A Key Issue In Democratic Primary Battles-- Medicare-For-All Or Not?

Sunday evening in Leeds, Jared Golden wrapped up his announcement tour as a congressional candidate for the sprawling Maine district he seeks to represent. He spoke at his parents' house and told his supporters that he "plans to make this campaign about working class Mainers... Speaking of jobs," he continued, let’s talk about Bruce Poliquin’s health care vote. He’s the only member of Maine’s Congressional delegation that voted to take health care away from tens of thousands of Mainers. Even worse-- the MaineCare cuts that he voted for would have resulted in a loss of good health care jobs at rural hospitals and health care providers. So much for staying focused on protecting jobs... I won’t hide my progressive values and my military service has nothing to do with my politics. The Marines didn’t make me a moderate. I’m a strong progressive and a proud patriot who loves this country. If Congressman Poliquin wants to make this campaign about the meaning of my military service then I say bring it on. I’ll stack my service to this country up alongside his everyday of the week and twice on Sunday. I won’t hide my progressive values from the people of this district the way he’s hiding his Wall Street values from them. My campaign is going to relentlessly focus on economic issues that are impacting the working people of Maine: creating jobs by investing in infrastructure, faster internet, public works and renewable energy."

At the same time Jared was speaking in Leeds, Maine, another progressive veteran, Randy Bryce was releasing a letter he wrote in Caledonia, Wisconsin to Blue America. "Congress," he wrote, "should prioritize the interests of ordinary Americans, not the 1%. What I’m saying isn’t anything controversial. These are issues that concern the vast majority of Americans and the solutions-- like single payer healthcare, a $15 minimum wage, and real campaign finance reform, to name just a few-- aren’t controversial either."

So why then don’t we see change?

Throughout government-- yes, both parties-- millionaires and billionaires are in control. Donald Trump inherited a fortune worth hundreds of millions of dollars. My opponent, the Speaker of the House, Paul Ryan, has a personal net worth of millions, and in 2014, for the first time, more than half of our elected officials in DC, members of both parties, were millionaires.

In Congress today, working people aren’t at the table, we’re on the menu.

When these out of touch elitists are asked to decide whether we should provide healthcare to every American or whether to give themselves a tax cut, they know their answer. When working people are asked to decide, we know ours. We are our brothers’ and sisters’ keepers. We look out for each other because we know what it feels like to be left out. We know what it feels like to make sure food is on our kid’s table. We know what it feels like to be a real, hard-working American.

...I can’t stress enough that the problems we are facing today aren’t Republican-caused problems alone. For too long the Democratic Party has used code words to trick us progressives into supporting them. That’s got to end because our lives are on the line.

When we say we are against corrupt trade deals, we must mean it. When we say we are for Medicare for All, we must mean it and pledge to sign on to Rep. John Conyers’s bill when elected. The days of third way triangulation need to be behind us because our lives-- and our childrens’ lives-- depend on it.

This fight, for single payer healthcare, to create an inclusive economy, and to protect the interests of working people, is going to be difficult. Powerful, wealthy interests will challenge our movement at every turn for fear they lose power in America, but together, we are going to win.

I’m grateful to be fighting by your side.

Not every Democrat is campaigning on a progressive vision of healthcare. Sure, even the lamest and most conservative DCCC recruits-- even their cadre of disgusting "ex"-Republicans multimillionaires-- claim to be against TrumpCare. But when Bryce talks about co-sponsoring John Conyers' H.R. 676 he's saying exactly what the DCCC forbids its recruits from saying. Although 117 congressional Democrats have already signed on-- that doesn't include the King's Landing party bosses like Pelosi, Hoyer, Wasserman Schultz nor, of course, the hacks like Ben Ray Lujan, Denny Heck, Jim Himes and Cheri Bustos who run the DCCC. They're recruiting and financing more anti-single payer candidates to bolster the dwindling conservative ranks in the House Democratic caucus.

Yesterday, Jeff Stein, writing for Vox explained what every Democratic Party primary voter needs to know about Conyers' legislation, a bill, he writes that "would fundamentally reshape American health care for every single person in the country... whose scope and speed would likely be unrivaled by any recent law in the Western world."

The most important change would be to virtually eliminate private medical insurance, forcing the 150 million people who get insurance through their employer to switch to a new plan and creating a universal system that would give every American free health care with no premiums or deductibles.

...Calling it “Medicare-for-all” actually undersells the ambitions of the Conyers bill. Medicare involves significant cost sharing, wherein the patient covers deductibles and premiums; Conyers’s bill would give everyone Medicare, but in doing so also transform Medicare into something much closer to Medicaid.

“Many people refer to single-payer as ‘Medicare-for-all,’ but it doesn’t actually operate like Medicare,” said Larry Levitt of the Kaiser Foundation. “Medicare is the part of our health care system that is single-payer-like, so it’s how people understand it.”

The bill would also likely result in the largest tax increase in modern American history, one that would almost certainly have to hit everyone. Under it, for-profit hospitals would have to become nonprofit entities or fold.

Beyond that, the bill would create new regulations and new federal bureaucracies in every state that would make Obamacare’s expansions of state power look Reaganesque.

The American health care system is made up of a hodgepodge of about five different insurance systems-- each with its own rules and costs and coverage benefits.

Currently, 153 million Americans-- or about 47 percent of the country-- receive insurance from their employers. There are also government programs, most importantly, Medicaid and Medicare, that combine to insure close to another 38 percent of Americans. Then there are the last two buckets-- the 5 percent of Americans who receive coverage on the Obamacare exchanges and the approximately 9 percent of Americans with no insurance at all.

Conyers’s bill would condense that patchwork into one single system, in which every American is on the exact same insurance plan-- a decision that would achieve generous universal coverage, while also steepening the bill’s political hurdles.

Conyers’s bill would allow every American citizen to receive a two-page application in the mail to qualify for a “Medicare-for-all” card. Once everyone is enrolled, the government would pay for virtually all of their care; under HR 676, the new government insurer would pick up the full tab for a basically all key coverage areas, including primary care, inpatient care, prescription drugs, long-term care, mental health, emergency care, outpatient care, vision care, and even chiropractic care.

...Under the bill as written, very few Americans could avoid joining this plan. The bill makes it illegal for insurers to sell coverage deemed “duplicative” with Conyers’s program; since the bill provides unlimited free coverage for virtually every possible ailment, basically every existing health insurance program would become illegal overnight... Only insurance covering “cosmetic surgery or other services and items that are not medically necessary” would be allowed to be sold privately, the legislation says.

This policy route would likely make it easier to hold down the costs of overall health spending in the US by getting everyone onto the same plan and, as a result, giving the government more bargaining power, according to Levitt. Forcing every person onto one government insurer would lower the cost of employment for many American businesses, which are often expected to pay for their employees’ insurance; it would also make it easier for employees to switch jobs without fear of losing their insurance.

We reached out to several congressional candidates who are running on a platform that includes signing on as an H.R. 676 co-sponsor. First, of course was Maine's Jared Golden. This morning he told me on the phone that he plans to sign on to John Conyers' Medicare-For-All bill (H.R. 676) and that he's open to working across the aisle, the way he does in the Maine legislature, to make progress towards universal health care. Remember, the Maine legislature passed bipartisan Medicaid expansions SIX times, just to see all six bills vetoed by Paul LePage. "In Congress I'll fight to expand Medicare coverage for everyone," he said. "In Maine we continue to have far too many people without health coverage which leads to expensive hospital visits that ultimately get passed off to those with coverage in the form of higher health care costs and premiums. I'll continue to advocate for this policy while also working with anyone, Democrat, Independent or Republican who has a plan that can expand coverage and lower premiums. It's always important to fight for your values, in this case access to health care for everyone, while also accepting compromise where it's possible in order to achieve some progress over none at all."

As Dr. David Gill has explained over and over again at this blog, pledging to co-sponsor Medicare-for-All is "an easy one. Given that I have been a member of Physicians for a National Health Program for 25 years, and that PNHP helped Rep. Conyers write H.R. 676," he is eager to co-sponsor the bill. Another doctor, Kathie Allen in Utah, told us that she's sign on as a co-sponsor "unless Bernie has a better proposal, or someone else does by that time. Conyers' bill is only about 15 pages long and I have my doubts that it is comprehensive enough to ease the transition from a profit-driven system to non-profit, universal coverage. It has a 10 year plan to partially 'buy-out' insurance companies, and advocates retraining insurance employees, but there is a lack of detail on how to do some of these things. I support the goal, however." And as Peter Jacob, the progressive running for the nomination to oppose Leonard Lance (NJ-07), told us succinctly, he's eager to co-sponsor because "We don't need health insurance in America, we need healthcare."