Bernie Sanders

Disclosure: I publicly endorsed Joe Biden in the Democratic primary yesterday. It had nothing to do with this post, however. Shout-out to Pradheep Shanker for bringing this to my attention.

Updated w/my exchange with Rep. Khanna at the bottom

Update: I added "(nearly all)" to the headline for extra clarity given the subject of this entry.

Ro Khanna is a Democratic Congressman representing CA-17. He's also a top Bernie Sanders surrogate and a huge Medicare for All advocate.

About an hour ago, he was interviewed on NPR for about five minutes regarding the Caronavirus, tomorrow's California Presidential primary...and Bernie Sanders' Medicare for All plan.

I'm transcribing the relevant portion of the interview verbatim just to make certain there are no misunderstandings...the M4All exchange begins at around 3:20 in:

NOTE: Michigan's Democratic Presidential primary isn't until March 10th, a week after Super Tuesday. With that in mind, I was planning on waiting until after it passed before announcing my own decision. After Joe Biden blew the doors off everyone in the South Carolina primary, however, I've decided to move up my announcement, because it looks pretty clear that there's only three possible ways things can go now: A Bernie victory, a Biden victory or a bonkers contested convention where anything goes.

When I supported Elizabeth Warren for the first half of 2019 (mostly...I never formally endorsed her but was 90% of the way there), I did so with the understanding that, if elected, her actual administration would be more restrained in governing than her official policy positions would indicate (it would have to be due to the nature of Congress)...and I was fine with that.

I knew that Warren knows enough about how the sausage is made to understand that you can only move the Overton Window so far before you end up achieving nothing at all. She gave what I felt was a pitch-perfect response to the question of achieving Universal Healthcare at a CNN Town Hall in March 2019:

For years now, I (along with many others) have criticized Bernie Sanders for the big blank section of his "pure" Medicare for All single payer healthcare proposal. He's kind of, sort of given some ideas about how he proposes paying for it in the past, but yesterday he finally released an updated, revised list of additional taxes, loophole cuts and so forth which he claims would cover the total cost.

Since I've given him so much grief before, and since I did a detailed write-up about Elizabeth Warren's proposal last fall, I owe him some coverage of his new pay-for proposal as well. Let's take a look:

According to a February 15, 2020 study by epidemiologists at Yale University, the Medicare for All bill that Bernie wrote would save over $450 billion in health care costs and prevent 68,000 unnecessary deaths – each and every year.

via the AP:

Nevada’s most influential union is sending a subtle message to its members discouraging support for Bernie Sanders and Elizabeth Warren over their health care stances even though the union has not yet decided if it will endorse a candidate in the Democratic presidential race.

The casino workers’ Culinary Union, a 60,000-member group made up of housekeepers, porters, bartenders and more who work in Las Vegas’ famed casinos, began distributing leaflets in employee dining rooms this week that push back against “Medicare For All,” the plan from Sanders and Warren to move to a government-run health insurance system.

The leaflet said “presidential candidates suggesting forcing millions of hard working people to give up their healthcare creates unnecessary division between workers, and will give us four more years of Trump.

Health care is one of the biggest issues for the union, whose members have fought and negotiated for robust plans.

Last night, the Washington Post posted a story with a headline which made top campaign representatives for both Bernie Sanders and Kamala Harris go nuts on Twitter:

Sen. Bernie Sanders changes how Medicare-for-all plan treats union contracts in face of opposition by organized labor

Sen. Bernie Sanders announced a key change to his Medicare-for-all insurance plan Wednesday, a move meant to assuage fears on the part of organized labor, whose support is being heatedly sought by all of the candidates for the Democratic presidential nomination.

So, I wrote my first Op-Ed piece for the Washington Post yesterday...

Harris’s rollout Monday was met with swift criticism from both the Biden camp, which called it “A Bernie Sanders-lite Medicare for All,” and the Sanders camp, which insists Harris “can’t call [her] plan Medicare for All.”

In saying this, the Sanders campaign is effectively trying to lay a copyright claim to Medicare-for-all, as if it, and only it, can define what it means. The reality is far less clear — and depending on your perspective, it could be Harris’s proposal that is more justified in claiming the Medicare-for-all branding.

I'm not going to overquote my own piece, but this has led to some backlash against me, so for the record:

A little over a year ago, on March 21, 2018, Sen. Elizabeth Warren introduced a robust ACA 2.0 upgrade bill in the U.S. Senate called the "Consumer Health Insurance Protection Act", or CHIPA. It was largely a companion bill to a House version which had been introduced a couple of weeks earlier by Reps. Frank Pallone, Bobby Scott and Richard Neal, although there were some significant differences as well.

At the time, I noted that besides both bills including many "wish list" items which I've been hoping would be added to the ACA for several years now, Warren's Senate CHIPA bill was also noteworthy for one other reason: The list of cosponsors:

...Sanders is actually a co-sponsor of the Warren bill, as are Democratic Sens. Kamala Harris (Calif.), Maggie Hassan (N.H.), Kirsten Gillibrand (N.Y.) and Tammy Baldwin (Wis.).

 

Over the past month or two, I've written a couple of pieces which explored the whole "MFA would eliminate private health insurance" issue.

My main point was that while most MFA activists have long insisted that eliminating (or virtually eliminating) private health insurance companies is not only a feature but the entire point of moving to single payer, ever since Kamala Harris walked back her “get rid of all that!” comment in a CNN Town Hall the next day, I’ve seen some MFA activists fall all over themselves to suddenly insist that “no, no...there’d still be plenty of room for private insurance, really!”

In September 2017, Sen. Bernie Sanders introduced his "official" Medicare for All, universal single payer bill to much fanfare. At the time, it garnered a lot of attention, but it also had some gaping holes...most notably the lack of any actual funding mechanism or specifics, as well as a big coverage gap which could be found in both the "Medicare for America" bill which I'm a big fan of as well as the House MFA version.

Today, Sanders launched a revised version of the bill which supposedly addresses both of those issues along with others. Let's take a look.

First of all, who's co-sponsoring it? In 2017, it was cosponsored by 16 Democratic Senators:

Mr. Sanders (for himself, Ms. Baldwin, Mr. Blumenthal, Mr. Booker, Mr. Franken, Mrs. Gillibrand, Ms. Harris, Mr. Heinrich, Ms. Hirono, Mr. Leahy, Mr. Markey, Mr. Merkley, Mr.Schatz, Mrs. Shaheen, Mr. Udall, Ms. Warren, and Mr. Whitehouse) introduced the following bill; which was read twice and referred to the Committee on Finance

 

Most people know that over the past three years, I've gone from being a fan of Vermont U.S. Senator Bernie Sanders to...well, not being a fan; let's just leave it at that. They also know that while I support an eventual move towards a single payer-based healthcare system, I simply feel that it will have to be achieved via incremental steps (preferably large steps, not baby ones).

However, for the past year, I've repeatedly made sure to temper my concerns and criticisms of Sen. Sanders views by making sure to note that Bernie himself cosponsored the Senate version of ACA 2.0 introduced by Sen. Elizabeth Warren, aka the Consumer Health Insurance Protection Act, or CHIPA.

I addressed this point at the time in response to earlier attacks on me by MFA purists:

I need to take a moment here to call out progressives who badmouthed and scolded me last week for promoting the House ACA 2.0 bill by insisting that ONLY Bernie's M4A bill will do, and ANYTHING short of that--even in the short term--is unacceptable.

Yesterday I posted an entry which gained some attention in which I noted that yes, Bernie Sanders' specific single payer bill (aka "Medicare for All", S.1804) would in fact eliminate "nearly all" private healthcare insurance...and in fact, that's one of the primary selling points of the legislation in the first place. I wasn't arguing for or against the bill, mind you, I was just asking supporters to stop misleading people about this point.

Note: I'm going to use "Bernie-MFA" going forward instead of just "MFA" because the term "Medicare for All" has been turned into some sort of catch-all rallying cry for universal coverage even though there are major differences between some of the bills and proposals on the table, and on this subject it's important to be clear about which bill I'm talking about.

OK, here it is. I've linked to a PDF with the full legislative text at the bottom of this blog entry; here's the summary version, with some notes:

TITLE I—ESTABLISHMENT OF THE UNIVERSAL MEDICARE PROGRAM

Establishes a Universal Medicare Program for every resident of the United States, including the District of Columbia and the territories. Guarantees patients the freedom to choose their health care provider. Provides for the issuance of Universal Medicare cards that all residents may use to get the health care they need upon enrollment. Prohibits discrimination against anyone seeking benefits under this act.

OK, so it apparently would cover undocumented immigrants, and every doctor/hospital/clinic/etc. would be required to participate, with anyone in the country being covered by any healthcare provider nationally.

UPDATE: I've expanded the second half of this entry.

A week or so ago, I took a good look at Bernie Sanders's Single Payer healthcare proposal and was, as I put it, "beyond disappointed" due to it's lack of detail, and naiveté about not only the political realities of trying to get such a plan through (which is the biggest issue that Sanders supporters insist can be overcome through a "political revolution" etc etc), but also due to the sheer mountain of legal, economic, infrastructure and logistical headaches that would have to be navigated.

The irony is that, for me, the math behind such a plan (ie, how much it would end up saving people overall in terms of actual dollar savings as well as reduced administrative overhead, greater efficiency, etc) was something which I didn't even get into. I was operating on the assumption that, while the specifics would obviously jump up and down here and there, the numbers were generally in the right ballpark. HOWEVER, according to Emory University expert Kenneth Thorpe (who's actually a strong single-payer advocate who has authored several SP plans himself), that may not be the case whatsoever. Dylan Matthews of Vox writes:

I've been debating (pun intended!) how to handle the ongoing 2016 Presidential primary season when it comes to the ACA. While the ACA has barely come up at all in either of the first 2 GOP debates, it's almost certainly going to start popping up sooner or later (and I'll be stunned if it isn't a major topic at the Democratic debates).

I'm gonna try doing an occasional "Candidate Roundup" with the latest ACA-related happenings when it comes to the various candidates...and there have been three major developments this week:

Hillary Clinton: