Although Sen. Bernie Sanders (I-Vt.) introduced his long-promised “Medicare for All” legislative proposal Wednesday, the release of the 96-page bill appeared to leave more questions than answers in its sweeping pitch to upend American health care and replace it with a European-style, single-payer system.
In a statement Wednesday, Sanders offered some praise for the Affordable Care Act before claiming that it didn’t go far enough because 28 million Americans remain uninsured.
“Today, we begin the long and difficult struggle to end the international embarrassment of the United States’ being the only major country on earth not to guarantee health care to all its people,” Sanders said in his statement before blasting congressional Republicans for “trying to take away health care from up to 32 million more” Americans by repealing and replacing Obamacare.
“We have a better idea: Guarantee health care to all people as a right, not a privilege, through a ‘Medicare for All,’ single-payer health care program,” Sanders continued.
Sixteen Senate Democrats cosponsored Sanders’ bill — more than one-third of the Senate Democratic Caucus. Several senators whose names have been floated as top 2020 presidential contenders opted to support Sanders’ bill, including Sen. Cory Booker (D-N.J.), Sen. Elizabeth Warren (D-Mass.), and Sen. Kamala Harris (D-Calif.). In addition, roughly 117 House Democrats have cosponsored a single-payer health care bill introduced by Rep. John Conyers (D-Mich.).
But after Sanders’ “Medicare for All” proposal was floated, several burning questions remained unanswered.
How does Sanders plan to pay for Medicare for everyone when it is expected to cost the country trillions of dollars? The Vermont senator gave precious few details in the bill itself, although he attempted to compensate for this by releasing supplementary details. In order to pay for every American to enjoy government-backed health care, Sanders recommended a sweeping tax hike.
“[Sanders is] saying to finance this proposal, he’s proposing a 7.5 percent payroll tax on employers. He’s also proposing a 4 percent, income-based premium tax on all Americans,” Dr. Robert E. Moffit, a senior fellow in The Heritage Foundation’s Center for Health Policy Studies, told LifeZette. “He wants to eliminate entirely all of the tax breaks for employer-sponsored health insurance. And he has a big long list of new taxes on upper-income people, the wealthy corporations, and large financial institutions.”
“It’s going to be financed by new and really openly heavy federal taxation. That’s what they’ve said,” Moffit added.
Dr. Ramin Oskoui, a leading cardiologist in the Washington, D.C., area and a senior health care adviser to LifeZette, said that Sanders’ optimistic assumptions that increasing tax rates or adding new ones to provide for universal Medicare is a “denial of reality.”
“Someone’s got to pay for this, and who will pay? The elderly, the sick and ultimately physicians will be enslaved and paid less and less,” Oskoui said. “But ultimately it’s the way he’s going to pay for it is going to be by higher taxes, rationed care, and deficit spending — borrowing against your future and mine.”
How would single-payer government health care hold the system accountable? Oskoui warned that if the government were given monopolized and unchecked control over the health care system, the country would witness a similar catastrophe to what happened with veterans’ care.
“I think the big tagline is that we know how single-payer works. It’s the [Department of Veterans Affairs],” he said. “Everything you want from a lack of accountability, lack of motivation, opacity in terms of cost, high costs … that’s what you’re going to have if you have single-payer.”
“The lack of accountability breeds poor care in health care,” Oskoui added. “I think the overriding theme ought to be the idea that, you know, we have single-payer in this country. We’ve seen the mediocrity, the lack of accountability, the lack of cost control. It’s called the VA.”
Sanders wants to expand insurance coverage to all Americans and believes his plan will do so. But even The New York Times noted in a Monday article that the current coverage plans of approximately 156 million would be disrupted.
“Nearly any single-payer plan would require substantial disruptions in the current health care system, upending the insurance arrangements of the 156 million Americans who get their coverage from work …” The Times noted. “Such a proposal would reshuffle the winners and losers in our current system.”
4.) Democratic Party Direction
The Democratic Party lost the White House and failed to claim majorities in either chamber of Congress during the 2016 elections. Ever since their crushing defeat, Democrats have struggled to unify and rally around a clear and cohesive message. With progressives like Sanders and Warren pulling the Party to the far left and moderates seeking to tether the party to the center, Democrats lack a clear direction.
“[Sanders is] basically laying the groundwork for a debate with a vision of universal health care. And what I think is remarkable about this is that this used to be considered kind of a fringe idea, kind of a product of the fever swamps of the far left,” Moffit said.
“I don’t recall any time, though, where it has become the mainstream position of either political party — not in my lifetime — where it has been the mainstream position. But now for crying out loud, it looks like it is,” he added.
Saying that universal health care and “Medicare for All” “is going to be the talking point for the next two years going into 2018 and then 2020,” Moffit predicted that Sanders’ introduction of the bill he talked about for so long “is going to be a big turning point in the debate” as “Democrats are back on offense again.”
5.) Democrats Divided
Although 15 senators joined Sanders in cosponsoring the bill and although 117 House Democrats support a similar measure, the “Medicare for All” proposal does not garner universal support across the caucus. Neither Senate Minority Leader Chuck Schumer (D-N.Y.) nor House Minority Leader Nancy Pelosi (D-Calif.) threw their support behind Sanders’ proposal, and other high-profile and more traditionally moderate Democrats were hesitant to back such a socialist proposition as a European-style single-payer system.
Even former President Barack Obama himself rejected the idea in back 2009, as NPR reported.
“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,” Obama had said. “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.”
Obama added that shifting to such a European-style system would prove to be far too radical for the United States’ current health care industry to handle.
And Sen. Sherrod Brown (D-Ohio), who widely is considered to be one of Senate’s most progressive senators hailing from a red state, declined to cosponsor Sanders’ bill.
If Democrats want to win back majorities in the House and Senate in 2018, and if they hope to snatch the White House from Trump’s grasp in 2020, their choice to pit progressives, moderates, 2020 candidates, vulnerable incumbents up for re-election and congressional leaders against one another in a litmus test of this nature is dangerously questionable.
6.) Government in Control?
If the Democratic Party turns increasingly leftward, it risks alienating the blue-collar workers and Obama voters who crossed party lines and voted for President Donald Trump in 2016. Although liberals love allowing the government to expand and encroach upon states’ rights in general, big government has left enough chaos in its wake that could cause moderate voters to harbor second thoughts about supporting such measures.
“We’ve got to stop this delusion that giving the government complete control is going to make things better. I think not only will it not make things better, but we’ve actually seen it makes things worse,” Oskoui said. “But that’s what socialism is — that’s the definition of socialism — it’s central control of an economy, but not to anyone’s great benefit.”
7.) Single-payer Rejected
Sanders, the 16 other senators and the 117 House Democrats believe that a single-payer system will work, but such a European-style system already was rejected in both Vermont and California, two of the country’s most liberal states. The Republican National Committee (RNC) conducted a study on single-payer’s failure to thrive in those two states.
And just last year, Democratic National Committee (DNC) Chair Tom Perez noted Vermont’s failure to cope with such a system because of its overwhelming cost, Bloomberg News reporter Josh Eidelson reported.
“The last state, for instance, that tried to put in place a single-payer health care system and gave up, last year, was the state of Vermont,” Perez had said. “And that reason they gave up was because it would have cost literally more than their current state budget to do it. It would have required raising taxes on people like you if you were a Vermont resident. They would have had to raise taxes on everyone.”
(photo credit, homepage image: Michael Vadon, Flickr; photo credit, article image: Gage Skidmore, Flickr)