HOME



Digby's Hullabaloo
2801 Ocean Park Blvd.
Box 157
Santa Monica, Ca 90405



Facebook: Digby Parton

Twitter:
@digby56
@Gaius_Publius
@BloggersRUs (Tom Sullivan)
@spockosbrain



emails:
Digby:
thedigbyblog at gmail
Dennis:
satniteflix at gmail
Gaius:
publius.gaius at gmail
Tom:
tpostsully at gmail
Spocko:
Spockosbrain at gmail
tristero:
Richardein at me.com








Infomania

Salon
Buzzflash
Mother Jones
Raw Story
Huffington Post
Slate
Crooks and Liars
American Prospect
New Republic


Denofcinema.com: Saturday Night at the Movies by Dennis Hartley review archive

January 2003 February 2003 March 2003 April 2003 May 2003 June 2003 July 2003 August 2003 September 2003 October 2003 November 2003 December 2003 January 2004 February 2004 March 2004 April 2004 May 2004 June 2004 July 2004 August 2004 September 2004 October 2004 November 2004 December 2004 January 2005 February 2005 March 2005 April 2005 May 2005 June 2005 July 2005 August 2005 September 2005 October 2005 November 2005 December 2005 January 2006 February 2006 March 2006 April 2006 May 2006 June 2006 July 2006 August 2006 September 2006 October 2006 November 2006 December 2006 January 2007 February 2007 March 2007 April 2007 May 2007 June 2007 July 2007 August 2007 September 2007 October 2007 November 2007 December 2007 January 2008 February 2008 March 2008 April 2008 May 2008 June 2008 July 2008 August 2008 September 2008 October 2008 November 2008 December 2008 January 2009 February 2009 March 2009 April 2009 May 2009 June 2009 July 2009 August 2009 September 2009 October 2009 November 2009 December 2009 January 2010 February 2010 March 2010 April 2010 May 2010 June 2010 July 2010 August 2010 September 2010 October 2010 November 2010 December 2010 January 2011 February 2011 March 2011 April 2011 May 2011 June 2011 July 2011 August 2011 September 2011 October 2011 November 2011 December 2011 January 2012 February 2012 March 2012 April 2012 May 2012 June 2012 July 2012 August 2012 September 2012 October 2012 November 2012 December 2012 January 2013 February 2013 March 2013 April 2013 May 2013 June 2013 July 2013 August 2013 September 2013 October 2013 November 2013 December 2013 January 2014 February 2014 March 2014 April 2014 May 2014 June 2014 July 2014 August 2014 September 2014 October 2014 November 2014 December 2014 January 2015 February 2015 March 2015 April 2015 May 2015 June 2015 July 2015 August 2015 September 2015 October 2015 November 2015 December 2015 January 2016 February 2016 March 2016 April 2016 May 2016 June 2016 July 2016 August 2016 September 2016 October 2016 November 2016 December 2016 January 2017 February 2017 March 2017 April 2017 May 2017 June 2017 July 2017 August 2017 September 2017 October 2017 November 2017 December 2017 January 2018 February 2018 March 2018 April 2018 May 2018 June 2018 July 2018 August 2018 September 2018 October 2018 November 2018 December 2018 January 2019 February 2019 March 2019 April 2019 May 2019 June 2019


 

This page is powered by Blogger. Isn't yours?

Hullabaloo


Thursday, March 21, 2019

 
Health care FTW

by digby



This piece by Paul Waldman about where the Democrats are heading on health care is very good news, as far as I'm concerned.
Something quite remarkable is happening right now among Democrats on the issue of health care: After an intense period in which rhetoric, policy and politics were all seemingly in flux, the party is rapidly moving toward something like consensus on where it ought to go next on its most critical domestic priority. 
As you may know, almost every Democrat running for president has said he or she supports Medicare-for-all, but most of them (with the exception of Sen. Bernie Sanders, who has been proposing a single-payer plan for years) have been vague about what that might mean. Maybe private insurance will be eliminated, or maybe not; maybe people will continue to get coverage through their employers, or maybe not. They will all presumably present specific plans eventually, but they haven’t yet. 
What they are doing is circling closer and closer to something that doesn’t yet have a name, but which I’ll call “Medicare For Anyone.” The fundamental difference between that and Medicare-for-all is that instead of eliminating (or minimizing) private insurance and putting everyone into the same pool, it would open up Medicare or something like it to anyone who wants it. 
In most of the variations that have been proposed, large numbers of Americans (newborns, people with low incomes, the uninsured) are automatically enrolled to make sure they’re covered. Employers can choose to stay with the insurance they have, or put their employees into the government plan. It’s paid for through a combination of taxes and premiums, with low-income people paying nothing and premiums rising with income.
For the moment I won’t get too deep into the policy details. But if you’re looking for a full version of it, there’s a proposal from Reps. Rosa DeLauro and Jan Schakowsky called “Medicare for America” that is probably what most Democratic candidates will either specifically endorse or which will be very similar to what they present. 
But if you want to sum it up in the most simplified form, this kind of proposal is like Medicare-for-all, except instead of everyone being put into Medicare, there will still be private insurance plans that people can stay with if they want to. If the policy heart of it is that everyone gets insured, the political heart is that it’s voluntary. 
Beto O’Rourke is already saying that the DeLauro-Schakowsky plan is what he wants. Pete Buttigieg says he supports Medicare-for-all either actually for all or “as a public option to buy in,” but either way with private insurance remaining involved as it is in the current Medicare program. 
And Sen. Kirsten Gillibrand said at an MSNBC town hall on Monday night that she wants to “allow anyone to buy into Medicare at a price they can afford. Something like 4-5 percent of income. They buy in, so it’s an earned benefit, and they are qualified automatically for Medicare.” She concluded, “Let’s have a not-for-profit public option compete for the business. I think over a couple years, you’re going to transition to single payer.” 
That’s also something you’ll hear from multiple candidates, not just because it’s a reasonable prediction of what would happen, but also because it’s a way of appealing to strong single-payer supporters. But not necessarily from all of them. In fact, a public option or a Medicare buy-in or Medicare For Anyone could encompass a wide variety of plans, some more sweeping than others, depending on how it’s designed. 
Not every non-Sanders candidate is endorsing Medicare For Anyone. Elizabeth Warren’s position at the moment is essentially that we’ll get everyone together and work it out, so long as we find a way to cover everyone at lower cost. But I can confidently predict that in the coming days, candidates who have also been vague on the question are going to be drawn to this idea like iron filings to a magnet. 
Why is this where the party is arriving? There are three main reasons. First, this kind of plan satisfies, at least for the most part, the progressive desire to insure everyone and eliminate the pathological features of the current system. Second, it addresses what is probably the greatest vulnerability of single-payer plans: the fear of change. It’s foolish to think that fear can be eliminated through sufficient logical persuasion, and Republicans will absolutely exploit it when they fight against whatever Democrats propose. So the fact that joining Medicare would be voluntary is essential to these proposals. 
And finally, it’s easy to explain. I cannot stress enough how important this is. The ACA was an absolute nightmare to explain to people, which left it vulnerable to all the demagoguery and lies Republicans could muster. Like Medicare-for-all, Medicare For Anyone is just three words, and it requires no explanation at all. You know what Medicare is, right? It’s the program your grandmother is on, the one she loves. Now anyone can join. That’s it. 
To be clear, there won’t be complete consensus, since many Democrats still favor an immediate move to single-payer, like the one Sanders has proposed, or the one offered by Rep. Pramila Jayapal. And there are others who have proposed more modest expansions of Medicare. But if and when the presidential candidates come together around a basic idea, that becomes the party’s position — and the one the next Democratic president will have to pursue. 
That’s what happened the last time we went through this. After Bill Clinton’s health reform failed in 1994, Democratic politicians and policy wonks spent a decade and a half working to devise a health-care reform they thought would be effective and politically possible. The result was a combination of expanded Medicaid, subsidies for those with low incomes, individual and employer mandates, and stronger regulation of insurers to protect patients. 
In the 2008 primaries, all the leading candidates proposed something like that, and it eventually became the ACA. But now, instead of spending 15 years working it out, Democrats are trying to do it in just a couple of years. And just as they were then, they’re trying to adjust based on what went wrong on both policy and politics in the last reform.
There are going to be a lot of details to debate. But this is where Democrats are heading.

This makes sense. I don't know whether we will end up with single payer in the long run. But we do have a large number of people already in government-guaranteed health care: Medicare, Medicaid and the VA. The idea here is to take the ACA one step further and add the Medicare opt-in to the menu for people who aren't covered by any of those or their employers. I suspect that this will end up being part of the menu for employers as well, making Medicare buy-in a benefit that employers pay for their employees. Over time most people will probably gravitate to the program because of the affordability and seamlessness of it.

This is a big step that the Democrats can get done right away if they win a majority. 

.