This will likely stir many people to want me to shred my “progressive” card, but I see many on social media frothing at the mouth because the presumptive nominee for the preznit of these untied states doesn’t support something called “Medicare for All.” And I think that’s a good thing.
Let’s start at the beginning, shall we?
In March 2009, President Barack Obama held a “healthcare summit.” At the table are doctors, insurers, drug companies, consumers advocates and lawmakers.
In July 2009, he is quoted by NPR: “If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That’s the kind of system that you have in most industrialized countries around the world. The only problem is that we’re not starting from scratch.”
Among the elements of the ACA: An end to cutting people off from medical intervention due to “pre-existing conditions.” Parents can keep their kids insured through age 26. State exchanges, but with subsidies to help the sticker shock. And, vitally, high-risk corridor payments to help insurance providers roll with accepting less healthy people while younger, healthier specimens are shamed and fined into getting covered.
The ACA was made in a brilliant and ideal way. Call all the stakeholders together. Solicit their ideas and concerns. Obama didn’t just get a law passed. He made public policy, one that was a bit of Jenga. But it was subjectively good, so you didn’t reckon some idiots would come along and start pulling pieces out.
Of course, they did. Republican states refused to create exchanges, refused to expand Medicare. Sen. Marco Rubio eventually killed the high-risk corridor payments. The Republicans were out to drown the ACA in acid, despite that it was good public policy that actually did what it said it would do, to provide more people with better coverage.
It fulfills that mission to this day, despite more than 70 unsuccessful votes to kill it with a straight vote, despite countless sabotage efforts, including the current effort in court to outright kill it and throw countless Americans off of their current insurance in the middle of a fucking pandemic. The ACA, like The Dude, abides.
So, what the fuck is Medicare for All?
When Bernie Sanders talks about Medicare for All and how it will be implemented, he basically says, “What we’re going to do is, we’re just going to tell the insurance companies to go fuck themselves with their own neckties, and they’ll just then have to eat those neckties for lunch, and they’ll like it! Screw those karens!”
This is, of course, paraphrased.
That is, basically, the only planning I see for how to implement the policy: Tell the insurance companies to fuck off. And, by the way, have we asked the average doctor how they feels about Medicare reimbursements?
This is bad politics. It’s bad policy. And it’s stupidly redundant considering the decade of spent political capital, face swats, and sweaty brows Democrats have endured to establish what I think analysts will one day see as one of the most successful domestic policy reforms of all time: Obamacare.
Get us a Democratic House, a Democratic Senate and Joe Biden as Preznit. Stop crowing about “Medicare for All” because “fetch” will happen first, Gretchen. Fix it. Improve it. Add a public option. Add a public option. Add a public option.
That we can get done. Medicare for All is a fucking bumper sticker. And it will never happen.
For the short term, I’ll settle for whatever Biden is offering. For the long term, the only cure for the health care marketplace is to eliminate the profiteers.
Nor do I disagree with that, and nor, I think, does Biden. That’s why his plan includes a public option and discusses health care as a right. The difference of opinion is in how we get there.
I know what Medicare pays my doctors, and no health professional could survive if all services were reimbursed at those rates. That’s why doctors must limit the number of Medicare patients they accept. Yes it will help to get profit out of the picture, but it will take a lot more than that. So incremental steps. I think that’s where Biden is coming from, and it’s the only practical way to move forward.