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Medicare for All

So last night I whipped up a bit of a fuss on Twitter with my response to an exchange between Pete Buttigieg and Rachel Maddow:

Asked by @maddow about a McKinsey client laying off thousands of insurance company workers — and whether Buttigieg’s work played a role — Buttigieg turns it around and warns that Medicare for All advocates would end every insurance worker’s job.

— Dan Diamond (@ddiamond) December 11, 2019

Maddow: "When you did that cost & overhead assessment for Blue Cross Blue Shield of Michigan, a couple years after that, they laid off like 1,000 people. Was your work part of what led to those layoffs?

Buttigieg: " I doubt it...I don't know what happened after the time that I left, that was in 2007, when they decided to shrink in 2009. Now, what I do know is that there are some voices in the Democratic primary right now who are calling for a policy that would eliminate the job of every single American working at every single insurance company in the country."

 

Tuesday, December 10th, is gonna be a pretty big day for federal healthcare policy, especially in the U.S. House of Representatives.

For one thing, it's my understanding that the big Prescription Drug Bill (H.R. 3, the Lower Drug Costs Now Act) is scheduled for a floor vote on Tuesday, although it's possible that it'll be bumped until later in the week given the grumbling by the Congressional Progressive Caucus.

For another, the House Energy & Commerce Committee is holding what I'm assuming are all-day hearings on not one, not two, but nine different Universal Coverage bills, including the Big Ones: Medicare for All and Medicare for America:

HEARING ON "PROPOSALS TO ACHIEVE UNIVERSAL HEALTH CARE COVERAGE"

Date: Tuesday, December 10, 2019 - 10:30am

Monday's Washington Post includes an excellent story by Annie Linskey, Jeff Stein & Dan Balz titled, appropriately enough, "How a fight over health care entangled Elizabeth Warren — and reshaped the Democratic presidential race":

In mid-November, a few dozen of the country’s most influential advocates of Medicare-for-all were reviewing details of Sen. Elizabeth Warren’s plan to finance the proposed government-run program when they learned that she had unexpectedly changed her position.

 

Please watch this interview with Hillary Clinton. The whole thing is worth watching, but the portion about healthcare policy and the best route forward starts at around 9:20 in and runs less than 7 minutes, to 16:00 (It's supposed to be cued up to exactly 9:20 but you may have to scrub forward to get to it depending on your device).

Please take 6 minutes and 40 seconds out of your day to actually listen to the words which are coming out of her mouth.

UPDATE: Full, verbatim transcript by yours truly:

Andrew Ross Sorkin: “I want to talk to you a little bit about healthcare, because I know it’s an issue that you care about deeply and have thought a lot about.”

Hillary Clinton: “I have.”

Sorkin: “Because we seem to be in a very divided world, not just among two different parties, but even within the Democratic Party. Medicare for All versus a Public Option. You look at what Elizabeth Warren presented last week, and you think...what?”

A few weeks ago, I said the following about Sen. Elizabeth Warren regarding healthcare policy:

  • I'm generally supporting Elizabeth Warren in the Democratic Primary (not a full endorsement, but I've been strongly leaning her way for awhile now)...

HOWEVER, for the time being at least, that seems to be where she's decided to lay her marker, so it is what it is.

(Note: Since then, I've publicly stated that I'm now leaning more towards Sen. Kamala Harris who was always my strong #2 choice. This doesn't mean I no longer like Warren--the two have simply swapped places in my #1 and #2 column.)

Back in late June, right after the first Democratic Primary Candidate Presidential Debate, I posted an analysis & table to break out exactly where each of the then-20 (!) candidates stood when it comes to the Next Big Thing in U.S. healthcare policy. I posted a couple of updates as the summer and early fall progressed.

At the time, my main point was that regardless of their official campaign rhetoric, the truth was that nearly all of the candidates were open to multiple paths towards expanding healthcare coverage...both in terms of the number of people covered, the scope of that coverage and the cost of coverage to the enrollees, with a greater portion of the total cost being borne by the federal government.

(sigh) Regular readers know two things about me when it comes to Sen. Elizabeth Warren:

  • I'm generally supporting Elizabeth Warren in the Democratic Primary (not a full endorsement, but I've been strongly leaning her way for awhile now)...

HOWEVER, for the time being at least, that seems to be where she's decided to lay her marker, so it is what it is.

The single biggest headache she's been dealing with all summer and fall, however, has been the "Will You Raise Taxes On The Middle Class" question which keeps popping up in interviews and the Democratic debates. Bernie Sanders has, to his credit or detriment, stated it plainly: Yes, his plan would indeed raise taxes on households earning more than $29,000/year.

Back in July I posted the written Congressional testimony of my friend Rebecca Wood. Rebecca is a staunch "Medicare for All" advocate whose daughter Charlie has complex medical issues.

Today, I'd like to present a Twitter thread by another friend I've met online, Lori, who also has a daughter with complex medical needs named Savannah. While their children both have serious medical issues which need constant care, Lori has a slightly different perspective on the issue of the best route towards achieving universal coverage. This was all in response to my own tweet, which was in response to a comment by Parker Malloy about people who "love" their private insurance:

Who are these people some candidates speak of who just absolutely love their insurance? https://t.co/JD3IEy1Kk9

— Parker Molloy (@ParkerMolloy) September 18, 2019

I've written many times before about how polling on the issue of "Medicare for All" has consistently proven that many Americans are confused about what the phrase actually means.

While a majority of the country keeps saying they want "Medicare for All", poll after poll has shown that a huge chunk of those who say so think it means "Medicare for All Who Want It"...that is, they think it refers to a Public Option, where it's up to them whether their major medical coverage would be public or private. This is true even among Democrats, who obviously support the concept in higher numbers than Republicans or Independents.

Yesterday a new poll came out from Monmouth University which mostly just confirms this point...

Last night, the Washington Post posted a story with a headline which made top campaign representatives for both Bernie Sanders and Kamala Harris go nuts on Twitter:

Sen. Bernie Sanders changes how Medicare-for-all plan treats union contracts in face of opposition by organized labor

Sen. Bernie Sanders announced a key change to his Medicare-for-all insurance plan Wednesday, a move meant to assuage fears on the part of organized labor, whose support is being heatedly sought by all of the candidates for the Democratic presidential nomination.

 

Both evenings of the Detroit Democratic Debates earlier this week started off with half-hour segments on healthcare policy. I meant to do write-ups about both of them but for one reason or another never got around to it until now. Tons of other healthcare wonks have already written their own think pieces by now, so I'm not going to go back and rehash the whole thing at this point.

HOWEVER, there's one quote which made my jaw drop, and it doesn't come from any of the Big Four (Biden, Warren, Harris or Sanders). It comes from Hawaii Representative Tulsi Gabbard...and it didn't even come during the debate itself, but afterwards in the "Spin Room" (they actually call it that) with Anderson Cooper.

So, I wrote my first Op-Ed piece for the Washington Post yesterday...

Harris’s rollout Monday was met with swift criticism from both the Biden camp, which called it “A Bernie Sanders-lite Medicare for All,” and the Sanders camp, which insists Harris “can’t call [her] plan Medicare for All.”

In saying this, the Sanders campaign is effectively trying to lay a copyright claim to Medicare-for-all, as if it, and only it, can define what it means. The reality is far less clear — and depending on your perspective, it could be Harris’s proposal that is more justified in claiming the Medicare-for-all branding.

I'm not going to overquote my own piece, but this has led to some backlash against me, so for the record:

(IMPORTANT: As my friend Shawn Pierce keeps pointing out, the phrase "Medicare for All" has two very different meanings...one is the brand "Medicare for All", which simply refers to any healthcare plan which ensures 100% universal, comprehensive healthcare coverage for everyone; the other is the specific bills introduced by Sen. Bernie Sanders and/or Rep. Pramila Jayapal, which would indeed completely eliminate private major medical insurance for 100% of the population as well as completely eliminating all out-of-pocket costs in favor of 100% federal public funding).

For months now, California Senator and Presidential candidate Kamala Harris has repeatedly struggled with how to address her support of Bernie Sanders' 100% mandatory, $0 out-of-pocket-cost, 100% comprehensive "pure" single payer "Medicare for All" healthcare bill.

FULL DISCLOSURE: Since June 2019, I've been contracted with the Center for American Progress to provide healthcare data analysis & advocacy on their behalf on a part-time basis.

NOTE: This is not an in-depth analysis, for three reasons:

  • Third, I have a bit of a personal/household crisis to deal with this week (don't worry...no one's sick, dead or getting divorced, but our house is in need of some serious attention)

If you've been reading my site for more than a couple of years, you know that back in February 2018 I fell in love (well, mostly) with a new Universal Healthcare Coverage proposal from the Center for American Progress called "Medicare Extra for All" or simply "Medicare Extra".

If I could only ask one question of the 20-odd candidates vying for the Democratic nomination for President at the next debate coming up right here in Detroit, Michigan, here's how I would word it. I've customized it for each of the five major candidates (apologies to the rest of them):

Preface to each of the candidates:

"Earlier this month, oral arguments were heard by the 5th Circuit Court of Appeals over a lawsuit against the Affordable Care Act filed by 20 Republican Attorneys General and fully supported by the Trump Administration.

"If the plaintiffs are successful and the ACA is struck down entirely, up to 20 million Americans would find themselves without healthcare coverage and tens of millions more with pre-existing conditions would lose critical protections, while states would lose hundreds of millions, or even billions of federal funding.

"Every Democratic candidate has come out in favor of significantly expanding publicly-funded healthcare coverage to some degree or another. Some want to build upon the Affordable Care Act. Some want to add a public option. Some want guaranteed universal coverage, and some are demanding universal single payer healthcare for everyone in the United States.

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