Can The Corporate Dems Kill Medicare For All? The New Dems And Blue Dogs Are On The Case-- Bigly

Sunday the NY Times published Robert Pear's extensive piece on how the health care and insurance industries are mobilizing to kill Medicare-For-All. Their message is pretty much the same as the message you hear from status quo corporate Dems: "The Affordable Care Act works reasonably well and should be improved, not repealed or replaced with a big new public program." That will be a major Status Quo Joe Biden campaign plank when he faces Bernie in the primaries. Before we get to Pear's piece, I want to do a quick refresher: which current members of Congress have taken the biggest bribes from healthcare and from insurance. Let's do the House first-- lifetime bribes (since 1990) for the dozen worst:

• Frank Pallone (D-NJ)- $6,170,050
• Steny Hoyer (D-MD)- $4,623,680
• Michael Burgess (R-TX)- $4,268,658
• Fred Upton (R-MI)- $4,118,094
• Kevin McCarthy (R-CA)- $3,681,424
• Kevin Brady (R-TX)- $3,360,254
• Greg Walden (R-OR)- $3,148,441
• John Shimkus (R-IL)- $2,966,262
• Anna Eshoo (D-CA)- $2,922,686
• Ron Kind (New Dem-WI)- $2,677,863
• Nancy Pelosi (D-CA)- $2,607,362
• Andy Harris (R-MD)- $2,579,632

And here's the numbers for the last cycle:

• Greg Walden (R-OR)- $1,129,860
• Kevin McCarthy (R-CA)- $962,695
• Kevin Brady (R-TX)- $904,650
• Frank Pallone (D-NJ)- $835,650
• Steve Scalise (R-LA)- $796,165
• Michael Burgess (R-TX)- $788,765
• Richard Neal (D-MA)- $760,757
• Raja Krishnamoothi (New Dem-IL)- $750,114
• Raul Ruiz (New Dem-CA)- $709,213
• Brett Guthrie (R-KY)- $644,473
• Cathy McMorris Rodgers (R-WA)- $604,894
• Ami Bera (New Dem-CA)- $561,791

Next let's look at the same criteria on the Senate side. So first lifetime bribes for the half dozen worst (since 1990)-- not including people who have run for president:

• Mitch McConnell (R-KY)- $6,152,309
• Sherrod Brown (D-OH)- $5,267,907
• Richard Burr (R-NC)- $4,655,669
• Chuck Schumer (D-NY)- $4,413,972
• John Cornyn (R-TX)- $4,362,072
• Ron Wyden (D-OR)- $4,201,699

And finally, senators from just the 2018 cycle:

• Bob Casey (D-PA)- $1,884,503
• Sherrod Brown (D-OH)- $1,233,474
• Tammy Baldwin (D-WI)- $1,169,052
• Doug Jones (D-AL)- $1,100,766
• Jon Tester (D-MT)- $1,023,611
• Marsha Blackburn (R-TN)- $957,697

Pear makes the point that "even before Democrats finish drafting bills to create a single-payer health care system, the health care and insurance industries have assembled a small army of lobbyists to kill Medicare for all, an idea that is mocked publicly but is being greeted privately with increasing seriousness. In DC-parlance "seriousness" means "financially." Aside from the 6 above-- 5 of whom, you will notice are Democrats-- the healthcare industry put immense sums into the campaigns of conservative Democratic candidates Kyrsten Sinema ($952,541) and Jacky Rosen ($946,309), each of whom has a reputation for selling their votes for the right price. Remember, the sector has given $654,151,628 to Republicans since 1990 and $591,098,658 to Democrats, yet this past cycle virtually all the big money went to Democrats. Of the biggest amounts they gave 20 Senate candidates, just 5 were Republicans. And running the battle to torpedo Medicare For All is not a Republican but slimy lobbyist and Hillary Clinton lieutenant, Lauren Crawford Shaver. You may remember Shaver from a November expose by Lee Fang and Nick Sergey at The Intercept revealing "the strategy that private health care interests plan to use to influence Democratic Party messaging and stymie the momentum toward achieving universal health care coverage."

At least 48 incoming freshman lawmakers campaigned on enacting “Medicare for All” or similar efforts to expand access to Medicare. And over the last year, 123 incumbent House Democrats co-sponsored “Medicare for All” legislation -- double the number who supported the same bill during the previous legislative session.

The growing popularity of “Medicare for All” in the House has made progressives optimistic that the Democratic Party will embrace ideas to expand government coverage options with minimal out-of-pocket costs for patients going into the 2020 election. But industry groups have watched the development with growing concern.

Over the summer, leading pharmaceutical, insurance, and hospital lobbyists formed the Partnership for America’s Health Care Future, an ad hoc alliance of private health interests, to curb support for expanding Medicare.

The campaign, according to one planning document, is designed to “change the conversation around Medicare for All,” then “minimize the potential for this option in health care from becoming part of a national political party’s platform in 2020.”

Behind the scenes, the group attempted to sway candidates during the midterms, encouraging several of them to focus on shoring up the Affordable Care Act instead of supporting single-payer health care.

...[S]oon after Election Day results came in, the Partnership went on the offensive, informing reporters that candidates who embraced “Medicare for All” had also lost, pointing to the defeat of progressives such as Kara Eastman in Nebraska. The group also relied on research from the business-friendly Democratic think tank Third Way to argue that victorious pro-“Medicare for All” candidates couldn’t attribute their success to having supported “Medicare for All” because few Democrats explicitly mentioned the policy in their campaign advertisements.

“’Medicare for All’ didn’t win,” said Joel Kopperud, the vice president of government affairs at the Council of Insurance Agents and Brokers, one of the industry groups backing the Partnership. “I don’t think that the Bernie Sanders $32 trillion solution that’s going to eviscerate the insurance for 156 million Americans is really something that’s going to be helpful to the party in critical states,” he added in an interview with The Intercept.

Kopperud represents insurance brokers who sell employer-based health insurance coverage. He noted that his organization has a vested interest in backing the Partnership. “Medicare for All,” as some envision the policy, would eventually eliminate the need for most health insurance plans-- a death knell for companies represented by the CIAB.

Private health care lobbyists are confident that they can prevent any federal expansion of Medicare in Congress, given Republican control of the Senate and the White House. In the states, CIAB and other private health groups have easily defeated measures to develop single-payer proposals, such as the ColoradoCare ballot question in 2016.

Over the last two years, several opinion surveys show rising support for expanding Medicare. In March, the Kaiser Health Tracking Poll found that 59 percent of Americans support the idea, and by August, a poll conducted by Reuters-Ipsos found an astounding 70 percent of Americans support “Medicare for All,” including a majority of self-identified Republicans.

But the Partnership is quick to zero in on research that shows support for the idea drops precipitously when respondents are told that the plan would require ending employer-based coverage, tax increases, and increased government control.

The campaign has worked with advertising agencies to draw up a series of messages to convince select audiences. Several of the messages, categorized as “positive,” are dedicated to educating the public on more minimal reforms that do not include expanding Medicare. Other messages, categorized as “persuasion” and “aggressive,” are designed to instill fear about what could happen if “Medicare for All” passes.

In the coming weeks, the Partnership plans to ramp up a campaign designed to derail support for “Medicare for All.” The group, working with leading Democratic political consultants, will place issue advertisements to target audiences, partner with Beltway think tanks to release studies to raise concerns with the plan, and work to shape the public discourse through targeted advocacy in key congressional districts.

The Partnership has tapped consulting firms with deep ties to Democratic officials. Forbes-Tate, a lobbying firm founded by former officials in President Bill Clinton’s administration and conservative Democrats in Congress, is managing part of the Partnership coalition. Blue Engine Message & Media, a firm founded by former campaign aides to President Barack Obama, has handled the Partnership’s interactions with the media.

In one planning document circulated over the summer, the Partnership suggested a series of messages to wean Americans away from supporting single payer. The talking points emphasize that the current system provides “world-class care,” and that any move away from the Affordable Care Act would be “ripping apart our current system.”

The strategy exploits familiar themes that have long been used by business groups against new government health care programs, calling for allies to say lines such as “bureaucrats in DC have no understanding of a person’s medical situation and will be making decisions about your health care instead of doctors.”

The Partnership plans to form a speakers bureau of former Democratic elected officials who can leverage the media to make the case that expanding Medicare is bad politics and policy. The memo names former Democratic Majority Leader Tom Daschle, now a health insurance lobbyist at the law firm Baker Donelson, as one such potential surrogate.

The memo points to early success in shaping media coverage, citing several “earned media” columns such as one published in August by former Rep. Jill Long Thompson (D-IN) which argues that Democrats should only focus on small reforms to the Affordable Care Act, and warns against wasting political capital on pursuing a “government-controlled health insurance system.” Thompson, now an associate professor at Indiana University Bloomington, did not respond to a request for comment.

Adam Gaffney, president-elect of Physicians for a National Health Program, a national coalition that advocates in favor of “Medicare for All,” said he is not surprised by the messaging.

“What we’re seeing is the wages of success: With single payer on the rise, it was only a matter of time before the insurance companies, big pharma, and other big-money groups came out swinging,” said Gaffney, who also serves as an instructor at Harvard Medical School.

“The smear of ‘socialized medicine’ has been used a thousand times and has lost its bite,” he added.

“We’re all focused on 2020,” Lauren Crawford Shaver, a partner at Forbes-Tate who is helping to manage the Partnership campaign, recently told the National Association of Health Underwriters in a podcast produced by the group.

Shaver, a former top staffer for the Hillary Clinton presidential campaign, explained to the group that she is working to peel support away from the “Medicare for All” bill sponsored by Sen. Bernie Sanders, I-Vt. The Sanders bill is currently sponsored by several rumored 2020 Democratic presidential candidates, including Sens. Elizabeth Warren (D-MA), Kamala Harris (D-CA) and Kirsten Gillibrand (D-NY).

“The No. 1 thing we need to focus on is that there are a lot of likely candidates that currently support the Senate bill,” said Shaver. “We need to make sure we educate the public, we educate both parties, and we educate all the campaigns about both the policy and political challenges.”

Shaver encouraged health care companies concerned about the growing popularity of “Medicare for All” to mobilize opposition among clients, customers, and employees. Industry groups will likely have workers or customers residing in key districts who can be tapped to influence wavering lawmakers on Capitol Hill.

...Despite a pledge by many Democratic candidates to eschew corporate PAC donations, health care lobbyists have funneled cash to many incoming lawmakers through the New Democrats PAC, the Blue Dog PAC, and other centrist committees. Unsurprisingly, the centrist New Democrats Coalition, the caucus of business-friendly centrist Democrats, has worked to depress momentum for “Medicare for All,” reprising the role centrist Democrats played in killing the public option during the Obama administration. In 2009, then-Sen. Joe Lieberman (I-CT), a founding member of the New Democrats caucus, threatened to join the Republican filibuster against health reform unless the public option was dropped from the bill.

Immediately following the midterm elections this month, the Washington Post published a column by Third Way warning that “Medicare for All” “failed the Hippocratic Oath” because opposition to the plan helped Republican candidates, thus causing “harm” to the long-term health interests of voters.

So here we are, over 3 months, later and the Times is documenting the progress that these groups, largely led by personally greedy Democrats willing to see large numbers of people die so that they can make some loot from the oligarchs who profit from healthcare and insurance. Pear introduces us to Charles N. Kahn III, the president of the Federation of American Hospitals, which represents investor-owned hospitals and who told him, "We have a structure that frankly works for most Americans. Let’s make it work for all Americans. We reject the notion that we need to turn the whole apple cart over and start all over again." The Democrats’ proposals," Pear reminds us, "could radically change the way health care providers do business and could drastically shrink the role and the revenues of insurers, depending on how a single-payer system is devised. The hospital federation and two powerful lobbies, America’s Health Insurance Plans and the Pharmaceutical Research and Manufacturers of America, created a coalition last June to pre-empt what they saw as an alarming groundswell of interest in proposals to expand the federal role in health care."

In a daily fusillade of digital advertising, videos and Twitter posts, the coalition, the Partnership for America’s Health Care Future, says that Medicare for all will require tax increases and give politicians and bureaucrats control of medical decisions now made by doctors and patients-- arguments that echo those made to stop Medicare in the 1960s, Mrs. Clinton’s health plan in 1993 and the Affordable Care Act a decade ago.

The coalition will step up the tempo in the coming week as Democrats in the House and the Senate plan to introduce bills to establish a single-payer system.

The name of the coalition is intentionally nondescript, and its executive director, Lauren Crawford Shaver, who led Mrs. Clinton’s efforts in 2016 to put marginal states into play, is cagey when asked for details. She says only that the group is planning “a big nationwide effort” with grass-roots allies.

But its reach is undeniable. The coalition has picked up more than 25 members, including the American Medical Association, the American Hospital Association and the nation’s Blue Cross and Blue Shield plans.

And it has already sprung into action.

When Senator Bernie Sanders, the author of the Medicare for All Act, announced on Tuesday that he was again running for president, the coalition immediately attacked him as “a leading advocate for upending our nation’s health care system in favor of starting from scratch with Medicare for all.”

Mr. Sanders, independent of Vermont, fired back at the insurance and drug companies. “They make tens of billions of dollars a year in profits from this dysfunctional health care system and pay their C.E.O.s outrageous compensation packages,” Mr. Sanders said. “We’ve expected their opposition all along.”

When members of Congress unveiled legislation to let people age 50 to 64 buy into Medicare, the coalition conflated it with proposals to put all Americans into Medicare.

“This is a slippery slope to government-run health care for every American,” said David Merritt, an executive vice president of America’s Health Insurance Plans, a lobby for insurers.

The buy-in proposal for older Americans dates back to Bill Clinton’s presidency, and many of its advocates have put it forward as a moderate alternative to Medicare for all.

But the coalition said the proposal was wrong for America, “whether you call it Medicare for all, Medicare buy-in, single payer or a public option.”

The chief sponsor of the House buy-in bill, Representative Brian Higgins, Democrat of New York, said: “The critics lump our bill with the bigger Medicare-for-all proposal. That’s strategic, and I think it’s deliberate.”

Mr. Higgins said the option of Medicare at age 50 would create “a countervailing force to private insurance.”

“Insurance companies are fighting it because they are afraid of the prospect of a potent new competitor that will cut into their profits,” Mr. Higgins said. “Medicare has lower administrative costs and lower executive salaries and could use its bargaining power to get better deals from hospitals and other health care providers.”

Senator Debbie Stabenow, Democrat of Michigan and the sponsor of the buy-in bill in the Senate, said she was not surprised at the criticism. “It’s a knee-jerk reaction to anything that expands Medicare,” she said.

But, she said, people 50 to 64 need the option.

“We see the auto industry laying people off, encouraging people to retire early,” Ms. Stabenow said. “Many people are holding their breath until they turn 65. They put off preventive screenings, so they come into Medicare at 65 with more health problems.”

Under the Affordable Care Act, insurers can increase premiums with a person’s age, and older people who do not qualify for subsidies face the highest premiums on the insurance exchange. For a 60-year-old in Charlotte, N.C., the average premium for a midlevel silver plan is more than $1,100 a month; in Phoenix, it is nearly $1,000 a month.

The mission of the industry partnership includes advocacy, advertising, lobbying and public education, but it has not registered under federal lobbying laws. Forbes Tate, a public affairs company that lobbies for many health care and drug companies, coordinates the work of the partnership, but is not registered to lobby on its behalf.

“There are no direct lobbyists for the partnership,” Ms. Shaver said. “We work through all of our different groups. They have their own lobbyists who do obviously lobby on Medicare for all. But there are no registered lobbyists for the partnership because we are not doing that directly at this time.”

The coalition, like President Trump, attacks any proposals that smack of socialized medicine. But it also has a positive agenda. It wants to expand Medicaid under the Affordable Care Act in Texas, Florida and other states that have yet to do so. It wants to expand federal subsidies under the health law so insurance will be affordable to more people. And it wants to stabilize premiums by persuading states to set up reinsurance programs, using a combination of federal and state funds to help pay the largest claims.

Beyond their desire to preserve the status quo, coalition members have done well by the Affordable Care Act. Many participants, such as the American Medical Association, the pharmaceuticals lobby and the hospital association, backed the A.C.A. from the start, banking that more insured Americans would mean more customers. The hospitals saw the health law’s Medicaid expansion as a lifeline as they struggled with the uninsured working poor.

...Members of the coalition had different positions in the struggle to pass the Affordable Care Act in 2009 and 2010, but rave about it today. Ten million people have coverage through the exchanges, 14 million have gained Medicaid coverage, and in a strong economy more people have jobs that provide health insurance, they say.

Some members of the coalition have financial as well as philosophical reasons for resisting the push to expand Medicare. Doctors and hospitals say Medicare generally pays less than private insurance, and hospitals say the payments frequently do not cover the costs of providing care to Medicare patients.

“Chronic underpayment to providers creates access issues for seniors, particularly with physicians, who may limit the number of Medicare patients they see,” said Richard J. Pollack, the president of the American Hospital Association. Congress, he said, often makes changes in Medicare for reasons that have nothing to do with sound health policy-- to offset the costs of tax cuts, for example.

Moreover, Mr. Pollack said: “The government can be an unreliable business partner. What happens when the government shuts down? What happens if the health care system is even more dependent on Medicare and the government shuts down again?”

But the coalition does not speak for all health care providers.

The American College of Physicians, the largest medical specialty organization in the country, has supported a Medicare buy-in for people 55 to 64.

And “during the whole debate over the Affordable Care Act, we supported having a public option in the individual insurance market in every state,” said Robert B. Doherty, senior vice president of the college, which represents 154,000 doctors who specialize in internal medicine.

You can imagine that people interested in building a stronger, healthier society don't see it the same way the lobbyist slime sees it. Martese Chism, Vice-President, California Nurses Association / National Nurses Organizing Committee (National Nurses United) was overjoyed when Pramila Jayapal announced the formation of the Medicare-For-All Caucus in Congress and signed up 78 House members immediately. "National Nurses United welcomes the inaugural Medicare for All Caucus in the House of Representatives. Every day, more Americans are rallying behind the need for fundamental reform of our flawed and fragmented health care system that denies health care to millions of our neighbors and family members. Nurses see patients every day that are harmed by this system, and we know that Medicare for All is the best solution to this crisis."

Dr. Carol Paris, President, Physicians for a National Health Program, had the same kind of reaction: "Given the ruthless attacks on our health care safety net and the skyrocketing costs of care, it’s no surprise that nearly 60 percent of Americans now favor improving Medicare’s benefits and expanding it to cover everyone in the U.S. As a physician and longtime health advocate, I’m thrilled that our nation is coalescing around the goal of universal coverage. But it can’t be achieved with expensive, fragmented, and unsustainable programs that rely on private insurance. Our research shows that only a single-payer plan like H.R. 676 can achieve the efficiency and cost savings necessary to provide high-quality care to everyone. PNHP applauds the members of the Medicare for All Caucus and encourages every elected official to choose the health of the American people over the insurance and pharmaceutical industries."

Societal advocates, rather than whores for the rich and powerful, are united in favor of Medicare For All. Nancy Altman, president of Social Security Works: "It’s long past time to improve Medicare and expand it to cover all of us. The creation of the Medicare for All Caucus in the House of Representatives is an important milestone in reaching that long overdue goal. Every person in the United States should have the right to guaranteed, high-quality health care, an essential requirement of economic security. We are excited to work with Representatives Jayapal, Dingell, and Ellison, along with every other member of the new caucus, to make Medicare for All a reality."

Please remember, every time you send money to or vote for a New Dem or Blue Dog, you're playing on the wrong team. If you haven't already, try to get over this bullshit about how we can't attack Democrats because... whatever. They are not all our friends. And that's putting it generously. Happy and proud to say I never voted for Clinton and never would. Listen to her in this debate fighting like a mad dog for the corporate special interests that have made her into a multimillionaire. 






UPDATE: Biggest Assholes In American Politics

Politico reported today that some of the anti-Bernie die-hards from the Hillary campaign are publicly bad-mouthing Bernie again. Remember, she was a long-time Republican activist in her formative years and many in her inner circle are fervently anti-progressive and abhor the kinds of policies Bernie is running on-- and are eager to sabotage them... and him. Politico reported that in the final three months before Election Day 2016, Bernie held 39 rallies in 13 states on behalf of Clinton’s campaign, including 17 events in 11 states in the last week alone. Some corporate-type Clinton people are still bitching about his using chartered flights and castigating him for it.

Michael Briggs, Sanders’ 2016 campaign spokesman who often traveled with Sanders on the private flights, said Clinton and her staff were “total ingrates” in light of the efforts the Vermont senator put in to try to help elect her in the general election.

“You can see why she’s one of the most disliked politicians in America. She’s not nice. Her people are not nice,” he said. “[Sanders] busted his tail to fly all over the country to talk about why it made sense to elect Hillary Clinton and the thanks that [we] get is this kind of petty stupid sniping a couple years after the fact.”

“It doesn’t make me feel good to feel this way but they’re some of the biggest assholes in American politics,” he added.

The Hillary people aren't complaining about the private jets they paid for to get Bill Clinton, Tim Kaine, Beyonce, Jay Z and Katy Perry around the country, just Bernie.