Tag Archives: Medicare for All

The Single Payer Debate

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http://www.rollcall.com/news/politics/sanders-displays-political-clout-single-payer-movement?utm_source=rollcallheadlines&utm_medium=email&utm_campaign=newsletters&utm_source=rollcallheadlines&utm_medium=email&utm_campaign=newsletters

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The seismic shift in support for Sen. Bernie Sanders’ plan to transform the U.S. health care system into a single-payer program indicates the reach the Vermont independent has within the Democratic Party.

At the same time that his onetime presidential foe Hillary Clinton is reminding people of the party’s devastating loss last fall, Sanders is trying to define its future. His bill to enroll every American in Medicare drew 16 co-sponsors, 16 more than when he first introduced similar legislation in 2013.

It has garnered support from possible 2020 Democratic presidential hopefuls — Sens. Cory Booker of New Jersey, Kamala Harris of California, Elizabeth Warren of Massachusetts and Kirsten Gillibrand of New York — as well as Sen. Tammy Baldwin of Wisconsin, an incumbent up for re-election next year in a state narrowly won by President Donald Trump.

It also provided a welcome talking point for Republicans who have long railed against government-run health care. Several GOP senators used Sanders’ legislation as a tool to warn voters of what could come if Republicans are unable to overhaul the health care system.

‘A political crisis’

During a bill introduction Wednesday that felt more like a campaign rally than the standard press conference, Sanders — flanked by co-sponsors — stuck to his standard script of bashing Republicans and special interest groups for doing nothing to address rising health care costs.

“The crisis we are discussing is not really about health care,” he told a crowded room of activists and supporters. “The crisis we are discussing today is a political crisis which speaks to the incredible power of the insurance companies, the drug companies and all those who make billions of dollars off of the current system.”

The politics of “Medicare for all” are divisive. And aside from a short comment about raising taxes across the board, Sanders has yet to outline a clear way to pay for such a system.

There is a divide within the Democratic Party on how to define such a system, and many Senate Democrats have yet to voice their support for Sanders’ plan, including vulnerable incumbents up for re-election such as Sen. Joe Manchin III of West Virginia.

Despite those differences, however, the expanding coalition of Democrats who now back such a proposal is a display of just how Sanders, who gave Clinton a serious challenge for the presidential nomination, continues to influence the national party.

“Sen. Sanders’ presidential campaign was a phenomenon that very few people saw coming. It uncovered a groundswell of progressive activation that the party now rightly wants to tap into as we head into 2018 and 2020,” Connecticut Democratic Sen. Christopher S. Murphy said. “I think that Democrats now feel a little freer to imagine some even bigger and bolder ideas.”

Asked whether the growing support for his legislation is indicative of his influence, Sanders hedged.

“Right now, we are focusing on what the bill is about,” he said. “We’ll talk about the politics of it later.”

A national message?

Several other Democratic senators supported the national party embracing more bold ideas — like Medicare for all — in the fallout from the 2016 election and tied that movement directly to the success of Sanders’ campaign.

“It’s an idea whose time has come. There’s a clear recognition that universal coverage has to be the goal,” Democratic Sen. Richard Blumenthal of Connecticut said. “These principles are now in the public mind, front and center, and that is due, in part, to the prominence that Bernie Sanders gave to them during the campaign.”

A Democratic aide echoed those thoughts and said the shift is indicative of a recognition that the party needs to be bolder and sharper in its proposals.

“I think there will be a lot of support for this bill,” the aide said. “It’ll make the clear contrast between the two parties on health care even more clear.”

While the Sanders proposal has gained more support among members of the Democratic conference, skeptics remain.

“The Sanders bill requires people to give up their insurance. It’s not an option that you buy in. It requires people to give up the insurance,” Sen. Claire McCaskill of Missouri said. “I’ve been down the road of requiring people to do things the government says on insurance and it is a road paved with big rocky boulders.”

Asked whether she correlates the growing support for Medicare for all to Sanders’ popularity among liberals, McCaskill — who is up for re-election in 2018 in a state Trump won easily — said she had not analyzed it from that perspective.

“I just think we’ve got to think this through and not make this some kind of political litmus test,” she told Roll Call.

While other Democratic lawmakers also said they hoped support for the Sanders bill would not be a political benchmark for the party, several openly said endorsing the concept would be crucial for any successful candidate.

“I have trouble seeing how a viable Democratic candidate does not support the idea of single-payer,” Blumenthal said. “This bill is going to drive the national message.”

Bernie-Care barrier?

Some Senate Republicans, who this summer failed in their attempt to repeal and replace the 2010 health care law, are making a last-ditch attempt to overhaul it.

Sens. Bill Cassidy of Louisiana, Lindsey Graham of South Carolina, Ron Johnson of Wisconsin and Dean Heller of Nevada are pushing legislation that would transform the health care system to essentially a large federal block grant to the states based on the size of their individual insurance pool.

Their message to the Republican conference was clear: It’s either our plan or Sanders’ proposal.

“If you want a single-payer health care system, this is your worst nightmare,” Graham said. “Bernie, this ends your dream of a single-payer health care system for America.”

Republican leadership echoed that message.

“We see what the alternative is and hopefully that’ll focus the mind,” Senate Majority Whip John Cornyn said. “Their party is clearly lurched to the left even further, and it’s made it hard for otherwise pretty pragmatic people, like Chuck Schumer, to do deals which he ordinarily would do with Republicans.”

But for Sanders, the failed attempt by the GOP to overhaul the current health care law only bolsters his case.

“To my Republican colleagues, please don’t lecture us on health care,” he said. “You, the Republican Party, have no credibility on the issue of health care.”

GOP Sees Offensive Opening on Health Care for 2018

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http://www.rollcall.com/news/politics/gop-medicare-for-all-strategy?utm_source=rollcallheadlines&utm_medium=email&utm_campaign=newsletters&utm_source=rollcallheadlines&utm_medium=email&utm_campaign=newsletters

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Republicans plan to tie all Democrats to “Medicare for all” proposals.

As more and more Democrats come out in favor of some form of “Medicare for all” legislation, Republican campaign strategists are salivating.

In much the same way the GOP has tried to tie all Democrats to House Minority Leader Nancy Pelosi in attack ads, they’re planning to tie all Democratic incumbents and challengers to different proposals from Vermont independent Bernie Sanders in the Senate and Michigan Rep. John Conyers Jr. in the House, regardless of whether they’ve personally embraced those policies.

“I’m thrilled,” said Corry Bliss, executive director of the Congressional Leadership Fund, the leadership-backed super PAC that plans to spend $100 million to help Republicans keep their House majority in 2018.

“I love their new policy so much that I’m thinking about taking the $50 or so million I was planning on spending on attacking Nancy Pelosi and putting a small portion toward explaining how single-payer hurts the American people,” Bliss said Tuesday.

That strategy isn’t much different from the GOP strategy of the past seven years, when the party has gone after Democrats on the 2010 health care law. But after months of their own health care legislative failures, Republicans think they finally have an offensive opening on health care again.

“It’s first time we’ve been in that position in a long time,” said one GOP campaign strategist, who acknowledged that this year’s health care debate revived the 2010 law.

Attacking all Democrats

The National Republican Congressional Committee was especially vocal on Wednesday, with a digital ad and a slew of press releases trying to pin Sanders’ proposal on Democratic incumbents and challengers.

“Studies reveal that single-payer would cost taxpayers a staggering $32 trillion over the next ten years,” the releases say, all pointing to the same study from the Urban Institute from May 2016.

“Sanders and Pelosi are leading their members down a path with nowhere to turn but left,” NRCC communications director Matt Gorman said in a statement.

In reality, Pelosi has shied away from Medicare for all proposals, trying instead to keep her caucus’ focus on improving the 2010 health care law. Her reticence toward the issue is a fact Republicans sometimes highlight to underscore its unpopularity — as in, “This is such a bad idea, Nancy Pelosi doesn’t even support it.”

But when it comes to messaging against the proposals, Republicans are happy to include Pelosi — a perpetual boogeyman — to help tie the issue around the neck of all Democrats.

California Rep. Scott Peters, a member of the moderate New Democrat Coalition and chairman of the group’s PAC, brushed aside the threats of those kinds of attacks.

“That won’t be a very effective campaign technique. People understand where we are,” he said, walking down the House steps Wednesday afternoon. Peters, an NRCC target in 2018, doesn’t support the Conyers legislation.

But with a majority of House Democrats signing onto it, and many 2020 hopefuls embracing the Sanders plan in the Senate, Republicans see it as nationalized party issue they can apply down ballot to all candidates.

“This is going to help frame the choice next year,” Bliss said. “It will be a huge issue in every single district that we spend in next year.“

One Republican admitted, though, it may be harder to message against a Democratic proposal that doesn’t stand a chance of becoming law anytime soon and doesn’t have a Democratic president behind it.

“I don’t think it will get to the same level as Obamacare did in the 2010 cycle,” the GOP strategist said. “You don’t have the same boogeyman in President Obama and Pelosi.”

Still, Republicans hope the issue will help them by pushing Democratic candidates to the left and sinking nominees in red districts or states won by President Donald Trump last fall.

In Wisconsin, where Trump eked out a win, Sen. Tammy Baldwin has come out in support of Sanders’ legislation. She’s the only senator up for re-election in a state the president won to have signed onto the Sanders’ proposal.

Trump has called for “insurance for everybody,” but Republicans say it’d be very easy to message against a Medicare for all plan to his voters.

“Here’s a socialist idea where everyone gets the same thing,” the GOP strategist said. “That doesn’t play.” It doesn’t fit with what she called the “you deserve more” narrative that Trump pushed to working-class voters during the campaign.

Keeping up the heat

Democrats aren’t backing away from their own offensive attacks on health care, trying to make the GOP-controlled Congress own their repeal-and-replace efforts.

That continued on Wednesday, with the introduction of the Senate Republicans’ latest effort at repealing the 2010 health care law.

“The 2018 election will be a referendum on the toxic GOP health care plan that spikes costs and strips coverage,” said David Bergstein, spokesman for the Democratic Senatorial Campaign Committee.

And they’re skeptical that this week’s attention on the Medicare for all legislation will take away from what a GOP-controlled Congress has been able to do — or not do — on health care this year.

“To have that be their golden ticket out of the nightmare they face right now seems just insane,” one Democratic operative said.

 

The Politics of Single Payer Healthcare

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https://www.axios.com/how-single-payer-helps-republicans-change-the-subject-2484804538.html?utm_campaign=KFF-2017-Drew-Axios-Sept14-single-payer&utm_medium=email&_hsenc=p2ANqtz–Q_Zmd1SqMI79AseTc1OIcHEN8DwUamYUmNIxGr2HLethhmoTOcQG43KssI13yVmZtpoP_AaEj9gRTHI4q68FAj7yloQ&_hsmi=56318621&utm_content=56318621&utm_source=hs_email&hsCtaTracking=18c76970-ffc0-4c0b-bb7a-ae1162b26233%7C7e107385-a85c-47b5-9c31-a303df175f96

 

Since the collapse of the GOP effort to repeal and replace the Affordable Care Act, single payer has gained new life on the left. Sen. Bernie Sanders released his “Medicare for all” plan yesterday, and a majority of House Democrats have signed on to another version proposed by Rep. John Conyers.

Data: Kaiser Family Foundation Polls; Note: 2008-09 is an average of 7 polls; Chart: Andrew Witherspoon / AxiosThe big picture: Politically, single payer — the idea of having the government pay for health care rather than private insurers — can help rally the left much like the prospect of repealing the ACA rallied the right. But it could also help Republicans, who own the problems in health care now, switch the target to the Democrats and their sweeping new health reform plan.

The pros for Democrats:

  • As the chart shows, single payer is popular among Democrats, with about two thirds in favor. But it has also gained popularity among independents in recent years, with over half supporting it. Republicans, not surprisingly, aren’t so crazy about it.
  • Single payer is a big idea many Democrats can rally around. It excites the base and party activists by establishing health care as a right, achieving universal coverage, and eliminating insurance companies. This analysis is about politics, but most advocates of single payer advance the idea because they believe in it, not as a political calculation.

The cons for Democrats:

  • They could lose a one-time opportunity to tar Republicans with the damage their ACA replacement plan would have done to millions of people, according to the multiple analyses that showed lost coverage and higher premiums for vulnerable people.
  • By campaigning on their own sweeping health reform plan, Democrats could give Republicans a fighting chance to change the subject.
  • More targeted policy ideas, such as Medicaid buy-in options for the ACA marketplaces and a Medicare buy-in for 50-64 year olds, could also be popular on the left and the center, while offering far smaller targets than a sweeping single-payer plan would.

Reality check: Single payer is popular, but polling today doesn’t tell us much about where the public will be if there is a national debate about actual single-payer legislation in the Congress. ACA repeal had the support of about half the public in Kaiser Family Foundation polling in late 2016 and early 2017, but fell to closer to 30 percent once there was an replacement plan under the microscope.

Support for single-payer falls by 10 to 20 percentage points when people are read common criticisms, such as that it will increase taxes or give the government too much control over health care. Arguments in favor, including that single payer will make health a basic right or reduce administrative costs, increase support by similar amounts.

We cannot simulate what will happen in a real debate, which depends on the actual details of the legislation and the power of the arguments made.

Be smart: This is more than just a health policy debate. It is also a proxy debate about the future of the Democratic Party. The party can swing left trying to build energy in the base, or it can move to the center, trying to capture the votes of many of the more conservative working people who voted for President Trump.

Don’t forget: Most Americans are far less focused on sweeping health policy ideas than they are on lowering their out-of-pocket costs. Health reformers – left, right, or center – who make the connection between their policy ideas and these pocketbook concerns may capture the most voters.

Incentives Are All Wrong for Single-Payer Health Care

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https://www.bloomberg.com/view/articles/2017-09-12/incentives-are-all-wrong-for-single-payer-health-care

Americans won’t give up their private insurance unless the government option is better. And that won’t be cheap.

The conventional wisdom these days is that the major Democratic presidential candidates for 2020 will end up endorsing some version of single-payer health care. Senator Bernie Sanders is expected to introduce his Medicare for All bill this week, with a considerable number of co-sponsors. This political posturing, however, is far from a practical proposal.

There’s an obvious problem with moving Americans to a single-payer system: Most people with private health insurance are pretty happy with their current arrangements. They are not looking to trade in that coverage for a new government program of uncertain quality, along with unknown higher taxes. When President Barack Obama was selling the Affordable Care Act, he promised Americans that they could keep their health insurance if they wanted to. When this didn’t turn out to be true for everyone, there was a significant backlash.

Progressive analysts thus have turned to how a single-payer system might come about more gradually. But longer transition times don’t solve the core problem.

Let’s say the federal government sets up a “public option,” as it sometimes is called. Individuals would have the opportunity to buy into government insurance at some price. The new government program would be competing with private insurance, but just how good will the new benefits be? If you’re healthy and have other coverage, you probably won’t switch — if you did, that would be a sign that the new government program was of very high quality and probably too expensive for the nation as a whole. Boosting the health care of the best-covered Americans isn’t the policy priority right now.

Instead, the public option might be set up to attract those who don’t already have good coverage. But those are the same people who don’t have the money to pay a fair market price for health insurance now. In essence, the program would come to resemble a Medicaid expansion, whether or not it would fall under the formal rubric of Medicaid.

That’s a plausible option for a marginal change; many states, of course, have already done a Medicaid expansion. The question remains whether such a program can evolve into single-payer health insurance. The answer is probably not. To become a single-payer system, as coverage climbs up the income ladder, the new reform would have to lure Americans out of private health insurance. It either has to make the private alternative worse, say by penalties like a stiff “Cadillac tax” on policies that exceed a certain level, or it has to make the public alternative especially appealing. We are then back to the change either being unpopular or spending too much money on people who already have decent coverage.

You can make a good case for continuing the forthcoming Cadillac tax on private insurance, as is embedded in Obamacare. But the point of that change was to get people to move to less health insurance coverage and to use less health-care resources, not to bounce them into a system with yet lower marginal cost for a doctor’s visit or extra medical procedures.

It’s worth thinking through why some single-payer systems, such as those on the European continent or in Hong Kong and Taiwan, seem to work. Typically those systems were instituted while health-care costs were still fairly low, and then kept down by government fiat. The U.S. is not in that position, and it’s hard to see doctors and hospitals — powerful lobbies — going along with significant cuts to their payments.

Single-payer systems can work for yet another reason: If a citizenry consumes much less health care, and it doesn’t damage patient outcomes so much. Patient queuing isn’t a disaster if people who really need treatment get priority, as is the case in the better-run single-payer systems. In other words, single payer has to be sold as a way of getting us all to cut back on the consumption of medical resources. Unfortunately, the Medicare for All movement is more about easing everyone’s access and boosting the usage of health-care resources, a typically American approach.

When it comes to access, the major problem in the U.S. is distributional: Some of the poor have insufficient access, and arguably some of the well-off receive health care at too low a user price. Given Americans’ love for consumption, it’s probably too late to fix the latter problem. We can, to some extent, improve lower-income access by Medicaid expansions.

The political war along the way to a full single-payer system is unlikely to be rewarding. According to one poll, single payer is supported by only 43 percent of Americans, hardly enough to overcome political gridlock.

Progress will come in bits and pieces. The notion of a universal cure-all is a myth, whether it comes to improving your health or improving America’s health-care system.

 

Why We Need Medicare for All

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This is a pivotal moment in American history. Do we, as a nation, join the rest of the industrialized world and guarantee comprehensive health care to every person as a human right? Or do we maintain a system that is enormously expensive, wasteful and bureaucratic, and is designed to maximize profits for big insurance companies, the pharmaceutical industry, Wall Street and medical equipment suppliers?

We remain the only major country on earth that allows chief executives and stockholders in the health care industry to get incredibly rich, while tens of millions of people suffer because they can’t get the health care they need. This is not what the United States should be about.

All over this country, I have heard from Americans who have shared heartbreaking stories about our dysfunctional system. Doctors have told me about patients who died because they put off their medical visits until it was too late. These were people who had no insurance or could not afford out-of-pocket costs imposed by their insurance plans.

I have heard from older people who have been forced to split their pills in half because they couldn’t pay the outrageously high price of prescription drugs. Oncologists have told me about cancer patients who have been unable to acquire lifesaving treatments because they could not afford them. This should not be happening in the world’s wealthiest country.

Americans should not hesitate about going to the doctor because they do not have enough money. They should not worry that a hospital stay will bankrupt them or leave them deeply in debt. They should be able to go to the doctor they want, not just one in a particular network. They should not have to spend huge amounts of time filling out complicated forms and arguing with insurance companies as to whether or not they have the coverage they expected.

Even though 28 million Americans remain uninsured and even more are underinsured, we spend far more per capita on health care than any other industrialized nation. In 2015, the United States spent almost $10,000 per person for health care; the Canadians, Germans, French and British spent less than half of that, while guaranteeing health care to everyone. Further, these countries have higher life expectancy rates and lower infant mortality rates than we do.

The reason that our health care system is so outrageously expensive is that it is not designed to provide quality care to all in a cost-effective way, but to provide huge profits to the medical-industrial complex. Layers of bureaucracy associated with the administration of hundreds of individual and complicated insurance plans is stunningly wasteful, costing us hundreds of billions of dollars a year. As the only major country not to negotiate drug prices with the pharmaceutical industry, we spend tens of billions more than we should.

The solution to this crisis is not hard to understand. A half-century ago, the United States established Medicare. Guaranteeing comprehensive health benefits to Americans over 65 has proved to be enormously successful, cost-effective and popular. Now is the time to expand and improve Medicare to cover all Americans.

This is not a radical idea. I live 50 miles south of the Canadian border. For decades, every man, woman and child in Canada has been guaranteed health care through a single-payer, publicly funded health care program. This system has not only improved the lives of the Canadian people but has also saved families and businesses an immense amount of money.

On Wednesday I will introduce the Medicare for All Act in the Senate with 15 co-sponsors and support from dozens of grass-roots organizations. Under this legislation, every family in America would receive comprehensive coverage, and middle-class families would save thousands of dollars a year by eliminating their private insurance costs as we move to a publicly funded program.

The transition to the Medicare for All program would take place over four years. In the first year, benefits to older people would be expanded to include dental care, vision coverage and hearing aids, and the eligibility age for Medicare would be lowered to 55. All children under the age of 18 would also be covered. In the second year, the eligibility age would be lowered to 45 and in the third year to 35. By the fourth year, every man, woman and child in the country would be covered by Medicare for All.

Needless to say, there will be huge opposition to this legislation from the powerful special interests that profit from the current wasteful system. The insurance companies, the drug companies and Wall Street will undoubtedly devote a lot of money to lobbying, campaign contributions and television ads to defeat this proposal. But they are on the wrong side of history.

Guaranteeing health care as a right is important to the American people not just from a moral and financial perspective; it also happens to be what the majority of the American people want. According to an April poll by The Economist/YouGov, 60 percent of the American people want to “expand Medicare to provide health insurance to every American,” including 75 percent of Democrats, 58 percent of independents and 46 percent of Republicans.

Now is the time for Congress to stand with the American people and take on the special interests that dominate health care in the United States. Now is the time to extend Medicare to everyone.

Sanders’ single-payer push splits Democrats

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http://www.politico.com/story/2017/09/13/bernie-sanders-single-payer-democrats-medicare-242616

Image result for single payer healthcare

Most liberals are on board with the bill being introduced Wednesday, but Democratic leaders and vulnerable incumbents largely steer clear.

Bernie Sanders’ single-payer health care plan has won over most other liberal senators, including many weighing 2020 bids.

The rest of the Democratic Party is another matter.

As Sanders prepares to unveil his Medicare for All legislation on Wednesday, most of the party’s congressional leaders and vulnerable Senate incumbents are steering clear. Even as the left celebrates Sanders’ ability to push the Democratic agenda leftward after his primary challenge to Hillary Clinton last year, that success appears to have its limits.

Senate Minority Leader Chuck Schumer told reporters that he would be “looking at all of” the party’s “many good” proposals to expand health care access, but declined to back Sanders. House Minority Leader Nancy Pelosi declared that her priority is shielding Obamacare from a GOP repeal push that’s not yet dead for good.

Connecticut Sen. Chris Murphy, one of the few Democrats subject to 2020 speculation who has not signed on to the Sanders bill, warned against letting the party’s attention slip to “longer-term health care policy” while the future of the Affordable Care Act remains up for debate.

“I think the risk is that we get distracted,” Murphy told reporters. “September’s not done. They can still ram through a repeal bill.”

Wisconsin Sen. Tammy Baldwin on Tuesday became the single-payer bill’s first supporter from the class of Senate Democrats up for reelection next year in states Trump carried. But other politically imperiled incumbent Democrats have said no to Sanders.

Sen. Claire McCaskill said in a brief interview that lawmakers have more work to do to keep health care costs in check “before we would think about expanding that [Medicare] system to everyone.”

Single-payer on a national level would have “a lot of problems,” McCaskill added, although she came out in support of allowing individuals as young as 55 to buy into Medicare. That idea is also backed by Baldwin and two other red-state Democrats up for reelection next year who are declining to endorse Sanders’ bill: Sens. Sherrod Brown of Ohio and Debbie Stabenow of Michigan.

Stabenow, also a member of Democratic leadership, said Tuesday that she would keep working on her Medicare-at-55 plan “because I think there is some bipartisan interest in that.” She said the party’s first order of business should be shoring up the Obamacare markets, followed by other goals.

“The first thing has to be to protect the health care people have now and stabilize markets, no question,” Stabenow said. “But we need to focus on lowering the cost of prescription drugs and providing more health care, more health care options.”

Improving the Affordable Care Act is the core of a bipartisan effort in the Senate health committee. The panel’s ranking member, Sen. Patty Murray of Washington, a member of the Democratic leadership, also declined to endorse Sanders’ bill on Tuesday.

“There’s a lot of Democratic ideas out there, and I haven’t had the chance to look at all of them,” Murray said, adding that she remains “very focused” on the committee’s work.

Republicans have already seized on the high costs of imposing a single-payer system — which Sanders’ presidential campaign proposed to pay for with new taxes on employers and wealthy individuals — to hammer Democrats for supporting the idea. The National Republican Senatorial Committee criticized Baldwin on Tuesday for backing “the left’s radical plans for government-run health care.”

Sen. John Barrasso (R-Wyo.), a member of GOP leadership, also reminded reporters Tuesday that Sanders’ home state of Vermont had to back away from its own single-payer health proposal after the economic burden proved too onerous.

Backers of the Sanders bill acknowledge that single-payer is a heavy political lift but describe it as an important benchmark for Democrats’ future. As the party hones its identity beyond opposition to Trump’s agenda, single-payer fans see enough room to set big long-term goals while waging the shorter-term battle to protect Obamacare.

“There’s nothing about the politics of the moment or the Affordable Care Act that in any way precludes supporting Medicare-for-all as the ultimate goal, and there’s a clear path to it,” said Sen. Richard Blumenthal. The Connecticut Democrat signed on to the bill Tuesday.

Sen. Al Franken (D-Minn.), who has been mentioned as a possible 2020 candidate, also expects to sign on to the single-payer bill, a spokesman said Tuesday. Franken noted that his cosponsorship reflects the bill’s status as a long-term goal while the party continues short-term work on Obamacare.

“This bill is aspirational, and I’m hopeful that it can serve as a starting point for where we need to go as a country,” Franken said in a statement. “In the short term, however, I strongly believe we must pursue bipartisan policies that improve our current health care system for all Americans — and that’s exactly what we’re doing right now in the Senate Health Committee, on which both Senator Sanders and I sit.”

For other Democrats, however, the idea’s time may have not yet come.

Ben Cardin said in an interview that he supports universal health coverage but has “certain concerns” about using single-payer to achieve that goal.

“There’s the political issue, but there’s also the issue about how you make sure there will be adequate resources put into health care,” the Maryland Democrat said.

Sen. Joe Manchin of West Virginia, a member of leadership who’s among the GOP’s top targets in 2018, walked a fine line Tuesday as Republicans revived his past comments welcoming a discussion of a government-run health care system.

“I am skeptical that single-payer is the right solution, but I believe that the Senate should carefully consider all of the options through regular order so that we can fully understand the impacts of these ideas on both our people and our economy,” Manchin said in a statement on Tuesday.

Sen. Dianne Feinstein, facing consternation from liberals in her home state of California — where an effort to enact single-payer statewide ran aground this year — said that she would want to see the price tag before taking a position on Sanders’ bill.

“My understanding is, the cost of single-payer is enormous,” Feinstein said, noting that she supports a public option for health insurance outside the private market.

Murphy and Hawaii Sen. Brian Schatz have offered their own ideas to shift the party’s health care debate leftward without going as far as Sanders’ plan would. The Connecticut Democrat is working on legislation creating a Medicare buy-in for all individuals and businesses, while Schatz told POLITICO he expects to release a Medicaid buy-in proposal later this month.

Murphy said he would not sign on to Sanders’ bill before its release, urging “our party to take some time and look at all the options available to us before we decide on one unitary route.”

And even as some Sanders-aligned activists spook Democrats with talk of possible primary challenges to candidates who don’t support the single-payer plan, other liberals were content to cheer the Vermont independent for attracting more than one-quarter of the caucus to his legislation. Progressive Change Campaign Committee co-founder Adam Green, who worked with Murphy on the Medicare buy-in plan, said that “Democrats are increasingly wrapping themselves in the flag of” Medicare for all without closing off other options that advance the ball.

“This is how big ideas like expanding Social Security and debt-free college were moved into the mainstream — the North Star gets put up, solid organizing is done, critical mass is built in Congress and on the campaign trail, and party consensus falls into place,” Green said by email. “It’s happening now.”

San Francisco’s universal health care plan eyed as model for California

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San Francisco’s universal health care plan eyed as model for California

Image result for healthy san francisco

Maria Consuelo believes she’s alive today because of a groundbreaking program this left-leaning city created a decade ago – one that guarantees health coverage to every one of its 864,000 residents.

It’s made San Francisco the only place in the country where truly universal health coverage exists, similar to what’s available in every other developed nation. Called Healthy San Francisco, it offers health care to those who can’t afford private insurance and are ineligible for other government health programs.

In Consuelo’s case, she visited a government-funded clinic in the fall of 2015 and told a doctor she had pain in her pelvis. Tests later showed cancer in her ovaries, leading to successful surgery to remove them in January 2016.

“This law really helped me,” Consuelo, a 55-year-old mother of five grown children, said while waiting to pick up some medication last week at San Francisco General Hospital. “If it could help others, that would be great.”

A similar thought is percolating in the mind of Lt. Gov. Gavin Newsom, a Democrat who helped implement the plan when he was San Francisco’s mayor.

Now, two years after he launched his campaign to succeed Gov. Jerry Brown, Newsom has been wondering: Would such a program work in every county in the Golden State?

His suggestion comes at a time when proposals for universal health care are receiving a surprising amount of attention. Last week, Sens. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego, unveiled details of their bill to create a single-payer system that would cover all California residents – just a few days after Vermont Sen. Bernie Sanders vowed to introduce a bill to launch a similar system nationwide.

Ironically, all of the universal health care buzz is coming after the GOP’s plan to replace the Affordable Care Act with a bare-bones substitute plan collapsed. The Congressional Budget Office had estimated that the Republican plan would have decreased the federal deficit by more than $300 billion, but increased the ranks of uninsured Americans by 24 million by 2026.

But Republicans in Congress are still vowing to chip away — if not replace — the law, commonly called “Obamacare,” which has insured five million Californians since 2014, bringing down the state’s uninsured rate from 17 percent to 7.1 percent in just three years.

States Where Single-Payer Health Care Could Work (If It Could Work Anywhere)

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https://www.bloomberg.com/view/articles/2017-05-30/states-where-single-payer-health-care-could-work-if-it-could-work-anywhere

Single-payer health care is the dream that just won’t die.

Eight years ago, when President Barack Obama came into office, there were folks on the left who hoped that somehow, his campaign concept of health-care-reform-by-mandate-and-subsidy could be transformed into a single-payer system like Britain’s or Canada’s. When it became clear that this wasn’t going to happen, they latched onto the idea of a “public option” that could, by out-awesoming all the private insurers, function as a backdoor route into a unified government system.

The public option vanished from the final bill, but the dream did not die. In 2014, as Obamacare finally rolled out, Vermont proposed building its own single-payer system, and hearts went a-flutter at the thought that plucky Vermont might show the rest of us how it’s done.

I predicted at the time that the plan would be too expensive, and therefore never go into effect. Eventually Vermont’s government confessed that it was too expensive, and would not go into effect. Vermont was not done with us, however, and in 2016, Vermont Senator Bernie Sanders kind-of-almost-came-close to winning the Democratic nomination on the slogan of “Medicare for All.” He lost to Hillary Clinton, and she lost to a candidate whose platform turns out to look more like “Medicaid for None.”

Hope springs eternal, however, and so do single-player plans. Their last run at the federal government having failed (along with a referendum in Colorado that voters rejected four to one), advocates are back at work in state legislatures. California and New York are both considering plans at the moment, and not just in the “Hmm, interesting. What’s for lunch?” sense. Say what you want about single-payer advocates, but say this too: You can’t stop them with much less than a Howitzer.

Of their plans, there are a few things to say. The first, and most obvious, is that none of them have solved the main obstacle to enacting single payer in the U.S.: the price tag.

Medicare-for-All is the next step to improving health care

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http://www.cincinnati.com/story/opinion/contributors/2017/04/17/medicare–all-next-step-improving-health-care/100482226/

Image result for medicare for all sign

It’s time to educate ourselves about Medicare-for-All, which has passionate and growing support in our country. Most Americans, 64 percent in a recent Kaiser poll,  like the general idea. Energetic and caring citizen groups promote it, such as SPAN Ohio (Single Payer Action Network). In the middle of our health care debates, we should pause to look closely at Medicare-for-All. We need more clarity for smart decisions.

I’ve been reading Medicare-for-All explanations by legislators, doctors, public interest groups and journalists. I’m no expert, but the fundamental concepts are coming clear to me. Here is some central information for those who wonder how Medicare-for-All would work in America.

Who would be covered? For what kinds of health care?

Everyone would be covered. The current Senate proposal, “The American Health Security Act” (S. 1782, soon to be updated), promotes “universal entitlement” and outlines plans to register everyone in this country, starting at birth.

Both House and Senate full-text proposals specify complete coverage for all health-care categories (except cosmetic procedures). They include care typically left out of general health insurance. Dental, vision and prescription coverage are named early in the House proposal, “Expanded and Improved Medicare for All Act” (H. R. 676). Both proposals offer complete maternity and child care, which could remedy Ohio’s “near the bottom” rates of infant mortality.

Vital screenings for cancer and STD/HIV belong with the promised diagnostic tests in these proposals. There is pressing need. In Ohio, 80,000 men and women are tested yearly by Planned Parenthood. Addiction and substance abuse treatment, mental health care, home and hospice care, and prosthetics are among an abundance of named services.

People would choose their own providers. Doctors and hospitals would remain independent. There would be no premiums, deductibles, or co-pays.

Who would pay for all this coverage?

The Senate and House proposals, state government bills, and Physicians for a National Health Program – all envision a Medicare-for-All that is affordable.

To reach real affordability, we need to exclude profit-making health insurance companies. Cut the cord of their power over costs. In ACA exchanges now, health insurers increase costs.  Even with this handicap, the ACA has taught us for years what affordability feels like. That’s why so many cling to the ACA. One in four Ohio hospitals believes that without the ACA, they would close.

Medicare-for-All, the next step from the ACA, offers complete affordability. It would appropriate funds from Medicare, Medicaid, CHIP, ACA, and other federal health programs. It would leave health insurance giants behind, saving another $350 billion to $500 billion yearly. Medicare-for-All would have negotiating clout with Big Pharma.

Without premiums and deductibles and co-pays, people could afford a few modest taxes to help with funding. Maybe a health income tax, small for most, larger for the top 5 percent of incomes. A limited, progressive excise payroll tax would help, as well as a tax on securities transactions – a few hundredths of a percent of fair market value.

If we adopt Medicare-for-All, what risks are we taking? Might health care be rationed? Would we have long waits? Ballooning costs?