Medicare for All – Or Progressive Overreach?

Bernie Sanders Medicare for All

Elizabeth Warren is right: “We must be willing to fight.”  Politics in this country is totally dysfunctional.  The economy isn’t much better.

We absolutely need “Big Structural Change,” starting with reforming a political system awash in money. A system where wealthy individuals and big corporations write the rules, while middle class wages stagnate; where the rich get richer, not by investing, but off of inflated stock prices and asset values that somehow passes for economic policy.

The thing is – if we are going to fight – let’s make sure it is the right fight.  Medicare for All isn’t going to happen in four years, as Bernie Sander’s Senate bill stipulates.  The health care and insurance industries are a huge part of our economy.  You can’t just upend the system overnight.  You risk major political and economic disruption.

Medicare for All is absolutely the right approach, in our view.  But we have to figure out a way to do it without scaring the hell out of more moderate voters, and handing Republicans a cudgel to beat us with.

How about we keep it simple – a public option that expands Medicare to include prescription drugs, vision and dental.  One that is administered by the Federal government and that anyone can buy into at cost with no insurance companies in the middle making money by denying health services to people in need.

Just to be clear.  It is not Pete Buttigieg’s “Medicare for All who Want it,” or Joe Biden’s “Medicare-like” plan, code language for insurance-company administered “Medicare Advantage” plans.

It is a government-administered, nation-wide public option.  Full-stop.  It allows Medicare for All to be phased in over time as more and more people become aware of its benefits vis-a-vis private insurance including lower costs and higher quality services.

Yes, taxes will still have to go up to cover the additional services, but not nearly as much, at least in the early years, as Elizabeth Warren has advocated in her proposal to pay for Medicare for All.  And, of course, total costs go down because you have a more efficient, nation-wide network without insurance company profits adding to costs.

We can still raise taxes on the wealthy and big corporations, to make our regressive tax system fairer and more progressive.  Let’s just use some of the proceeds to pay for other priorities including education, job training and infrastructure investment.

A true Medicare public option is still a heavy lift.  Just being willing to fight won’t cut it;  we are going to have to fight like hell.  Just as it did during the Obama Administration, the insurance industry is going to attack a public option with everything it has – and it has a lot of money and paid-in-full political influence.

But at the end of the day – or make that the election cycle – we have a lot better chance to bring about real change if we don’t get carried away with over the top rhetoric and set unrealistic goals and timeframes.

Let’s fight to make our system fairer and more progressive, and ensure everyone has access to quality health care.

But let’s do it in a way that brings people along and doesn’t scare the hell out of moderate voters who may need more time to get their head around the idea, despite an onslaught of Republican propaganda, that “We are Not Socialists; We are Progressives” who care about people; who prioritize quality health care over insurance industry profits.

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