Debate grows over ‘Medicare for all’

Associated Press

WASHINGTON

“Medicare for all” is quickly becoming a rallying cry for many Democratic White House hopefuls, but there are growing questions about how to pull off such a dramatic switch to a government-run health care system.

The debate over scrapping private insurers has heated up in recent days since Democratic Sen. Kamala Harris of California, a supporter of “Medicare for all,” told CNN’s Jake Tapper, “Who of us has not had that situation, where you’ve got to wait for approval, and the doctor says, well, I don’t know if your insurance company is going to cover this? Let’s eliminate all of that. Let’s move on.”

But since her nationally televised remarks, several of Harris’ rivals have pointedly spoken about their plans to work toward universal health care in more pragmatic, incremental ways. Those Democrats portray the single-payer health care proposal they’ve backed as only one strategy to achieve universal coverage, while emphasizing the importance of other, less-sweeping paths.

Among the skeptics, former New York Mayor Michael Bloomberg has said “Medicare for all” would “bankrupt us for a very long time.”

Uniting Democrats is a desire to guarantee coverage for all, including an estimated 29 million people who remain uninsured. Some are backing a plan that would let people buy into Medicare, with tax credits from the Obama-era Affordable Care Act.

At the forefront of the debate is Vermont independent Sen. Bernie Sanders’ “Medicare for all” bill, which holds out the promise of health care as a right, the potential for national savings from reduced administrative costs and government price-setting, and no more copays, deductibles or surprise medical bills. His plan envisions a four-year transition, phasing in the change by age groups. Simultaneously, some big tax increases would be taking effect.

But there would be enormous challenges to put in place a single-payer health insurance with the government fully in control of the $3.5 trillion U.S. health care system, experts say. And polls show a looming political problem because many people don’t yet realize it would mean giving up their private coverage. Another issue: Sanders’ office says his plan would cover abortion, a major change from current federal laws and policies.

In addition to Harris, Democratic senators Cory Booker of New Jersey, Kirsten Gillibrand of New York and Elizabeth Warren of Massachusetts have signed onto the Sanders bill.

Gillibrand, who crafted language in Sanders’ bill that allows people to buy nonprofit insurance coverage during the transition, emphasized the importance of that bridge.

“If more people buy into Medicare over whatever your transition period is, you will disrupt the insurance market, because you’ve created more competition for lower prices and quality care,” Gillibrand told The Associated Press.

Others are less sanguine about a single-payer approach. “We can’t pay for it, it eliminates choices, most versions ... would make private health care coverage for almost all health care needs illegal, and it will diminish quality and access,” said former Maryland Rep. John Delaney.

A longtime supporter of single-payer said Democrats should tread carefully. Now retired from political office, former Democratic congressman Jim McDermott of Washington said, “A single-payer system would be best if we had a magic wand, but in the real world, it is going to be extraordinarily difficult to make this change.”