The popular myth of Medicare for All

WASHINGTON—Sen. Bernie Sanders, I-Vt., might not win the 2020 Democratic presidential nomination, but one of his signature proposals is already developing broad support on the left.

“I am running because the time is long overdue for the U.S. to … guarantee healthcare as a right, not a privilege, through our Medicare for All single-payer program,” Sanders said in his presidential campaign launch announcement last week.

In the years since a version of the plan was first introduced in the House of Representatives in 2003, Medicare for All has become a rallying cry for the liberal wing of the Democratic Party. Now, after more than a decade of mainstream avoidance of the issue, several 2020 Democratic presidential hopefuls, including Sens. Kamala Harris of California, Cory Booker of New Jersey, and Kirsten Gillibrand of New York, co-sponsored Sanders’ most recent bill.

Sanders’ version of Medicare for All would force all residents of the United States to acquire their healthcare from the federal government’s system. It would make it unlawful for “a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act.” It would also prohibit employers from providing private health insurance. Medicare for All would either kill private insurance companies or force them to meet all federal regulations, essentially making them a part of the government-provided system.

Single-payer healthcare often carries negative connotations, which makes Sanders’ repackaging under the label of “Medicare for All” an effective strategy. A 2017 Kaiser Family Foundation poll found that 62 percent of Americans supported Medicare for All, while only 48 percent said they supported a single-payer health insurance system. The two are the same (in Sanders’ context), but one sounds a whole lot better to Americans.

Many who support single-payer healthcare want to close gaps in coverage that the Affordable Care Act of 2010 didn’t fix. Though the proportion of uninsured Americans has gone from 16 percent to 12 percent since the Obamacare insurance exchanges opened in 2014, the number of underinsured people—those who have insurance but still spend 5 to 10 percent of their income on healthcare—has climbed from 17 percent to 23 percent.

Charles Blahous of the Mercatus Center at George Mason University estimated in a July 2018 paper that during its first 10 years of full implementation, Medicare for All would cost the government roughly $32.6 trillion—an amount that even doubling current personal and corporate tax rates wouldn’t cover. Blahous also cited a study by the Centers for Medicare and Medicaid Services, a federal agency within the Department of Health and Human Services, that found nearly half of U.S. hospitals would have negative operating margins by 2040 if they accepted only Medicare payments, which are lower than what private insurance pays.

Jim Capretta, a fellow at the American Enterprise Institute, told me that the plan would be unrealistic and too disruptive, noting, “It would displace the 160 million or so Americans who are enrolled in employer-sponsored coverage. … People with employer coverage today will push back against the idea unless they are exempted out of it.”

But for individuals to push back against the idea, they have to understand it. That’s difficult, since in the past few months, Democrats have put forward their own variations, also under the name “Medicare for All.”

Harris, who is still a co-sponsor of Sanders’ bill, has tried to walk back her stance and co-sponsored other bills that wouldn’t shift the playing field as drastically. Booker also hedged his bets at a recent campaign stop in New Hampshire, according to The Washington Post. “Medicare for All is great,” he said, “but if we can’t get that, but if we can extend Medicare down to age 55 ... that’s going to create such an effect on the whole system that’s going to make it better.”

New York Times columnist Ross Douthat has questioned the wisdom of both political parties’ obsessions with overhauling and re-overhauling health insurance and advocated for a deeper look at the economic stagnation and social crisis that drives up the cost of care. He argued Republicans should work toward policies that boost the economy and Democrats should focus on funding programs that support work and families.

“When your main challenges involve men who aren’t working, wages that aren’t rising, families that aren’t forming and communities that are collapsing, constantly overhauling health insurance is at best an indirect response, at worst a non sequitur,” he wrote.

Unhappy ending

The man accused of running an election tampering scheme that invalidated the results of a November congressional race in North Carolina was arrested Wednesday on charges of illegal ballot handling and conspiracy. Authorities also charged four others who worked with him.

North Carolina State Board of Elections Executive Director Kim Westbrook Strach called the indictment against Leslie McCrae Dowless “a stern warning to anyone trying to defraud elections in North Carolina.”

Dowless is accused of manipulating absentee ballots to benefit Republican Mark Harris, who led Democrat Dan McCready by 905 votes in November’s unofficial election results for the North Carolina’s 9th District. The state elections board declined to certify the results amid questions about ballot irregularities in Bladen County and last week called for a new election. The indictment says Dowless “unlawfully, willfully and feloniously” tampered with the vote.

Harris, a former pastor of First Baptist Church in Charlotte, acknowledged the need for a fresh vote after his son, John Harris, an assistant U.S. attorney in North Carolina, offered pivotal testimony at a board of elections hearing last week. The younger Harris detailed how he warned his father several years earlier of concerns about Dowless’ work for another Republican candidate after conducting an analysis of questionable results in the 2016 Republican primary. The testimony contradicted previous claims by members of the Harris campaign that they didn’t know about Dowless’ dubious history.

The Charlotte Observer praised John Harris in an editorial for doing “something that’s hard to find in politics, this week or any other. He told the truth—not with glee and not with self-interest, but because it was the right, if hard, thing to do.”

Mark Harris once declared he felt God’s call to seek elected office, citing the need for pastors to engage with the culture, but said Tuesday he would no longer run amid health concerns that will require him to have surgery in March. He has not been charged in connection with the alleged election fraud.

“Through the challenges of life, [my wife] Beth and I continually place our trust in God, and we both know He holds the future in His Hands,” Harris posted on Facebook as he announced his decision. “Please stay engaged, for it is our civic duty to do so.” —Anne K. Walters

A raw Green New Deal

The sweeping environmental and economic reforms proposed in the Democrats’ Green New Deal legislation would cost between $51 trillion and $93 trillion and result in fundamental changes in U.S. society, a conservative think tank analysis concluded.

The proposal, put forward as a nonbinding resolution by Rep. Alexandria Ocasio-Cortez, D-N.Y., and Sen. Ed Markey, D-Mass., aims to address climate change and create jobs but has drawn fire for the breadth of its goals, including guaranteeing jobs for all Americans.

The American Action Forum analysis, released Monday, noted the difficulty in quantifying the implications of the plan given its vast and sometimes contradictory goals. AAF estimated $5.4 trillion was needed to create a low-carbon electrical grid and $1.3 trillion to $2.7 trillion for zero-emissions transportation systems.

Far more expensive would be the economic and social proposals put forward in the plan, with $6.8 trillion to $44.6 trillion to guarantee a job for every American, $36 trillion for universal healthcare, $1.6 trillion to $4.2 trillion to guarantee housing, and $1.5 billion to tackle food security, AAF concluded.

While many Democrats, including the party’s top 2020 presidential contenders, have signed on to co-sponsor the resolution, it is far from universally popular on the left. Sen. Dianne Feinstein, D-Calif., who does not support the proposal, told a group of schoolchildren who confronted her about the issue that the Green New Deal is too expensive and stood no chance of passing the Senate.

“The United States government does a lot of things with the money, and they’re important things, and you just can’t go in and say, OK, we’re going to take hundreds of millions from here and hundreds of millions from there,” she told the students in an exchange captured on video. “It just doesn’t work that way.” —A.K.W.

A senator’s lament

Despite missing Monday’s vote for the Born Alive Abortion Survivors Act by mere minutes due to a three-hour flight delay, Sen. Tim Scott, R-S.C., took to the Senate floor Tuesday to deliver an impassioned speech.

Lamenting that the measure failed by seven votes, Scott said he would have voted yes. “This is common sense. This is human decency,” he said. “This is not an issue of being pro-life or pro-choice. This is an issue of being pro-child, which we all should be.”

Two other GOP senators, Kevin Cramer of North Dakota and Lisa Murkowski of Alaska, were also traveling at the time of the vote. Cramer was a co-sponsor of the bill and was planning to vote in favor of it, but his flight was also delayed. Murkowski’s office said the senator missed the vote because she “had prior commitments in Alaska and was en route at the time” but did not respond to questions about how she would have voted if she were present.

Sens. Bob Casey of Pennsylvania, Doug Jones of Alabama, and Joe Manchin of West Virginia were the only Democrats to cross party lines and vote in favor of the measure. —Harvest Prude

This week in Congress

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