Five Reasons Democrats Should Push A Medicare-for-All Option

As the next iteration of Trumpcare/Ryancare is finalized by warring conservatives, it’s fair to demand that Democrats share their post-Obama vision for health care.

Yes, Democrats need to be fighting efforts to repeal and replace the increasingly popular Obamacare/Affordable Care Act (ACA) system with Trumpcare/Ryancare. Though the ACA is the spurned love child of the Heritage Foundation, Orin Hatch, Newt Gingrich and Mitt Romney, it’s much more humane than Trumpcare/Ryancare, which would cause at least 24 million Americans to lose their Obamacare health coverage, and many more if states choose to further weaken protections.

Cursor_and_medicare-for-all_jpg__360×216_But for the long haul, Democrats need to set their sights higher than Obamacare. They must become full-throated champions for allowing Americans the option of buying into the Medicare system.  Here are five reasons why:

Reason #1. Medicare is popular “government run health care.” For decades, Republicans have robotically vilified “government run health care” and “socialized medicine,” presuming that Americans agree with them that government will screw up anything it undertakes.  And Democratic politicians have cowered in fear.

However, Medicare is a notable exception to that rule. While the private sector-centric Trumpcare/Ryancare has 17% approval and Obamacare has 55% approval, Medicare has the approval of 60% of all Americans, and 75% Americans who have actual experience using Medicare.  It’s not an easy thing for a health plan to become popular, so Medicare’s relative popularity is political gold.  Democrats need to tap into it.

Reason #2. Medicare is better equipped to control medical and overhead costs than private plans. Medicare has a single administrative system, while dozens of health insurance corporations have dozens of separate and duplicative administrative bureaucracies.  That decentralized approach to administration is expensive.

Also, for-profit health insurance corporations have to build profits and higher salaries into their premium costs. For instance, the insurance corporation United Health Care, to cite just one of dozens of examples, pays it’s top executive $33,400,000.   That’s 135 times more than the not-for-profit Medicare system pays its top executive, about $247,000.

Medicare also is large enough that it has a great deal of negotiating leverage.  It could have even more if Congress empowered Medicare to more effectively negotiate pharmaceutical prices.

Because of all of that, the Center for Budget and Policy Priorities finds:

Medicare has been the leader in reforming the health care payment system to improve efficiency and has outperformed private health insurance in holding down the growth of health costs…  Since 1987, Medicare spending per enrollee has grown by 5.7 percent a year, on average, compared with 7.0 percent for private health insurance.

So, if Democrats want to better control health care costs to help the economy and struggling Americans, the Medicare model offers the best hope for doing that, not the corporate-centric model that we currently are using.

Reason #3. A Medicare-for-All option is very politically viable. Most Democratic politicians understand that a Medicare-for-All option makes good sense policy wise, but shrug it off as politically infeasible. They’re dead wrong.

By a more than a 5-to-1 margin, Americans support having a Medicare-for-All option. An overwhelming 71% support it, while only 13% oppose it. If you won’t try to sell a proven progressive idea that is supported by a 5-to-1 margin, you have no business being in progressive politics.

While “government-run health care” has been a weak brand for brand for Democrats, they have a clear path for rebranding their agenda.  Medicare brand equity is right there waiting for Democrats to take advantage it, if they’ll only open their eyes to the opportunity.

Reason #4. A Medicare-for-All option will expose private health corporations as uncompetitive. Right now, one of the Democrats’ biggest political problems is that too many Americans have been brainwashed by conservatives into believing that the private sector is always more efficient and effective than the public sector. In other areas that don’t involve “public goods,” that is true, but not with health insurance.

The best way to bust that “private is always best” myth is to allow Medicare to sit alongside corporate health plans in the individual marketplace. If American consumers choose Medicare over private plans, because Medicare proves itself to be the cheapest and best option, then the conservatives’ “private is always best” myth finally will be busted.

Reason #5. A Medicare-for-All option can serve as a bridge to the best health care model – a public single payer system. The research is clear that countries who have single payer health care financing have better and cheaper health care than the United States has with it’s substantially private sector based health care system. For example, the nonpartisan, nonprofit Commonwealth Fund finds:

Even though the U.S. is the only country without a publicly financed universal health system (among 13 high-income countries: Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States), it still spends more public dollars on health care than all but two of the other countries. …despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions.

Obscure research reports like this aren’t proving persuasive to American voters. But when younger Americans are able to see for themselves through their shopping that Medicare is cheaper and better than private health insurance options, Medicare will build a bigger market share.  After Medicare earns a larger market share, Americans may ultimately be much more open to shifting from a Medicare-for-all option to a Medicare-for-all single payer system that the United States ultimately needs in order to compete in the global marketplace and become a healthier nation.

It’s not enough for Democrats to only expose the reckless Trumpcare/Ryancare model and defend Obamacare status quo.  They must also promote a Medicare-for-All vision for moving America forward. With the current President and Congress, a Medicare-for-All option obviously can’t pass.  But aggressively promoting over the coming years will improve the chances that this Congress and President will soon be replaced and that a Medicare-for-All option can be enacted in future years.

5 thoughts on “Five Reasons Democrats Should Push A Medicare-for-All Option

  1. You are, of course, right from the policy perspective (as usual) and from the perspective of progressivism. And, yes, a landslide majority of the public supports it. And yet it will never pass.

    As a thought experiment, let’s imagine Bernie Sanders goes on Fox and Friends and makes the case for single-payer MFA. The hosts are appalled but the First Viewer calls Senator Sanders live on air and invites him over to the White House immediately after he leaves the studio. The Senator and the President huddle without staff for 10 minutes – the length of time it apparently takes @realdonaldtrump to understand anything that’s “really complicated” – and they emerge to a hastily assembled press corps to announce that the President now understands that the best way to fulfill his pledge of “better – much better – healthcare for everyone that costs so much less” – is MFA and he’s putting the full weight of the White House, his 50 million social media followers and Ivanka behind it. Because he’s all about flexibility and getting things done.

    Tell me how you get to 218 in the House and 60 votes in the Senate. In the face of every entrenched interest group who sees themselves losing under single payer, decades of Republican dogma, single-issue anti-government legislators (an oxymoron but they exist), anti-Trumpers, Breitbart, yada yada yada.

    I’ve twisted the cube a bunch and can’t get the colors to line up .

    • Fair push-back, Jon.

      First, even if I knew it would never pass, I would still say Democrats should advocate for it. Reasons: a) it is the right progressive thing to do, and a progressive party needs to loudly promote a progressive agenda so that people can actually understand what the fuck a progressive is and does; and b) the issue can be developed into an electoral asset (see Donald Trump reaping huge political rewards by advocating for a Mexico-financed wall that he knew would never happen, but would serve as a powerful symbolically important metaphor for his so-called America First values).

      But I think it could pass some day. If Democrats starting pushing for a Medicare for All option hard, it could pass in my dwindling lifetime. Certainly not under this President or Congress, but when the political lineups change. However, if they don’t campaign for it now and sustain it over many years, because the congressional votes aren’t immediately available, it will never happen.

  2. I have evolved over the last year to a supporter of single payer health insurance. The problem with the private sector (non-profit and for profit) health insurers is that there is no incentive to provide coverage for anyone but those who are lucky enough to not need health care and will never cost the insurer a dime. Nor is there an incentive to expand into markets that are marginally profitable.

    To me, the goal is to provide access to quality healthcare for as many people as possible, and to make that access affordable. We can then design a healthcare system to reach that goal that involves insurers, providers, and patients, instead of approaching the problem ass backward. And am I wrong to believe that this will also require a fundamental change in how we view access to healthcare? From a “privilege” to a “right?”

    I believe we need to start with the premise that access to healthcare is a moral imperative and figure out how to provide for everyone.

Leave a Reply

Your email address will not be published. Required fields are marked *