Wyden Isn't The Only Democrat Who Wants To Help Paul Ryan Kill Medicare-- Blue Dogs Are Salivating

Last week we saw how Wisconsin Democrat Rob Zerban pushed back against Ron Wyden's harebrained scheme of working with Paul Ryan to destroy Medicare. Obviously Wyden isn't the only bad Democrat in Congress. Many of the worst conservative handmaidens of the 1%-- the Blue Dogs and the New Dems (essentially Blue Dogs without the KKK robes and the anti-gay/anti-Choice fanaticism)-- are quietly lining up behind Wyden and Ryan in the push for a transpartisan death blow against the New Deal and the middle class.

Shamus Cooke guessed Christmas Day would be as good a time as any to expose this unholy alliance.

Politicians are attacking Medicare and Medicaid on all sides--Democrats and Republicans alike. Obama's national health care bill will slash hundreds of billions from Medicare over the next decade, an act supported by so-called "progressive" Democrats. Soon after this "victory" Obama created the Super Committee to balance the budget, which included automatic "triggers"-- if no decision was reached-- that are now slated to cut $600 billion more from Medicare. 



On a state-by-state basis, Medicaid-- a program that provides health care to the poor-- is being cut in virtually every state, where they are using their manufactured budget crises as an excuse. This under-funding of Medicaid has created a lack of doctors for patients, according to USAToday: 



"With a shortage of doctors...[Medicaid] patients have little choice but to use hospital emergency rooms for more routine care." (July 5th, 2011).



But it gets worse. Now, "long term solutions" are being sought. After critically wounding the system with disfiguring cuts, Medicare's plug is about to be pulled. Different privatization plans have been put forth that would instantly kill Medicare. One such plan was recently announced by Democratic Senator Ron Wyden and Republican Congressman Paul Ryan, which, if enacted, would deliver a deathblow to Medicare as we know it. Some commentators have wrongly dismissed Wyden as a "crackpot" risking political suicide; in fact, Wyden is a cautious, "pragmatic" politician, i.e. he blindly follows party leaders and their corporate bosses.



The Wyden-Ryan plan has deep roots not only amongst Republicans, but also Blue Dog Democrats and the New Democrat Coalition-- the powerful congressional caucuses that actually run the Democratic Party. These are the people that create the right-wing economic policies that President Obama has been pursuing since his election victory-- thus Obama's ability to work in a bi-partisan manner with the Republican Party. The Wall Street Journal commented on Obama's right-wing health care plan:



“To listen to President Obama and his closest Democratic allies, you’d think John McCain had won the election and their bill had been drafted by Paul Ryan, Tom Coburn and the scholars at the American Enterprise Institute [a right wing think tank].” (February 26, 2010).



By attaching his name to Paul Ryan (the anti-Medicare crusader), Wyden is now revealing the ultra-right, pro-corporate trajectory of the Democratic Party leadership. And although the White House has spoken against the bill, Obama's own health care reform bill created the framework now copied by the Wyden-Paul plan.



Why does the Wyden-Ryan plan amount to privatization? A brief glance at the recent history of Medicare is necessary to explain. 


Medicare was once dominated by the federal government, where, as a result, administrative costs were low and quality was high. In the 1990's Medicare patients were given an option to have their Medicare services performed by private providers, who were now able to profit off Medicare by charging extra fees for extra services, which they added to the basic amount of funds received via Medicare.



The reason that people often chose private providers was that Medicare funding was being cut and consequently, less services were being offered under traditional Medicare. For those who could afford it, private providers became preferred, since people could then purchase the services they needed but were not offered under traditional Medicare. This "option" created the beginning of a two-tier system of Medicare, opening the door for the systems fracturing.



The Wyden-Ryan plan would crack the nut wide open. But instead of saying privatization, a dirty word, "premium support" is used instead, a sterile sounding term with nasty consequences. It essentially means that each Medicare patient will receive a set amount of money for their Medicare that they can use to "shop" for their insurance. This would be the first time that Medicare spending would be capped, and the rate of growth of this capped fund would not match the rate of growth of health care prices. Once you've accepted the cap, the cap can be continually lowered by Congress or not raised to keep pace with inflation.



Instead of reducing Medicare costs by going after profit-hungry pharmaceutical corporations, patients will have their services curtailed via the cap.



The "choices" offered under the Wyden-Ryan will fully insert the profit motive into the national health care program: Medicare patients with poor health or chronic conditions would find that most private plans are closed to them, since it's unprofitable to actually offer the necessary, varied treatments for these patients. Thus, Medicare participants in poor health would remain in traditional Medicare, where costs would rise as more chronic patients joined and healthier patients fled to cheaper plans that allowed only healthy people. Richer patients would also flee to private plans for another reason: Medicare payments to doctors and hospitals are being continually lowered, doctors would naturally refuse to take Medicare patients as they now refuse to take Medicaid patients.



The subsequent higher costs of traditional Medicare would then push up premium prices, co-payments, and deductibles, where very soon the "public option" of Medicare would be unrecognizable to its ancestor. The poor and those with chronic conditions would be legally discriminated against, since private companies are allowed to do so; a once proud public program will have been mutilated and rendered unusable, i.e. it will have been privatized. 



Medicare was first hijacked by the health care corporations in the 90's with the introduction of Medicare Part C, the original "option" to have privately run Medicare; and because Part C was privately controlled, it received 14 percent more money in inflated payments than did traditional Medicare patients (so that patients would be pushed into the program while corporations could turn a profit).



Later, Medicare Part D was designed and implemented by these same health care corporations to boost profits (a gift from President Bush Jr.). It thus became common for private companies to have their hand in the Medicare honey jar.



How is profit made in the health care business from Medicare? These companies get a set amount of money from the federal government, and if they provide less health care service than what they are paid, they turn a profit. They also profit by providing additional, unneeded services at inflated costs. The Government Accountability Office reported that in 2006, the private plans earned profits of 6.6 percent while having much higher administrative costs than traditional Medicare. 



By 2030 Medicare is expected to enroll 78 million people. Medicaid already provides health care to over 50 million Americans. The number of uninsured Americans stands at 50 million and is rising fast. Tens of millions of more Americans cannot afford the health care plans they are currently in, and millions more would prefer quality health care plans, not the ones they actually have. 



Hundreds of millions of Americans thus have a common interest in health care, yet the above attacks on health care continue while costs continue to rise.



It makes sense that Americans should unite in a single health care constituency. Medicare cannot be defended by only current Medicare recipients; nor can Medicaid be saved by current benefactors. In order to unite all working Americans into a powerful coalition, Medicare for All should be demanded, so that all Americans will see their interests reflected in the fight. Few issues so directly affect so many people, but to expand the fight still further, a coalition could be formed that demands jobs, peace, and education, the other "big" issues that-- when put together-- directly affect nearly every single working person.



The raw material for such a coalition already exists. If the labor and Occupy Movements unite to organize massive, ongoing demonstrations for these basic demands, the potential for a mass movement will have been realized. The majority of Americans would find common cause with such a movement, and after seeing masses of people in the streets, will believe that the fight can be won.

Like Social Security, Medicare is a self-funding program that can be easily preserved by raising taxes on the richest Americans and corporations. Taxing the rich can also help create a national jobs program, save public education and other vital social services, while also helping to galvanize such a movement.

Politicians are using the national and state budget crises to implement drastic austerity measures-- destroying public jobs and services from libraries and health care to roads and education. In Europe the fight against austerity has aroused the entire working populations of several countries, including Greece, England, Italy and Spain. The working people of the U.S. are facing the same austerity crisis and need to unite in the European fashion.

Want to fight back? You can help retire Paul Ryan here and help make the Blue Dog coalition extinct here; and you can send a message to the Democratic Party here. The DCCC and the Democratic Party establishment is in a quiet but deadly war against actual progressives and fully supporting conservative candidates who buy into the Wyden-Ryan plan. If you're not seeing Democratic candidates vowing to join the Progressive Caucus, you're seeing Democrats unwilling to stand up and fight for the New Deal. This week old-line Democratic establishment hack Walter Mondale endorsed anti-labor, reactionary and corrupt ex-Albuquerque Mayor Marty Chavez for Congress against progressive state Senator Eric Griego, something we've been warning about since last spring. The DCCC is quietly lining up conservative candidates to run against the best progressives working to represent working families in Congress. Is the DCCC as toxic for America as the Republicans? I'll leave that for you to decide.

Ryan, Pence And Price Have A Problem: Even Republicans Want Health Care

Yesterday, Greg Sargent started the news cycle rolling at the Washington Post with a simple question: Will Donald Trump really go through with all of it?. Like many of us, Sargent is rightfully worried that Trump, Pence, Ryan and McConnell "may soon be going forward with an agenda that could inflict radical, disruptive change on millions of people," especially in regard to gutting the Affordable Care Act and destroying Medicare. "We don’t know," he wrote, "how far Trump will actually go. It’s also true that Republicans are taking steps to mitigate the short-term impact of some of the changes being mulled, and are struggling internally with the details in ways that suggest their best laid plans could conceivably go bust. But is there any particular reason not to anticipate the worst at this point?"

Los Angeles Congressman Ted Lieu is thinking along similar lines but he focused on another GOP threat to healthcare-- V.A. privatization. "As the Member of Congress representing the nation’s largest VA hospital," Lieu told the media, "I oppose any effort to privatize VA healthcare.  My opposition to privatization is guided by the voices of veterans and advocates in my district, who understand that we can improve service delivery to our veterans without tearing the VA down brick by brick.  On average, our veteran population is older and sicker than the rest of America-- they have earned and deserve a world-class healthcare system designed to meet their unique needs. Finally, as a veteran myself who served on active duty, I humbly believe that a veteran should be at the helm of the VA.  Our nation’s warriors deserve a leader with a profound understanding of their service and sacrifice.  They deserve a leader dedicated to guaranteeing timely access to the highest quality care."

A poll taken between Nov 15 and 21 by the the nonpartisan Kaiser Family Foundation found that only 1 in 4 Americans want the Republicans to repeal Obamacare. 52% of Republicans would like that to happen, significantly less than the 69% would said they wanted that to happened before the election, but majorities across party lines support many Obamacare provisions-- though not the mandate-- which basically pays for the goodies they all want. This is what the vast majority of Democrats, Republicans and Independents all support from the Affordable Care Act:

• allowing young adults to stay on a parent's insurance until age 26.
• no copayments for many preventive services.
• closing the Medicare prescription drug coverage gap known as the "doughnut hole."
• financial help for low- and moderate-income people to pay their insurance premiums.
• a state option to expand Medicaid to cover more low-income adults.
• barring insurance companies from denying coverage because of a person's medical history.
• increased Medicare payroll taxes for upper-income earners.

Some Republicans are getting nervous about moving from demagoguery to actually taking away people's-- voters'-- healthcare. But not all. Ryan, Pence and Tom Price are all willing to set themselves aflame on a pyre that burns up Obamacare, Medicare, Medicaid and Social Security if it comes to that. Trump... perhaps not so much-- not that anyone knows what Trump thinks about any policies. In his column yesterday, Paul Krugman asserted that Trump is about to betray the white working class voters in Ohio, Michigan, Indiana, Wisconsin and Pennsylvania who made him the electoral college winner.

The evidence of that coming betrayal is obvious in the choice of an array of pro-corporate, anti-labor figures for key positions. In particular, the most important story of the week-- seriously, people, stop focusing on Trump Twitter-- was the selection of Tom Price, an ardent opponent of Obamacare and advocate of Medicare privatization, as secretary of health and human services. This choice probably means that the Affordable Care Act is doomed-- and Mr. Trump’s most enthusiastic supporters will be among the biggest losers.

The first thing you need to understand here is that Republican talk of “repeal and replace” has always been a fraud. The G.O.P. has spent six years claiming that it will come up with a replacement for Obamacare any day now; the reason it hasn’t delivered is that it can’t.

Obamacare looks the way it does because it has to: You can’t cover Americans with pre-existing conditions without requiring healthy people to sign up, and you can’t do that without subsidies to make insurance affordable.

Any replacement will either look a lot like Obamacare, or take insurance away from millions who desperately need it.

What the choice of Mr. Price suggests is that the Trump administration is, in fact, ready to see millions lose insurance. And many of those losers will be Trump supporters.

You can see why by looking at Census data from 2013 to 2015, which show the impact of the full implementation of Obamacare. Over that period, the number of uninsured Americans dropped by 13 million; whites without a college degree, who voted Trump by around two to one, accounted for about eight million of that decline. So we’re probably looking at more than five million Trump supporters, many of whom have chronic health problems and recently got health insurance for the first time, who just voted to make their lives nastier, more brutish, and shorter.

Why did they do it? They may not have realized that their coverage was at stake-- over the course of the campaign, the news media barely covered policy at all. Or they may have believed Mr. Trump’s assurances that he would replace Obamacare with something great.

Either way, they’re about to receive a rude awakening, which will get even worse once Republicans push ahead with their plans to end Medicare as we know it, which seem to be on even though the president-elect had promised specifically that he would do no such thing.

As Krugman pointed out, during the campaign, Trump solemnly swore to not cut Medicare (and reassured his fans that he would replace Obamacare with something "great." So how did Pence talk him into an extremist crackpot like Tom Price as Health Secretary?

TalkingPointsMemo provided a handy reminder and roadmap to Ryan's plans to assault and destroy Medicare, his life's dream. Will Trump be able to-- or even want to-- stop him?

Ryan has been pushing his privatization plan-- or what he calls "premium support"-- for years. It's been part of his annual budget blueprints, and it has evolved over time. The basic idea is that Ryan would give the elderly a set amount of money to buy health insurance rather than Medicare's fee-for-service system where the government pays doctors and hospitals based on the services they provide.

How much money the elderly would receive to buy insurance, the quality of the plans available, how the government would regulate them and the rate at which the benefits would increase have varied over the years and sometimes have been unclear.

As Medicare is currently configured, American workers and employers contribute equally to the public insurance program via the Medicare payroll tax. When people turn 65, they become eligible for Medicare's guaranteed coverage, pay premiums and receive a robust package of benefits.

Looming as the biggest unknown is whether Medicare-- in its current form as a single-payer, guaranteed-coverage, fee-for-service system-- will remain intact.

Will Medicare be eliminated explicitly, as it has in past Ryan plans? Will it be changed so substantially that the long-term effect will be to weaken it so that phasing out it out is inevitable? Or will Ryan seek to change Medicare in fundamental ways while still preserving its most important protections?

How committed President-elect Trump and Rep. Tom Price (R-GA), his nominee as secretary of Health and Human Services, are to Medicare privatization is another wild card in the mix.

"It is quite clear at this point that Ryan and Price would say they are retaining traditional Medicare as an option, but the question is under what terms. Is it provided under terms that would allow traditional Medicare to continue and flourish? Or is it conversely under terms that would cause it to wither and perish?" said Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities.

Over the years, Ryan's plans have evolved, in part because of pressure from his own members. Ryan told the New Yorker in 2012 that he recognized his plan needed to be accepted by more than just a few conservatives in the House. He needed to develop a plan that met the vision for the broader Republican conference.

...[T]he underlying principle for Ryan's plans comes from the conservative idea that private businesses are more efficient at managing health care than the government would be. That, some experts argue just isn't true. Medicare, by and large, is a fairly efficient program. Seniors manage to get a lot of health care they are happy with for a decent price.

"Medicare is more efficient than private insurance for two main reasons. One it is able to pay providers less and second it also because of its size, it has lower administrative costs as well," Van de Water said.

Health care experts who have spent years analyzing Ryan's plans note that there are still a lot of questions to be answered. Here's what we do know:

Ryan's 2008 Plan On Medicare: Ending Medicare

In 2008 when he was the ranking member of the House Budget Committee, Ryan proposed that traditional Medicare should be replaced with a voucher program. The idea was that individuals would get a set amount of money from the government to purchase health insurance and eventually Medicare would be phased out.

...Ryan's 2011 Budget: Ryan Works To Phase Out Medicare

In 2011-- after months of listening sessions with his Republican colleagues-- Ryan released his budget, titled Path to Prosperity, which again proposed a major overhaul to Medicare, but had greater support in the wake of Tea Party takeover of the House of Representatives by Republicans who ran on cutting the federal deficit. It left Medicare intact for existing beneficiaires but newly eligible participants would be funneled to an exchange where private insurers competed and individuals could choose private plans. This was Ryan's phaseout plan.

...Experts argued that the plan would put more cost on individuals than they would incur under traditional Medicare and that administrative costs associated with the plans actually eradicated any savings to the government.

"The Congressional Budget Office estimates that under the Ryan plan the cost-increasing effects would swamp the cost-reducing effects, so much so that by 2030 the overall cost of care for the Medicare population would be at least 41 percent higher than it would be under Medicare and the amount that enrollees would have to pay directly would more than double," Henry Aaron – a Brookings Institution fellow who co-wrote his own premium support plan in the 1990s– wrote in a paper on premium support. Ryan claimed in numerous interviews that his proposed changes to Medicare actually were based on the plan that he and Rivlin developed together. “Alice Rivlin and I designed these Medicare and Medicaid reforms,” Paul Ryan said at the time, according to the Washington Post. Rivlin, however, fully rejected Ryan's revised "premium support" plan.

...Ryan's Plan Has Evolved To Leave Some Form Of Traditional Medicare In Place

In more recent years, Ryan's plan has evolved. The idea is still the same. Senior citizens would get a set dollar amount to buy health insurance. Yet, instead of giving voucher recipients only the option to buy private insurance on a health insurance marketplace, the elderly could choose to use their subsidy to buy traditional Medicare.

...[S]ome health care policy experts argue that traditional Medicare could still be jeopardized under Ryan's later privatization plans. Here's the issue. Under Ryan's privatization plan, it's understood that the government will give a set amount of money for individuals to buy insurance, but that dollar amount would be determined by a bidding process of private insurers. Experts are not convinced that quality protections would be strong enough so they worry that the competitive bids could be far cheaper than traditional Medicare in many places, but not be near the quality of the coverage. In that case, individuals who might be interested in going with traditional Medicare to ensure they had more protections may have to pay out of pocket.

"They might have to pay more and they might have to pay a considerable amount more depending on where they are," said Stuart Guterman, a senior scholar at the Commonwealth Fund. "It’s not overtly phasing out Medicare, but it does clearly put pressure on some folks in some areas."

Guterman also worries that even if traditional Medicare were an option, it might be strained if enough younger, healthier beneficiaries opted for private plans, older, sicker individuals stayed with Medicare. It could result in Medicare slowly losing it's power to set competitive prices for services.

“I think it’s a legitimate concern if the mix shifts so that fewer and fewer Medicare beneficiaries are enrolled in traditional Medicare. Then it would be harder for them to set prices effectively," said Guterman.

2016: Ryan Blames Medicare Overhaul On Obamacare

On the campaign trail, Trump boldly declared that Medicare would remain the same for seniors. He argued that the program was not going to be touched. But as soon as Trump won, Ryan appeared on Fox News and argued that something had to be done about Medicare and hinted that it might come as part of the repeal to the Affordable Care Act.

"Because of Obamacare, Medicare is going broke," Ryan said in an interview. "So you have to deal with those issues if you're going to repeal and replace Obamacare."

The reality is that changes to Medicare made by Obamacare actually made the program more solvent, not less. The Medicare trustees wrote in 2010 that "the financial status of the Hospital Insurance trust fund is substantially improved by the lower expenditures and additional tax revenues instituted by the Affordable Care Act. These changes are estimated to postpone the exhaustion of HI trust fund assets from 2017 under the prior law to 2029."

Would Ryan's Plan Really Kill Medicare Or Not?

Republican strategists and propagandists get crazy whenever anyone points out that the Ryan budget-- voted for by nearly every Republican in Congress-- ends Medicare. Ryan was careful to call the inadequate, costly voucher system he would have set up in its place "Medicare." But is it Medicare? Does Ryan's draconian and dystopian budget kill Medicare or not? With just over 3 weeks left before voters in Wisconsin's first congressional district decide whether or not to replace Ryan with Rob Zerban, Blue America has deployed dozens of newspaper ads like the one below and 8 billboards across the district like the one up top, letting voters know that Ryan wants to do what rightists have always wanted to do for their Wall Street paymasters: end Medicare.

Ryan and other Republicans are insisting their plan doesn't kill Medicare (because, after all... they still call their hot mess of as plan by the same name). And when Rob Zerban released the ad below, they went berserk trying to get it pulled off TV as false. But it's still running. And Rob, obviously, is standing by his assertion that the Ryan plan ends Medicare-- and both media outlets and independent economists agree that Ryan’s budget would voucherize Medicare, costing seniors an extra $6,500 per year-- fundamentally ending the program’s promise to cover healthcare costs for seniors and gradually phase out the whole system.

Clearly, Ryan’s plan would undermine Medicare by leading richer and healthier seniors to abandon traditional Medicare in favor of private health care plans-- leaving Medicare with poorer and sicker beneficiaries. This would increase Medicare’s costs, which would inevitably force Medicare to raise premiums, or slash services. According to the Center on Budget and Policy Priorities, the Ryan “plan also would likely lead to the gradual demise of traditional Medicare by making its pool of beneficiaries smaller, older, and sicker-- and increasingly costly to cover.”

  Yet a new TV ad released today by the Ryan campaign claims the Ryan budget “protect[s] and strengthen[s]” Medicare, and “empowers future seniors.” It's another example of why Ryan got the nickname Lyin' Ryan.

  “We don’t say anything we don’t mean-- Paul Ryan’s budget ends Medicare,” said Rob Zerban. “Call it premium support, CouponCare, or a voucher system, but the bottom line is Ryan’s budget forces seniors to pay thousands of dollars in extra healthcare costs now, while leading Medicare towards financial ruin in the long-term. If the fact-checkers should investigate anything, it’s Paul Ryan’s bold-faced lie that his plan strengthens Medicare and empowers seniors-- when scores of news outlets, think tanks, and independent economists agree it does just the opposite.”

Krugman weighed in on this in June of 2011. “[T]he fact is that Republicans are trying to end Medicare. The program we now call Medicare is one in which the government acts as your insurer, paying your major medical bills; coverage is guaranteed to all seniors. The program Republicans want gives you vouchers and tells you to go buy your own insurance, if you can. That’s not at all the same thing.” And it wasn't just Krugman. The Wall Street Journal, which wants to send Medicare, agreed that that is what Ryan is trying to accomplish: “The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills.”

A little over a year later, 2 months ago, Bloomberg News was saying agreeing that Ryan's plan kills Medicare, even if he keeps the name. “Ryan’s budget bill also would end traditional Medicare by capping spending and offer vouchers to buy private insurance.” And the Center on Budget and Policy Priorities explained it in slightly greater detail:

The higher premiums would lead more of Medicare’s healthier enrollees to abandon it for private plans, very possibly setting off a spiral of rising premium costs and falling enrollment for traditional Medicare. Over time, traditional Medicare would become less financially viable and could unravel-- not because it was less efficient than the private plans, but because it was competing on an unlevel playing field in which private plans captured the healthier beneficiaries and incurred lower costs as a result. Ryan also would allow private plans to tailor their benefit packages to attract healthier beneficiaries and deter sicker ones, which only makes this outcome more likely.

Iowa Senator Tom Harkin explained it to voters in his state: “When Mitt Romney named Congressman Paul Ryan to be his running mate, he reminded Iowans of the choice we face in this election. One of the proposals in the extreme House Republican budget that Congressman Ryan crafted is its plan to end Medicare as we know it.” So, Rob is standing by his ad-- and Blue America is standing by our ads as well. Here's where you can help both Rob and Blue America Stop Paul Ryan. We have to do it for future generations.

And, yes, of course, Mitt Romney is just as bad. Not only has he bought into the Ryan plan, he has his own unambiguous record of disinterest in the struggles of middle class families. While he was governor of Massachusetts he raised the costs on nursing homes 8 times, no big deal for your garden variety financial predator... but devastating for normal people who work for a living. We need to defeat Ryan in his congressional district and watch Obama and Biden defeat him on a national level when they pulverize Romney in 4 weeks.

Improved Medicare For All or Watered-Down Medicare For All?

Medicare For All supporters hold signs during an event on healthcare September 13, 2017 on Capitol Hill in Washington, D.C. Photo by Alex Wong/Getty Images (source)

by Thomas Neuburger

This is a follow-up to my recent piece on Medicare For All and the challenge it presents to the Democratic Party (see "Medicare For All — The Democratic Party Audition for 2020").

It's already been announced that a bill will be written and hearings held. Rep. Pramila Jayapal is spearheading that effort:

The new Democratic majority in the House will hold the first hearings on Medicare-for-All legislation, a longtime goal of the party’s left, after Speaker Nancy Pelosi lent her support for the process.

“It’s a huge step forward to have the speaker’s support,” said Rep. Pramila Jayapal (D-Wash.), who will be the House sponsor of the legislation, usually denoted as HR 676. “We have to push on the inside while continuing to build support for this on the outside.”

Some version of universal health care has been a Democratic goal for decades. The Expanded and Improved Medicare for All Act, first introduced in 2003 by then-Rep. John Conyers Jr. of Michigan, has become the vehicle for Democrats who want to bring single-payer, Canada-style health care to the United States.

That legislation was typically sidelined, even when Democrats had power; in 2009 and 2010, when the House passed the Affordable Care Act, the “Medicare-for-All” package was not part of the discussion. But in his 2016 campaign for president, Sen. Bernie Sanders (I-Vt.) championed Medicare for All. The following year, for the first time, a majority of House Democrats co-sponsored HR 676.

Note the title of Conyers' bill — the "Expanded and Improved Medicare for All Act".

Why "Improved Medicare" For All?

Conyers' bill was called "Expanded and Improved Medicare for All" because Medicare is currently deficient in a number of ways. Nancy Altman of Social Security Works explains (emphasis mine):

[S]eniors who are currently enrolled in Medicare would benefit enormously. The cost of prescription drugs for seniors is skyrocketing. Out-of-pocket health care costs are projected to consume half of the average Social Security check by 2033. Medicare for All would eliminate co-pays and deductibles. It would take on Big Pharma and dramatically lower prescription drug costs for the entire nation. No longer would seniors be forced to turn over a huge chunk of their hard-earned Social Security benefits to pharma CEOs and for-profit hospital executives. No longer would seniors have to cut their life-saving medicines in half to afford money for food.

Medicare for All would also improve Medicare’s benefits for seniors. The current program does not cover several essential health care needs, including dental, vision and hearing. This forces too many seniors to suffer avoidable isolation caused by inability to see and hear. It weakens the health of too many seniors who are unable to obtain the dental work necessary to allow adequate nutrition. Improved Medicare for All adds these benefits.

Perhaps the biggest gap in Medicare is its failure to cover long term care. By adding more home health care services that allow people to age at home and institutional care for those who have no other choice, Improved Medicare for All would make an enormous difference in the lives of millions of seniors and their families. It would also benefit every state that covers some of these services under Medicaid.

There are other areas that could be improved as well. Conyers' bill did not cover reproductive health. In addition, reimbursements to primary care physicians, in my anecdotal experience, is woefully low, so much so that many primary care physicians are forced to raise prices on their non-Medicare patients to cover the underpayment from Medicare, while others have been forced to decline Medicare patients entirely. (This comment applies only to primary care physicians, not high-priced surgeons and the like.)

Unwarranted Fears?

There are already concerns on the horizon about the new bill. According to one report, it may not contain key elements of Conyers' longstanding Medicare For All bill, HR 676: "Some in the single payer movement see the abandonment of HR 676 as a betrayal of years of grassroots activism, activism that drew 124 co-sponsors to HR 676 in the House last year. Now, with Democrats in charge of the House, the Medicare for All single payer bill is being rewritten, watered down and renumbered." Within the piece, Margaret Flowers of Health Over Profit is quoted as saying the new bill "maintains the for-profit providers in the system."

These fears are unwarranted according to those who have seen the bill. First, it's not being written in secret; many people have seen it and are participating in the process, including strong progressive advocacy groups like Social Security Works. Second, the bill states explicitly that profit-driven healthcare is the problem and works to codify the elimination of profits from the healthcare system.

In that sense, the charge that the bill "maintains for-profit providers in the system" is both right and wrong. For-profit providers, for example, hospitals, do have a role in the new system, but profits are eliminated from their reimbursement. And the for-profit insurance industry is eliminated entirely from the Medicare For All system — no coverage gaps, no public-private partnership arrangements. This is a rather elegant solution, in my opinion, far better than the "industry buyout" proposals in earlier bills.

Alex Lawson, SSW's executive director, told me by email today that "Jayapal’s bill, which I have been in the redrafting group for, is the best Medicare For All bill out there right now. This process with Jayapal’s office has been the most inclusive and responsive process I have ever seen on the Hill."

Watered-Down Medicare For All

This brings us to the great fear of many in the health care community — that if Democratic pro-industry politicians are unable to defeat a true Medicare For All bill, they will offer "more practical" alternatives that appear to solve the problem but are weaker and watered down.

The benefit to politicians of passing a watered-down bill is obvious. It allows the compromised in Congress to claim they're in favor of a very popular policy (70% of all Americans support it) while actually working to make sure no industry ox is gored when the final bill passes. Supporting a weaker bill creates the appearance of progressive action without most of the benefits.

Look again at the fear that Rep. Jayapal's bill "maintains the for-profit providers in the system." The concern, though wrong, is the right concern. Medicare For All should provide complete coverage by itself, coverage robust enough that anyone who depends on Medicare alone has all she needs to maintain good health and get good cost-free care when needed. If the wealthy wish more than that, private supplemental coverage would certainly be available at market prices. But private coverage should have no part in providing necessary coverage for the non-wealthy.

In a properly designed system, Medicare would therefore replace private insurance for most people, which means that under a plan like this, the private health insurance industry could lose up 95% of its current customers — by design. That's the only way the system can do what it's supposed to do.

No industry, no matter how venal, wants to lose most of its customers, and this industry is no different — they're going to fight like demons to hold on.

What shape is that fight starting to take? This shape, according to Politico (emphasis added): 

Democrats, with their eyes on 2020, have introduced at least eight plans for expanding health coverage beyond Obamacare’s gains. They range from modest Medicare reforms to more ambitious restructurings that would extend government-run care to millions of new patients — an array of options that fall short of campaign trail promises for full Medicare for All.

That spectrum includes Sen. Debbie Stabenow (D-Mich.)'s bill allowing patients to buy into Medicare starting at age 55 — which Brown also supports — and Tim Kaine (D-Va.) and Michael Bennet (D-Co.)'s plan to create a Medicare-style public option to compete with private insurers on up to bigger revamps, like Sens. Jeff Merkley (D-Ore.) and Chris Murphy (D-Conn.)'s expansion [of] Medicare eligibility to nearly all Americans. Sen. Brian Schatz (D-Hawaii) would let everyone purchase Medicaid. Those options have been characterized by supporters as more practical alternatives to the completely government-run system popularized by Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.).

That's quite a range of options. Note that Jayapal's proposal is equated to Sanders' proposal, a "completely government-run system." Note also that most or all of the lesser proposals leave the for-profit insurance industry more or less intact.

The Problem Can't Be the Solution

The private health insurance industry cannot be left intact. About this, Lawson is adamant, writing:

Private insurance is the problem. Co-pays, deductibles, out of network, denied care, uninsured, these are all concepts that we need to eliminate in order to build a healthcare system. These are all ways the private insurers take more of our money while denying our care. We need to eliminate corporate insurance, the problem cannot be the solution, it can’t even be a piece of the solution.

Private insurance is just another way Wall Street can stick their hands in our pockets and steal our money, leaving millions sick, anxious and broke.

No one who truly supports "Improved Medicare For All" should disagree.
  

This Morning President Obama Talked About Saving Medicare-- And Buck McKeon Talked About Destroying It

Dr. Lee Rogers with his new-born daughter, Lily, now 3 months old

President Harry Truman first proposed Medicare in 1945. Republicans and conservative Southern Democrats fought it bitterly for two decades before President Lyndon Johnson signed it-- and Medicaid-- into law on July 30, 1965, part of the Great Society. Harry Truman was the first person to enroll. It finally passed because the Republicans were allowed to water it down but even then only 13 Republican senators voted for it. 17 voted NO and 2 didn't vote. 7 Democrats also opposed it but 57 voted YES. In the House half the Republicans voted YES (70) and 68 voted NO and 2 didn't vote. 237 Democrats voted YES and 48, mostly southern racists who soon joined the GOP, opposed it. Almost 50 years have passed since then and the Democrats are still trying to improve it and make it more accessible-- while the GOP is as determined as ever to destroy it.

This morning, President Obama addressed the nation and talked exclusively about Medicare, primarily because the Republicans have been making a lot of false accusations, as always, and he was concerned that there's a lot of "misinformation flying around."

This week, we found out that, thanks to the health care law we passed, nearly 5.4 million seniors with Medicare have saved over $4.1 billion on prescription drugs. That’s an average of more than $700 per person. And this year alone, 18 million seniors with Medicare have taken advantage of preventive care benefits like mammograms or other cancer screenings that now come at no extra cost.
 
That’s progress. It means that seniors everywhere are getting the care they need for less. And if you have questions about what benefits you’re entitled to, you can go to medicare.gov to find out.
 
This news is also a reminder of what’s really at stake when we talk about the future of Medicare. It’s not about overheated rhetoric at election time. It’s about a promise this country made to our seniors that says if you put in a lifetime of hard work, you shouldn’t lose your home or your life savings just because you get sick.
 
Over the last 47 years, millions of Americans have worked for that promise. They’ve earned it. And for many seniors, the care they’ve gotten through Medicare has made all the difference in the world. 
 
Growing up as the son of a single mother, I was raised with the help of my grandparents. I saw how important things like Medicare and Social Security were in their lives. And I saw the peace of mind it gave them. 
 
That’s why, as President, my goal has been to strengthen these programs now, and preserve them for future generations. Because today’s seniors deserve that same peace of mind. And the millions of Americans who are working hard right now deserve to know that the care they need will be available when they need it.
 
That’s why, as part of the Affordable Care Act, we gave seniors deeper discounts on prescription drugs, and made sure preventive care like mammograms are free without a co-pay. We’ve extended the life of Medicare by almost a decade. And I’ve proposed reforms that will save Medicare money by getting rid of wasteful spending in the health care system and reining in insurance companies-- reforms that won’t touch your guaranteed Medicare benefits. Not by a single dime.
 
Republicans in Congress have put forward a very different plan. They want to turn Medicare into a voucher program. That means that instead of being guaranteed Medicare, seniors would get a voucher to buy insurance, but it wouldn’t keep up with costs. As a result, one plan would force seniors to pay an extra $6,400 a year for the same benefits they get now. And it would effectively end Medicare as we know it.
 
I think our seniors deserve better. I’m willing to work with anyone to keep improving the current system, but I refuse to do anything that undermines the basic idea of Medicare as a guarantee for seniors who get sick.
 
Here in America, we believe in keeping our promises-- especially to our seniors who have put in a lifetime of hard work and deserve to enjoy their golden years. That’s what Medicare is all about. That’s why we need to strengthen and preserve it for future generations. And as long as I have the honor of serving as your President, that’s exactly what I’ll do.

Blue America has endorsed four physicians running for Congress this year, Dr. Syed Taj (D-MI), Dr. Matt Heinz (D-AZ), Dr. David Gill (D-IL) and Dr. Lee Rogers (D-CA). On Friday Lee's opponent, anti-health care fanatic Buck McKeon addressed seniors in Santa Clarita and spread around more of the lies and misinformation President Obama was alluding to. Lee, a distinguished surgeon at Valley Presbyterian Hospital, one of the largest acute care hospitals in California, had a different way of addressing the issue from the president. He looks at it, first and foremost as a doctor who deals with patients-- and with insurance companies.

“Right now Congressman McKeon is addressing local seniors at the Santa Clarita Senior Center about Medicare. Let’s hope he’s apologizing for voting multiple times to end Medicare as we know it. Those are strong words, but they’re true. McKeon supports a plan to replace automatic enrollment in Medicare at age 65 with a voucher that forces seniors into the private market at the mercy of private insurers. According to the Congressional Budget Office, the plan McKeon voted for would cause seniors to spend $6,400 more per year out of pocket on their health care. Nearly half of America’s seniors live on less than $18,000 per year. We can’t expect seniors to be able to afford this drastic change. The reason why we started Medicare was because private insurers were taking advantage of seniors. McKeon talks about death panels, but there would be no greater death panel than a private insurer throwing up roadblocks and delays for seniors’ health care. Medicare doesn’t do this.
 
“McKeon criticizes the Affordable Care Act for reducing Medicare costs by $716 billion over 10 years. But there are absolutely no cuts to seniors’ benefits. McKeon’s criticism is disingenuous because the plan he voted for called for many of the same reductions. Much of these savings would come from reducing overpayments to private insurers participating in the Medicare Advantage program. Taxpayers spend about 14% for health services when they are covered by Medicare Advantage, as opposed to traditional Medicare. McKeon supports a plan that restores these overpayments to insurers.
 
“The difference is that President Obama’s plan uses the savings to strengthen Medicare by closing the prescription drug donut hole and waiving co-payments for preventative services, like mammograms. The plan McKeon supports would increase costs to current seniors immediately by making them pay more for their medications and restore co-payments for preventative services. That’s not a change for people younger than 55, that’s an increased cost for beneficiaries now.

“I’m a doctor. A majority of my patients are on Medicare. I know what it’s like to suffer, waiting for private insurers to authorize services. Medicare provides needed health care to seniors who don’t have time to wait. Budgets have a lot of numbers and are confusing, but they represent priorities. McKeon’s votes indicate his priorities are to give tax breaks to millionaires and billionaires while seniors pay more for their health care. Instead, I will prioritize our seniors, by keeping their costs low and strengthening Medicare by reducing waste. Supporting Medicare is not a partisan issue. I call on Representative McKeon to denounce the Romney-Ryan plan to dismantle Medicare just like his Republican colleague, Congressional candidate Tony Strickland, has done in the neighboring Ventura County district.”

Let me just end this post with part of a memo from Carville-Greenberg, a Democratic consulting firm, which asserts that Ryan's Medicare plan imperils congressional Republicans.

Even before Mitt Romney named Paul Ryan to the ticket, our Battleground polling results indicated an erosion of support for Republicans, largely based on Paul Ryan’s plans for Medicare and entitlements. The advantage Republicans held among seniors in 2010 has been completely decimated. Across these Republican districts, incumbents now hold just a two-point lead with voters over age 64-- a group Republicans won by 18 points in 2010.

Not surprisingly, the leading factor in this shift away from the GOP is Paul Ryan’s war on Medicare. By a decisive six-point margin, voters in these districts now say they trust Democrats more than Republicans when it comes to Medicare. Among voters in the 27 most competitive Republican battleground seats, Democrats now hold an 11-point advantage on Medicare.

We are in the business of predictive politics, so you’ll forgive us if we pause for a moment to say… we warned them two years ago. Immediately following the 2010 election, we offered our analysis of the “shellacking” suffered by Democrats at the midterm ballot box. We acknowledged the wounding outcome but-- after careful analysis of our own poll results-- we saw a broader and more important message in the midterm: Democrats did not lose because voters wanted to move in the direction that Paul Ryan and the House Republicans have since tried to take the country.

Back then we wrote:

There is no evidence that this was an affirmative vote for Republicans. Their standing is no higher in this year’s post-election polls than it was in 2008 and 2006. There is a lot of evidence that voters do not share Republicans’ priorities, particularly on Social Security and Medicare, and voters did not mandate a consuming focus on spending cuts and deficit reduction…[the results do] not translate into a mandate for Republicans to slash spending… and squander the next two years trying to repeal health care.

We do not yet know the outcome of the 2012 election and we’re certainly not calling it now-- the Congressional ballot remains tight and there are still more than two months of tough campaigning to go.  But at this moment, our latest battleground survey in the 54 most vulnerable Republican-held districts-- many of the same Republicans who “shellacked” us in 2010-- shows that GOP incumbents are paying a heavy price for misreading the 2010 election results and overreaching on a conservative Paul Ryan agenda that voters did not mandate.

Republicans Are Way Out On A Limb When It Comes To Ryan's Plan To Kill Medicare

Father Stephen Umhoefer, 72, was the pastor for Paul Ryan when he was growing up. The idea of Ryan becoming vice president has him "worried" because Ryan‘s austerity budget and proposed steep cuts in social programs are inconsistent with the Catholic teachings that Ryan cites to justify the policies. "He shouldn't wrap himself in Catholic teaching because he is not using that [teaching] in what I would say is a balanced way," said Umhoefer.

For Umhoefer, the test of the budget is a simple one: "The first question is how does this affect the poor. And everything else follows from that. That doesn't mean it's a Republican or Democrat [question]-- you could argue that. But the primary question is how does this affect the poor?"

Umhoefer said that Ryan's lack of attention to the poor and the emphasis on individualism espoused by role models such as Ayn Rand concerned him. "Paul would say that the only way to save the country from a coming [fiscal] disaster is 'follow my plan.'" But according to Umhoefer, the problem is "you can't tell somebody that in ten years your economic situation is going to be just wonderful because meanwhile your kids may starve to death."

Umhoefer said that in Janesville, which lost some 5,000 jobs related to the auto industry after a GM plant closed in 2009, residents continue to seek emergency food and housing support and social service organizations have been running out of funds. A house across the street from the church sits with a red "condemned" sticker prominently on the door, and another house on the block has a sign that declares, "Price Reduced."

"The welfare check runs out and people are suffering now in ways that they haven't before," he said, noting that the church has hired two former auto workers with wages and benefits far below their former level.

Umhoefer said that wealthy church members have offered support for shared sacrifice and revenue raising proposals such as the Warren Buffet rule that asks millionaires to avoid loopholes and pay a tax rate of 30 percent. "I can't always invite my neighbor over to dinner, but I... need to pay a certain amount of taxes. And I need to vote to make sure taxes are used to help make sure that my neighbor isn’t starving," he said.

The video up top is the first DCCC television independent expenditure and, in his attempt to elect reactionary Blue Dog Gary McDowell (MI-01), Steve Israel seeks, appropriately enough, to tie Republican freshman Dan Benishek to Paul Ryan's plan to kill Medicare. Kill Medicare? Is that really what Ryan, Benishek and the rest of the GOP want to do? Oh, absolutely. Yesterday, Paul Krugman did what he calls a utility post as "a summary of what’s actually in the Ryan plan."

In the first decade, the big things are (i) conversion of Medicaid into a block grant program, with much lower funding than projected under current law and (ii) sharp cuts in top tax rates and corporate taxes.

...After the first decade, Medicare is gradually transformed into a voucher scheme, with the value of the vouchers lagging well behind projected health care costs. Even so, however, much of the supposed deficit reduction comes not from Medicare but from further cuts in discretionary spending relative to GDP, with the number eventually falling to 3.5 percent of GDP (see Table 2 in the CBO report). There is, once again, no specification of how this is to be accomplished; bear in mind that this number includes defense, which is currently around 4 percent of GDP.

Ryan basically proposes three big things: slashing Medicaid, cutting taxes on corporations and high-income people, and replacing Medicare with a drastically less well funded voucher system. These concrete proposals would, taken together, actually increase the deficit for the first decade and beyond.

Krugman claims the Ryan plan is so vague and so filled with untenable assumptions that it "isn’t even a plan, it’s just a set of assertions." For a someone who idiots inside the Beltway have been trying to sell for several years as "serious" and a "wonk," Ryan, it turns out, really is just a well-scrubbed gym bunny who can usually regurgitate Wall Street and Insurance Industry talking points fairly well-- even though the talking points don't add up. And now that he's playing in the Big Times, and coming under real scrutiny for those assertions, he's looking more and more like a goof ball and another major Romney embarrassment. Josh Barro's report for Bloomberg yesterday detailed the confusion for the Romney campaign which is hammering Obama for cutting $716 billion out of Medicare even while Ryan's budget, approved by the Republican-controlled House, includes those same cuts. "Conservatives," Barro writes, "are protesting that Ryan's plan to cut Medicare is different from the president's. They're right-- Ryan would actually cut $205 billion more out of Medicare over the next ten years than Obama would... What Romney and Ryan are up to is simple: They want to have it both ways on Medicare. They are for Medicare cuts, because Medicare is expensive and the federal budget needs to be controlled. And they are against Medicare cuts, because Medicare cuts are unpopular. The political impulses behind this strategy are clear. Why any policy experts would try to offer a substantive defense of it is not."

Steve Benen helped clarify what the argument is all about-- inasmuch as anyone could given the confusion at the base of it. "Consider," he suggests, "this remarkable series of events:"

1. President Obama extends new benefits to seniors on Medicare and finds savings in the system to strengthen Medicare's finances.

2. Paul Ryan approves of Obama's Medicare savings and incorporates them into his own budget plan.

3. Mitt Romney endorses Ryan's plan, which includes Obama's Medicare savings.

4. Romney changes his mind, and tries to argue he's for and against the Medicare savings at the same time (for them in Ryan's plan, against then in Obama's law).

And finally 5. Ryan denounces the Medicare savings he supports.

So to review, the Romney/Ryan ticket is for and against Obama's Medicare savings, for and against including Obama's Medicare savings in the Republican budget, for and against extending benefits for seniors, and for and against strengthening Medicare's finance-- all at the same time.

Democratic challengers to Republicans who voted for Ryan's plan to kill Medicare and Medicaid have to figure out how to clarify the issue to local voters. And if they're not anti-Choice and antigay Blue Dogs, it's not very likely Steve Israel will allow the DCCC to help them. They're on their own. In NC-10, for example, state Rep. Patsy Keever gets no help from the DCCC in her battle against Ryan lackey Patrick McHenry, despite the fact that McHenry's support for Ryan's budget who have been absolutely devastating for the residents of the area, raising costs for seniors and individuals with disabilities enrolled in Medicare, reducing their benefits, and putting predatory private insurance companies in charge of the program. For current beneficiaries, important benefits-- such as closing the hole in Medicare’s drug coverage-- would be immediately eliminated. For individuals age 54 and under, Medicare’s guarantee of comprehensive coverage would be replaced with a “voucher,” what Ryan, Romney and McHenry call "premium support,” to buy private health insurance. By design, this federal contribution does not keep pace with medical costs, shifting thousands of dollars in costs onto the individual. Under the old boundaries of NC-10, the budget would have increased prescription drug costs for 8,800 Medicare beneficiaries in the district who enter the Part D donut hole, forcing them to pay an extra $87 million for drugs over the next decade. It also would have eliminated new preventive care benefits for 120,000 Medicare beneficiaries in the district. According to a study for the House Energy and Commerce Committee the Ryan-McHenry plan "would have even greater impacts on individuals in the district age 54 and younger who are not currently enrolled in Medicare." It would:

• Deny 510,000 individuals age 54 and younger in the district access to Medicare’s guaranteed benefits.

• Increase the out-of-pocket costs of health coverage by over $6,000 per year in 2022 and by almost $12,000 per year in 2032 for the 115,000 individuals in the district who are between the ages of 44 and 54.

• Require the 115,000 individuals in the district between the ages of 44 and 54 to save an additional $26.9 billion for their retirement – an average of $182,000 to $287,000 per individual-- to pay for the increased cost of health coverage over their lifetimes. Younger residents of the district will have to save even higher amounts to cover their additional medical costs.

• Raise the Medicare eligibility age by at least one year to age 66 or more for 64,000 individuals in the district who are age 44 to 49 and by two years to age 67 for 393,000 individuals in the district who are age 43 or younger.

With no help from the venal, Blue Dog-loving Israel, how is a progressive like Patsy Keever going to get the money she needs to get the message out in the sprawling North Carolina district. That's where we come in.

And this morning Patsy weighed in-- and very specifically:

By choosing Ryan as his running mate, Governor Romney sent a loud and clear message to all Americans: he’s betting on the far right. We now have a crystal-clear picture of the plan Romney has for America, because it’s the same plan that Congressional Republicans like Patrick McHenry have been trying to push on us for years. Congressman Ryan has been its chief architect, Patrick McHenry has been his faithful servant, and now Mitt Romney has hopped aboard.

The Romney-Ryan-McHenry plan would end Medicare as we know it by turning it into a voucher system and leaving seniors to fend for themselves in the private market. A nonpartisan expert found that the Ryan/McHenry proposal would cost seniors up to $6,350 every year in additional health care costs. I don’t know where Romney, Ryan and McHenry come from, but most seniors I know can’t afford to pay over $6,000 more a year for health care.

With that-- I’d like to announce my second policy difference in the series of differences that my campaign will be laying out to illustrate the choice voters have to make this fall:

Patrick McHenry wants to end Medicare and replace it with a voucher system that would cost seniors at minimum an additional six thousand dollars a year for their health care. I want to keep our promise to our seniors and protect the current Medicare benefits that they have earned by paying into the program throughout their lifetimes.

We need congressmembers like Patsy Keever to replace corporate shills like McHenry but we're not going to wake up on the first Wednesday in November and find the good fairy waved a magic wand. It's going to take a lot of work between now and then-- and Patsy and her team are willing to do it. And they need help.

Many Democrats Do NOT Back Medicare For All-- All Of These Do Though

Blue America just reinstituted a new page for Medicare-For-All supporters. Every one of the dozen candidates on the page has specifically asked to be on the page and has told why they are campaigning on Medicare-for-All.

A few minutes ago, I got off the phone with a candidate for Congress who is 100% positive that she's a woke progressive activist. But she's not for Medicare-for-All. She's not against it. But she's not for it. She hats think more about it. I told her to call me back after she's thought more about and can tell me why she backlit and can argue with someone about why she is absolutely going to vote for Pramila Jayapal's bill. I'm not looking to get behind a candidate and discover she or he was really another version of Kamala Harris who is kind of for it but not really. CNN Friday:

In the cauldron of a campaign-- under pressure from skeptical voters, political rivals, donors and other interest groups-- the fragile coalition that joined Sanders that day in 2017 has largely fractured. Only the Vermont independent, who has made Medicare for All the central theme of his second presidential bid, and Warren remain committed to the bill.

Harris ultimately chose to push forward in late July with a new health care proposal. Her plan would grow Medicare over a decade on the way to universal coverage. But unlike Medicare for All, it would retain a role for the private insurance industry.

The California Democrat recently confessed what had become obvious from early on in her campaign.

"I support Medicare for All. But as you may have noticed, over the course of the many months, I've not been comfortable with Bernie's plan, the Medicare for All plan," Harris said during remarks at a fundraiser in the Hamptons. "And I'll tell you why. And again, it comes back to listening."

Back in August 2018, Harris had touted herself "the first Senate Democrat to come out in support of Bernie Sanders' Medicare for All bill." But in the time since then-- as she entered the presidential race and began campaigning-- she said voters she met on the trail and, specifically, union members had expressed their own misgivings. So Harris took heed and charted a different path from Medicare for All.

Her proposal was pilloried from the left and center. Former Vice President Joe Biden's team-- which has taken the more moderate stance of expanding the Affordable Care Act-- called it a "have-it-every-which-way approach" that, because Harris has forsworn a middle-class tax hike to pay for it, meant she wasn't being "straight" with voters.

Is Kamala as bad as the bought-off opponents of Medicare-for-All like McConnell and Biden. Absolutely; just as bad. Here's a short sentence or two from their website or from a statement they gave me or a video or meme they released. If you believe we need Medicare-for-All supporters in Congress to support Medicare-for-All and make it a reality. Please click on the Blue America Medicare for All thermometer on the right and contribute to the candidate or candidates who you think have the best explanation.

Jamaal Bowman (NY): "I strongly support Rep. Pramila's Medicare-for-All bill. It's time to design a healthcare system that works for everyone. No one should die or be turned away because they lack healthcare coverage. We are the wealthiest country in the world and its time for us to take care of our people. Rep. Pramila's bill does just that... Healthcare is a human right. Over 40,000 people die each year and millions are impacted do to lack of health care. So many are forced to deplete their savings and have their overall quality of life drastically disrupted through no fault of their own. It is immoral for us to boast to be the richest country in the world while millions of people suffer. The ideals of our nation and the progressive movement are rooted in our collective humanity, so we fight for the rights of all people. It is time for us to get Medicare for all done. "

Shaniyat Chowdhury (NY) described why he is an enthusiastic supporter of single payer/Medicare for All: "The American healthcare system needs to be completely overhauled. Approximately 44 million people in this country have no health insurance, and an additional 38 million are underinsured. This means preventable catastrophes play out across our nation every day-- people lose their homes because they can’t pay their medical bills; they don’t seek medical attention when needed; and they ration the medication they need to survive and die as a result. Even for those who are insured, our current system is not an efficient or effective one. Americans pay some of the highest rates for medical care in the world but rank only 37th in health outcomes. This disparity is a result of health insurance companies wasting money on excessive administrative costs while patients have to fight for the services they need. Americans also pay significantly more for the same prescription drugs as our Canadian and European counterparts because the pharmaceutical industry has the power to set prices without any meaningful regulation. Our lawmakers have failed to act to make drug pricing fairer for all Americans, as they accept donations from the powerful pharmaceutical and insurance lobbies. We need to drastically shift how we see healthcare.  It is not a commodity-- it is a human right. Every person in the United States should have access to good doctors and the medical care they need. Nobody should die because they can’t afford insulin, or lose their home because of exorbitant medical bills. There are approximately 55,000 people in our district without health insurance and this is unacceptable. Every New Yorker deserves healthcare."

Audrey Denney (CA): "As your Representative in Congress, I will fight to protect and expand Medicare for All and decrease prescription drug costs." And that came with a video:



Kara Eastman (NE):



Robert Greenwald of BraveNewFilms made the video above about Kara Eastman's healthcare experience that led her to being such a big proponent of Medicare-For-All. Watch the short film. It's very emotive and consider that she told us she supports "Medicare for All so that no American has to go through what my mom did, unable to leave her house for the final year of her life-- all because a pharmaceutical company demanded $2,500 for a single pill, and her insurance didn't want to cover it. That's wrong. Our current healthcare system puts a price on the value of a human life-- and in the richest country on earth, it does not have to be this way... While Congressman Don Bacon (R-NE02) is notorious for voting 'Hell Yes' to take healthcare away from Nebraskans, I am a supporter of Medicare for All, which would provide medical care and drastically decrease healthcare costs for our state and our country. Americans deserve a system that allows them to have freedom when it comes to their medical care. I am proud to be a part of the Democratic Party’s growing movement to address the healthcare crisis in our country."

Mark Gamba (OR): "The most comprehensive solution to our healthcare crisis being proposed is the Medicare for All Act of 2019 In Congress I will champion this bill and continue to strive towards the best, most visionary solutions to our healthcare crisis. I will work with my colleagues in Congress and around the country to provide better care to more people for less money."

Marie Newman (IL):

Michael Owens (GA)

Eva Putzova (AZ):

Mike Siegel (TX): "Medicare for All is the best approach to guarantee quality care for every American. Unfortunately, DC Democrats consistently attempt to dissuade me from full-throated support for Medicare for All; my primary election opponents prefer to say they are fighting for "access" to healthcare. But on the campaign trail, every day, I learn more stories of folks who won't be covered by other programs. For example: two retired Los Angeles teachers living in Harris County; the husband, a bit older, wasn't approved for a non-invasive cancer treatment by Medicare Advantage, and had to choose surgery instead. He is eligible for Medicare, but his younger wife's health insurance is tied to his, and if he left their current plan, she would go uncovered. Or another example: a disabled teenager who depends on long-term supports and services, who must rely on an inadequate patchwork of state and federal programs, supplemented by his family's major contributions. All of these folks would have piece of mind, and excellent care, under Rep. Jayapal's bill. We need to fight hard for Medicare for All, because 'meeting in the middle' on healthcare means leaving countless people behind. Half-measures will lead to more deaths and bankruptcies, more closed hospitals and ruined families. We need to keep fighting not for what is convenient, but for the best possible result for all of us... Healthcare is a human right, and I will fight for universal access by joining the Medicare for All caucus, working with nurses and retirees, and putting my shoulder to the wheel in this essential effort to strengthen the safety net and ensure all Americans have a fair shot."

Andrew Romanoff (CO): "I support Medicare for All, including coverage for mental health and substance use treatment, prescription drugs, vision, dental, hearing, maternity, and long-term care. Such a system, as other countries have shown, saves money and saves lives."

Rachel Ventura (IL)

Kim Williams (CA)- "I strongly support Medicare for All because there is no time left for a middle ground approach."

• Ending private insurance to eliminate out-of-pocket costs
• Providing single-payer health care to expand healthcare coverage
• Eliminating co-pays, premiums and deductibles that increase individual costs
• Expand mental health support and resources

Right from Kim's website:

And-- as if all that energy that went into her website wasn't enough-- Kim sent me this last night: "Today my friends and I knocked on 100 doors in 100° heat. And we were not alone. En route, we came across a family near an expressway ramp. Each of them held a large cardboard sign with a woman’s face on it beside the words, 'Stage four cancer. Please help.' They, too, were not alone. Half a million people will file for bankruptcy this year because of medical debt. It was clearly too late for the woman on the picture and likely too late to save this family from a devastating debt. Leaving families like this in such a state of crisis while insurance execs line their pockets is unconscionable, and waiting on the healthcare industry to fix the healthcare industry is unrealistic. We need a brand new Congress that will finally recognize healthcare as a human right, stop putting profits over people, and pass Medicare for All."

Brianna Wu (MA): "Massachusetts led the way with the framework for Obamacare, a step in the right direction-- but our work isn’t finished. It’s time to commit to Medicare for All, a solution that will guarantee health care for all Americans. Studies have shown that Medicare for All will save us $2 Trillion in costs from the current healthcare system, along with $500 Billion per year in administrative costs from private insurance alone. Every other industrialized country in the world has a public health care option. Seventy percent of Americans want Medicare for All. This is a no-brainer. It’s time to get it done."

UPDATE: Jason Butler (NC) Is A Medicare-For-All Supporter Too

"Ensuring affordable healthcare for every American is the moral imperative of our age. We cannot continue to be a nation where corporations make billions in profit while hundreds of thousands of individuals go bankrupt from medical debt every year. Politicians should represent the best interests of their constituents-- not the best interests of insurance companies. In my district here in North Carolina, far too many people are suffering because of lack of insurance and still thousands of others are being crushed under the alarming increase in healthcare costs. Healthcare gives life, ensures a bright future for our children, strengthens American families, supports our veterans, the empowers the economic flourishing of our communities. This is why I fully support Medicare for All and, if elected, will fight to ensure healthcare for every American."

And now watch how New Mexico Secretary of State Maggie Toulouse Oliver, the progressive running for the open Senate seat, explains Medicare for All in the video below to voters in her state: