Both Warren & Sanders propose a form of single-payer, government run healthcare. Both have been critiqued for being extreme and out of step with the American people, that the plan is unaffordable. Let’s examine the facts.
Unwatchable Debate: I made the comment after the Nevada debate that it was borderline unwatchable. Update: It has become entirely unwatchable, as candidates flail their arms throughout, interrupting and running roughshod over time limits. I gave up and turned it off. If the moderators can’t control things, one of the candidates should make a public statement: “I watched a tape of last night’s debate. It was Trump’s dream, a bunch of Dems behaving like school children interrupting and blurting responses and I was as guilty as anyone. I will no longer raise my hand, I will respect the time limits, I will not interrupt. For the sake of the country, I hope you will do the same.” First candidate to make that statement gets a boost in the polls.
What did you think? Who won? Why?
Connecting the Dots
The Reason Medicare-for-All is Deemed Impossible Is the Same Reason Why Gun Violence Prevention, Affordable College, Universal Pre-K, & Addressing the Climate Crisis Are Out of Reach: We Are Being Had
Before we dive into an examination of Medicare for All, a few words about why we even need to have this discussion. Most of the developed world has some form of universal healthcare and in ALL instances the care is less expensive, more easily accessible, and results in better health outcomes. Yet, in America, the concept is deemed off the table by centrist Democrat and Republican politicos as being too extreme.
Most of the developed world has universal healthcare, stronger gun violence control measures, more progressive tax policies, more affordable college, universal pre-K, and many other progressive policies. Why not here in the US?
In March 2019, Retake published a post, Wonder Why So Many of Our Bills Are Not Getting Through? that outlined very clearly the level of broad support for all of these policies and the insidious ways in which lobbyists, big business, and research foundations funded by the 1% collectively conspire to ensure that these policies are viewed as unrealistic, too expensive, and undermine American values.
To understand how and why Medicare for All is so misrepresented and misunderstood, it helps to understand the extent to which the policy debate in so many areas is circumscribed by the priorities of the wealthy, Wall St. big business, and mainstream media. I recommend that before you read this post or just after, you review the post from March as it will provide a broader context and a deeper explanation for just how systematically our priorities are shaped and/or ignored. Click here to review the post from March.
At the end of this post, we close with a video from John F Kennedy as he speaks to the American people in 1962 about the critical need for universal healthcare and the important role government should play to ensure justice in America. It is stirring and still timely speech and you will find echoes of Warren and Sanders throughout.
The State of US Healthcare
Before we dive into Medicare for All, a quick look at the state of our current healthcare system. In brief, as Walter Cronkite famously opined, “America’s health care system is neither healthy, caring, nor a system. ” It is a mess and not many are happy about it. From the Washington Post:
Relative to people in other wealthy nations, Americans are less likely to be in good health and more likely to die of preventable causes. Our babies and mothers are more likely to die after child birth, and our lives are shorter overall.Washington Post: “Here’s the Medicare for All Study Bernie Keeps Bringing Up”
The assertions above are validated with links to studies, but the charts that follow, excerpted from a Kaiser Family Foundation study, offer ample evidence of the state of our healthcare system. The US is last in the developed world in virtually every health outcome measured in the study. Here are a few samplings.
The US Leads the Developed World in Years of Life Lost
The US Leads the Developed World in Disease Burden, Fully 31% higher in the U.S. than the comparable country average.
US Leads the Developed World in Errors in Medical, Medication & Lab Errors
US Leads the Developed World in Rates of Preventable Conditions
And, With All Those Health System Deficits, US Leads the Developed World in the Cost of Healthcare.
With so much evidence of the need for vast improvement in our health system, why are policymakers so reluctant to examine seriously whether other options might achieve better outcomes? And remember, for each one of those charts, for each percentage point indicating a failing of our healthcare system, thousands and thousands suffer or die unnecessarily. And for this, we also pay more. As the review below makes clear, we pay much more.
Medicare For All: Myths & Realities
Single-payer has been marginalized and attacked by centrist Democrats and mainstream media for being too expensive, for not having the political support necessary to be enacted into law, and for taking away private plans for 150 million Americans. Today we examine these concerns one by one.
Medicare For All has been practiced throughout the developed world, in some cases for almost a century (England). These countries achieve far higher healthcare outcomes at far less cost (above). But numbers have a way of obscuring the human impact. With Medicare for All, we can improve and extend our lives, reduce the stress so many face caused by high co-pays, high premiums and denied coverage, and, as described by a recent Yale University study, Medicare For All can also significantly reduce what Americans, employers and the government pay for their healthcare.
Affordability & Quality
Last October, Yale University’s Center for Infectious Disease Modeling and Analysis published an independent study of single-payer healthcare, a plan that is essentially what is proposed by Bernie Sanders and Elizabeth Warren, although Warren has retreated a bit from her initial plan. As the excerpt below makes clear, not only is the government-run, single-payer Medicare for All model realistic, it would save the government $450 billion a year, save employers $100 billion a year, save families $2,400 per year and save 68,000 American lives each year. No co-pays, no premiums, no treatment denials. From a Washington Post report on the study:
The study concludes, a single-payer system akin to Sanders’s plan would slash the nation’s health-care expenditures by 13 percent, or more than $450 billion, each year. Not only that, “ensuring health-care access for all Americans would save more than 68,000 lives.”
In their breakdown of the numbers, researchers applied the existing Medicare fee structure across the entire health-care system and found it would save about $100 billion annually. Keep in mind that this basically represents less money going to doctors and hospitals, a major sticking point for medical groups that oppose Medicare-for-all. But those declines would be more than offset by several hundred billions in savings from reduced administrative and billing costs, Galvani and her colleagues estimate.
The lack of patient billing under a Medicare-for-all system would also eliminate the roughly $35 billion a year that hospitals now pay to chase down unpaid bills.
The authors estimate an additional $219 billion in savings from reduced “administrative overhead” that the current decentralized system creates, including “the elimination of redundant corporate functions and the truncation of the top-heavy salary architecture of health insurance corporations.” For instance, the plan would replace dozens of health insurance executives, many of whom make well over $20 million a year, with one administrator paid the same salary as the current Secretary of Health and Human Services.
Finally, letting the national Medicare system negotiate pharmaceutical prices would save about $180 billion…Add it all up and here’s what you get: a new system that would cost about $3 trillion a year, instead of the $3.5 trillion that is being spent now. “
Given the vastly superior health outcomes achieved in developed countries employing a form of universal healthcare and at significantly higher costs, one would expect that there would be significant public support for Medicare For All. And, a recent CBS survey found this to be the case.
No Political Support? What About Public Support?
The second objection raised by centrists and the media is that Medicare For All does not enjoy the political support needed to become law. They have that half right. There is a lack of political will in Congress, but if you look at the American public, you find a completely different story.
CBS has conducted the most recent polling on the approval levels for different kinds of healthcare plans. The results are instructive on many levels. First, the level of support for single-payer, government run healthcare is overwhelming. By over a 2-1 margin Americans favor government run, health insurance for all. That is not a small margin.
What’s more, while the margin among Democrats is over 10-1, among Independents the margin is well over 2-1. Even 34% of Republicans favor healthcare for all. With this kind of bipartisan support, one would think that politicians from both sides of the aisle would be lining up to sponsor legislation to make it the law of the land.
So, If Medicare For All Is So Popular & Cost Effective Why Is It Unfeasible?
On Christmas Eve, we published a post that laid out exactly why we don’t get universal healthcare. The post described the extraordinary level of insurance, hospital and pharmaceutical lobbying conducted to misinform legislators, the alt-fact “education” campaign fueled by industry and “research” foundations created by 1% billionaires.
There is a reason we don’t have a healthcare system that makes sense and it can be summarized in one word: greed.
For two reasons, we close with a video from JFK. First, he paints a very human picture of the choices faced by Americans who are uninsured or under-insured. He sensitively depicts what life is like for vulnerable individuals struggling to make ends meet, Americans who have worked their entire lives only to reach the autumn of their lives and be one medical emergency away from poverty.
Viewer alert: JFK was speaking in the 60s and so there is an unsubtle sexist thread running throughout and a bit of manifest destiny to boot. But this was 1962 and when JFK is focused on the need for universal healthcare and the proper, moral role of government in our lives, he sounds like Sanders or Warren….only almost 60 years ago. It is time to get this right.
Paul & Roxanne