Medicare for All

Updated 8/17/23: D'oh! I completely forgot about this development when I started running my state-by-state rate filing analyses this summer. No wonder Humana has disappeared from over a dozen states for 2024!

Update 3/15/23: At the request of Humana's Sales Integrity Dept., I've removed their logo from this blog entry.

Before I start, let me say that I've never been a fan of Medicare Advantage, at least as its currently structured, for a number of reasons. I am not advocating for the Medicare Advantage system--again, as currently structured--to be expanded.

Earlier this evening, U.S. Senator Bernie Sanders of Vermont tweeted this:

Good politics: Over the past decade, every Medicare for All co-sponsor up for re-election beat their Republican opponent – every single one.

Good policy: Medicare for All would save 68,000 lives and cost $650 billion LESS than our current dysfunctional healthcare system a year.

— Bernie Sanders (@BernieSanders) December 22, 2020

I'm not gonna dig back through the past 5 election cycles to verify whether this claim is accurate or not, but I did at least check into it for the most recent election last month.

In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).

Federal dollars can't be used to pay for abortion outside of the above restrictions, but Medicaid is funded via hybrid federal/state funding, so there are 15 states where Medicaid does pay for abortion using the state's portion of the funding.

 

Here's the full transcript (verbatim) of Joe Biden's exchange with Lawrence O'Donnell about whether he'd veto some version of Medicare for All if it were to actually pass the House and Senate:

O'Donnell: "Let's flash forward: You're President, Bernie Sanders is still active in the Senate, he manages to get Medicare for All through the Senate; it's some compromise version, Elizabeth Warren's version or some other version...Nancy Pelosi gets a version of it through the House of Representatives; it comes to your desk. Do you veto it?"

Biden (after pausing to choose his words carefully): "I would veto anything that delays providing the security and the certainty of healthcare being available now. If they got that through and, some miracle, there was an epiphany that occurred, and some miracle occurred that said, 'it's passed', then you gotta look at the cost. I'd want to know how did they find the $35 trillion? What is that doing? Is it gonna significantly raise taxes on the middle class, which it will? What's gonna happen?

 

My post from yesterday was pretty harsh on a Medicare for All advocate (though not on Medicare for All itself, contrary to what some people seem to think), so I figured I should follow up with something a bit friendlier today. Via Helaine Olin in the Washington Post:

Osmel Martinez Azcue wanted to do the right thing, for both his own health and the health of the nation. When the Florida resident came down with flu-like symptoms shortly after returning from a trip to China, he immediately went to a local hospital to get tested for coronavirus.

A few weeks later, according to the Miami Herald, Azcue received an invoice for more than $3,000. His insurer claims he’s responsible for $1,400 of the total. He’s expecting even more bills to arrive over the next few weeks.

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.

Yesterday, reporter and (pretty apparent) Bernie Sanders supporter Ryan Grim said the quiet part out loud in response to the news that the powerful Nevada Culinary Union isn't a fan of Medicare for All:

Hey @Culinary226, check in with your government affairs people. There are not 60 votes in the Senate to ban the private health insurance you got in your union negotiations, nor will there be after the election. You're gonna be okay.

— Ryan Grim (@ryangrim) February 12, 2020

Yes, apparently the new strategy to win over support from organizations which don't like one of the core tenets of your preferred candidate is to reassure them that there's absolutely zero chance of that tenet ever actually happening.

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.

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