if I lose my job, I'd jump at the chance.  And I am sure many if not most on private insurance would do the same.  

    People on private insurance don't love it, they're just glad to have access to health care.  They can do without the excessive costs and battles with insurance company administrators.  I URGE anyone on Medicare now, please talk specifics about the benefits, it will help convince people of the 

  6. OT: News Flash: Chuck Todd actually committed an act of journalism in an interview with Senator Ron Johnson when he said, "…you actually raise an interesting question about this. Why was the president so insistent that President Zelenskiy had to be public about announcing an investigation? And I ask that because, you know, one of the foundations of due process in this country is actually not to publicly announce who you're investigating, because you may be investigating somebody who's innocent." 

  7. Medicare for all is a necessary ideal.  The path to that goal is in dispute and rightfully so.  As with ACA (Obamacare) any bump in that path will be used by the opposition to disrupt health service provision for all.  The opposition will continue to contend that the goal of health service provision for all follows an unacceptable ideology,  So we remain the rich industrial country who does not join with the view of  mainstream civilization of a right to free essential health care services.

    I know any progress down that path will be difficult for this country as a whole and any politician that promises much will undoubtedly disappoint.  I guess we have a choice between a group of Dems with very high ideals and ones that are more pragmatic.  So our present choice is for measured steps forward or giant leaps forwards.  It is a judgement call which approach might turn out best in the long run. 

    It is my experience that "large leaps forward" are risky.  It is essential to know what presently works well in health service provision and to make sure it is not disrupted or destroyed in the process of improvement.  So often one ends up not with a great leap forward, but in a mess where all get less.  Never forget the old saying, the path to hell is paved by those with "good" intentions.  Beware of those who contend you have to make things worse to make things better.  They are usually only effective in making things worse.

    • When have "we" ever even attempted a "large leap forward?"

      Republicans have on a few occasions — the largest tax cut in history! each one is exclaimed.  Each time leaving devastation in its wake.

      Why do republicans continually get to "go big" on efforts we know are losers, but dems must go small on efforts with no path forward to "big"?

      If we've never attempted a "large leap forward" how do we know it will be a disaster?

      • Oh you can go big, and many want to.  I have endured school districts going with big changes, some very poorly advised so I have scars.  In my experience building on what is working is better than a giant leap into the abyss, but we have good Democrat candidates representing both sides.  Tiny fast steps or a big bold leap is your real choice.  Sam Brownback did one of those big Republican leaps on us, and  we will be years digging out of the mess he made.  I am probably wrong.  As I said it is a judgement call. 

  8. Why Democrats have an uphill climb on health care:

    On Republicans' side: insurance companies, health networks, pharmaceutical companies, "anti-socialist" culture warriors, corporate media, propaganda media, gullible base voters, voter suppression laws, gerrymandering, the Senate, the Executive

    On Democrats' side: people who don't like private insurance, lower income people who often don't vote, progressives, the House

  9. FWIW, I've been happy with health insurance working in the tech industry. But I recognize that I'm privileged.

    I had cancer in 2017. My policy had a $1500 deductible, and $2200 maximum out of pocket, with zero premiums and a $500 company contribution to an HSA.  This had my maximum out of pocket under 2% of gross pay. I'd been on a non high deducible plan the previous year and paid $77 semi-monthly in premiums, deductible was $500, then 20% copays until hitting the OOP maximum.

    My treatment was billed out at a bit of $1,000,000 with the negotiated rate coming to a bit over $500,000. I paid $2200, which was easily covered by the company contribution to the HSA and the money that formerly had gone for my premium going to an HSA. Since I knew my maximum was $2200 I didn't even look at billing during my course of treatment. I knew finances were not an issue, and that was a great help for my state of mind during treatment and recovery from treatment. It definitely contributed to my outcome of no evidence of disease, and now that it's 2+ years since completing treatment it looks like I beat cancer.

    So there are people that are happy with their company supplied insurance.

    It also makes me incredibly pissed off that others have to worry about how to pay for the care they need. I fully support Medicare for all.

    Warren is aware that the Senate won't pass it in 2021-2022 session. She's identified specific policies that can be done without needing a supermajority. Much as I like Bernie's bill (and Warren co-sponsored it) it is DOA in 2021 regardless of Bernie becoming president.

    •  now that it's 2+ years since completing treatment it looks like I beat cancer.

      That's good to hear!

  10. I’ll also note that I have had periods of unemployment that went longer than COBRA insurance was available. Thankfully planned parenthood was available for basic clinical medicine (routine blood work and prescription renewal – not sexual health related ) during that time period.  Needless to say they receive a lot of my charitable giving, having a stopgap that did visit and labs for a $5 charge is worth supporting.

    universal coverage is needed.  So are stopgaps like PP.

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