Establishment looks to crush liberals on Medicare for All

Politico said:

The united front that helped Democrats save Obamacare just a year ago is falling apart over single-payer health care.

Deep-pocketed hospital, insurance and other lobbies are plotting to crush progressives’ hopes of expanding the government's role in health care once they take control of the House. The private-sector interests, backed in some cases by key Obama administration and Hillary Clinton campaign alumni, are now focused on beating back another prospective health care overhaul, including plans that would allow people under 65 to buy into Medicare.

This sets up a potentially brutal battle between establishment Democrats who want to preserve Obamacare and a new wave of progressive House Democrats who ran on single-payer health care.

Click to expand...

Surrealistik said:

https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215





Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).

Click to expand...

Xelor said:

I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

Click to expand...

Surrealistik said:

https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215





Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).

Click to expand...

Kal'Stang said:

Ok, I was able to sit through 10 minutes of that. I can't stand Cenk's voice for too long. I used to like TYT. And then they became completely bat **** crazy.

That said, I actually agree with them on this one. At least on the basic issue of corruption in Congress and insurance companies/pharma companies etc etc and on single payer.

Click to expand...

MTAtech said:

Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Click to expand...

MTAtech said:

Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Click to expand...

Xelor said:

I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

Click to expand...

MTAtech said:

Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Click to expand...

MTAtech said:

Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Click to expand...

MTAtech said:

Obamacare was a compromise because it was the only plan that could pass. It’s actually a conservative plan formed by the Heritage Foundation in the 1990s.

Given that the GOP controls the Senate and the WH, Medicare for all has no chance of passage. However, since the House is now controlled by Democrats, efforts to kill Obamacare are dead too.

Lovebug said:

If that is true, why do you think Republicans are so against it?

Click to expand...

Click to expand...

Surrealistik said:

I can only assume it has to do with fear of the federal government's not inconsiderable negotiating power in a MFA scenario depleting profit margins/demanding compensation more in line with the rest of the developed world. I would also assume that said hospital lobbies opposing MFA are no monolith as, yes, I can see it also benefiting private hospitals through elimination of administration expense, and federal government pressure on suppliers to cut margins.

Click to expand...

Renae said:

Oh dear, the old "It's a conservative plan" because some group years ago suggested it as an Idea... doesn't make it a conservative plan or a good one.

Click to expand...

Conservatives Sowed Idea of Health Care Mandate, Only to Spurn It Later

The individual mandate, as it is known, was seen then as a conservative alternative to some of the health care approaches favored by liberals — like creating a national health service or requiring employers to provide health coverage.

“In 1993, in fighting ‘Hillarycare,’ virtually every conservative saw the mandate as a less dangerous future than what Hillary was trying to do,” Newt Gingrich, the former speaker of the House, said at a debate in December, casting his past support of a mandate as an antidote to the health care overhaul proposed by Hillary Rodham Clinton during her husband’s administration.

Since then the politics of health care have grown more twisted and tangled than the two snakes entwined around the staff in a caduceus, which is sometimes used as a symbol of medicine. It is now Republicans and conservatives who oppose the individual mandate, arguing that it is unconstitutional, while Democrats, who were long resistant to it, are its biggest defenders.
...
To combat President Clinton’s proposal, a large group of Republican senators, including the minority leader at the time, Bob Dole, and several who are still in office, proposed a bill that would have required individuals, and not employers, to buy insurance.

Click to expand...

Greenbeard said:

Given the likelihood this will be a key issue for the Dems over the next few years, it's worth starting to consider some of the challenges behind the Medicare-for-all slogan. A provocative article in The Nation this week gets the ball rolling: Medicare-for-All Isn’t the Solution for Universal Health Care.

Some of the factors considered are: Medicare has a private option that's been growing in popularity every year; most people in employer-based insurance have coverage that's more generous than traditional Medicare (sometimes folks overcompensate for this fact by suggesting single-payer coverage be more generous than coverage that exists anywhere in the world); the (big) issues inherent in rapidly transitioning from here to there remain largely unaddressed; loss aversion suggests that forcing everyone off their coverage is politically fraught.

Of particular note is a bit on international comparisons and the often related assumption that adapting some other nation's model implies enjoying that nation's health care cost structure:

“For the most part, these countries were spending maybe 2 or 3 percent of [their economic output] on health care when they set up these systems after World War II,” says Dean Baker, co-director of the Center for Economic and Policy Research. “Most of them are spending 8 or 9 or maybe 10 percent of their [output] now, and this is 70 years later.”

In 2015, the United States spent 17.8 percent of its output on health care. The highest share ever for an advanced country establishing a universal system was the 5 percent that Switzerland spent in 1996, and they set up an Obamacare-like system of heavily regulated and subsidized private insurance. (They also spend more on health care today than anyone but us.)

There’s a common perception that because single-payer systems cost so much less than ours, passing such a scheme here would bring our spending in line with what the rest of the developed world shells out. But while there would be some savings on administrative costs, this gets the causal relationship wrong. Everyone else established their systems when they weren’t spending a lot on health care, and then kept prices down through aggressive cost-controls.

“Bringing costs down is a lot harder than starting low and keeping them from getting high,” says Baker. “We do waste money on [private] insurance, but we also pay basically twice as much for everything. We pay twice as much to doctors. Would single-payer get our doctors to accept half as much in wages? It could, but they won’t go there without a fight. This is a very powerful group. We have 900,000 doctors, all of whom are in the top 2 percent, and many are in the top 1 percent. We pay about twice as much for prescription drugs as other countries. Medical equipment, the whole list. You could get those costs down, but that’s not done magically by saying we’re switching to single payer. You’re going to have fights with all of these powerful interest groups.”

Baker is himself a single-payer advocate, and he’s worked with various groups that advocate for it, but, he says, “I don’t think you can get there overnight. I think you have to talk about doing it piecemeal, step-by-step.”

Click to expand...

That's an important point that needs to be contemplated under any effort to move toward Medicare-for-all or single-payer or anything similar. No more magic asterisking away the U.S. cost structure if the debate is about to turn serious.

Anyway, I endorse the underlying message:

Click to expand...

Understanding that other countries’ schemes vary significantly in the details—and that in the United States, the cost of care would remain a serious challenge under any system—should lead to a different conversation among progressives. Rather than making Medicare-for-All a litmus test, we should start from the broader principle that comprehensive health care is a human right that should be guaranteed by the government—make that the litmus test—and then have an open debate about how best to get there. Maybe Medicaid is a better vehicle. Perhaps a long phase-in period to Medicare-for-All might help minimize the inevitable shocks. There are lots of ways to skin this cat.

At a minimum, it’s time to get past the idea that anyone who doesn’t embrace Medicare-for-All, as it’s currently defined, must be some kind of neoliberal hack.

Click to expand...

MTAtech said:

Yeah, just "some group years ago." Except that "group" was the most influential Republicans in Congress.

Click to expand...

Xelor said:

I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

Click to expand...

American said:

Sure, with massive bribery. Remember the Cornhusker Kickback, Louisiana Purchase and the Florida Flim Flam?

https://www.cbsnews.com/news/tallying-the-health-care-bills-giveaways/

The last statement by Harry Reid is a beauty.

Click to expand...

Renae said:

It wasn't a conservative plan and they dropped the idea. That card is so over played.

Click to expand...

Surrealistik said:

The public support/movement definitely wasn't there for MFA at the time Dems controlled all chambers of govt, so I can understand Obamacare's drafting and passage then. In the end sadly, Obamacare couldn't even deliver on the much desired (and talked about) public option thanks to the insurance lobby's influence, particularly with regards to that snake Joe Lieberman.

These days, yes, despite the overwhelming popular support, we will need to take back all the other chambers to make MFA a possibility, but that's besides the point that establishment interests are actively working to get Dems to collectively backpedal and abandon it as a long term ambition, and are otherwise attempting to erode the momentum and foundation required for its passage if/when the party ends up in a position to enact it.

Click to expand...

Oborosen said:

Hopefully they can explain how they will pull it off this time around and keep the premiums from skyrocketing all over again.

Click to expand...

Xelor said:

I know why insurance companies oppose "Medicare for all" proposals. I don't know why hospitals do; such proposals would damn near eliminate their doubtful accounts expense.

Lovebug said:

They would have to charge equally and account for it, is my guess. Right now it seems to be a bit more for profit to make up for the ones who can't pay. What people, esp those who are against a single payer system, don't understand is that they are already paying for the next guy.

We need to have this settled once and for all.

For the OP, establishment...as in keeping both sides of the aisle important and in power?

Click to expand...

Click to expand...

• For procedure X or item Y, hospital H has "rack rates" (list prices) of XRR and YRR, respectively. Those prices are what they charge everyone; however, because of the provider's having, with the payer, agreed to accept a given discount off the list price -- perhaps XRR - .20(XRR) for payer A; XRR - .22(XRR) for payer B; and so on -- different payers may remit different sums to the provider. As a result of the reimbursement rate agreements, different care receivers (folks who have different insurers) may see in their statements from their insurers different list price amounts. Obviously hospital P may charge completely different-from-hospital-H "rack rates" for procedure X and item Y.

Surrealistik said:

https://www.politico.com/story/2018/12/10/establishment-democrats-progressive-medicare-1052215

Unfortunate but expected; can't say that this at all came as a surprise.

I can only hope that progressives in the party push back against their establishment, insurer bought colleagues given the popularity of this core platform measure, particularly given that Medicare for All is currently polling at ~70% (https://thehill.com/hilltv/what-ame...blicans-say-the-support-medicare-for-all-poll | https://www.reuters.com/investigates/special-report/usa-election-progressives/ ).

Click to expand...

Nickyjo said:

First sentence like a Trump comment: “I didn’t pay the women and when I did it wasn’t illegal.” Anyway, why did they drop the idea, the one they never had?

Click to expand...

Is the Affordable Care Act really the same as "the Republican plan in the early '90s?"

Short answer -- sort of. There was a Republican bill in the Senate that looked a whole lot like Obamacare, but it wasn’t the only GOP bill on Capitol Hill, it never came to a vote and from what we can tell, plenty of conservative Republicans didn’t like it.

Qualls told PunditFact that she was thinking of the Senate bill.

1993: Health care takes center stage

President Bill Clinton took on an ill-fated effort to reform health care in 1993. As the president’s task force (led by First Lady Hillary Rodham Clinton) worked behind closed doors to craft solutions to ever-rising health care costs and a growing number of uninsured families, Republicans scrambled to forge an alternative.

Republican Sen. John Chafee of Rhode Island was the point man. The bill he introduced, Health Equity and Access Reform Today, (yes, that spells HEART) had a list of 20 co-sponsors that was a who’s who of Republican leadership. There was Minority Leader Bob Dole, R- Kan., Sens. Orrin Hatch, R-Utah, Charles Grassley, R-Iowa, Richard Lugar, R-Ind., and many others. There also were two Democratic co-sponsors.

Among other features, the Chafee bill included:

An individual mandate;

Creation of purchasing pools;

Standardized benefits;

Vouchers for the poor to buy insurance;

A ban on denying coverage based on a pre-existing condition.

"You would find a great deal of similarity to provisions in the Affordable Care Act," Sheila Burke, Dole’s chief of staff in 1993, told PunditFact via email. "The guys were way ahead of the times!! Different crowd, different time, suffice it to say."

That said, the Senate plan from 1993 was not identical to the health care law that passed in 2010. The Republican bill did not expand Medicaid as Obamacare does, and it did have medical malpractice tort reform, which the current law does not. In contrast to the current employer mandate, the Chafee bill required employers to offer insurance, but they were under no obligation to help pay for it.

Click to expand...