Thursday, October 17, 2019

Outmaneuvered By Centrists

The most controversial health care proposal in the Democratic Party- or either party- is Medicare for All which, as it turns out, Pete Buttiegieg was in favor of before he was opposed. Nonetheless, he now is running against it and so, arguably, the most important remark- directed at Elizabeth Warren- made at Tuesday's Democratic debate was

Well, we heard it tonight, a yes or no question that didn't get a yes or no answer. Look, this is why people here in the Midwest are so frustrated with Washington in general and Capitol Hill in particular. Your signature, Senator, is to have a plan for everything. Except this.

No plan has been laid out to explain how a multi-trillion-dollar hole in this Medicare for all plan that Senator Warren is putting forward is supposed to get filled in. And the thing is, we really can deliver health care for every American and move forward with the boldest, biggest transformation since the inception of Medicare itself.

But the way to do it without a giant multi-trillion-dollar hole and without having to avoid a yes-or-no question is Medicare for all who want it. We take a version of Medicare. We let you access it if you want to. And if you prefer to stay on your private plan, you can do that, too. That is what most Americans want, Medicare for all who want it, trusting you to make the right decision for your health care and for your family. And it can be delivered without an increase on the middle-class taxes.

Warren did not have an adequate response. Nor did Senator Bernie Sanders, who (have you heard?)- wrote the bill!

Buttigieg's Medicare For All Who Want It is at least a little more sophisticated than advocacy by Joe Biden and Amy Klobuchar for a "public option," which they've never defined, probably because when pimping for the health care status quo, always say "public option." The tactic worked for President Obama, who in retrospect was wary of offending the insurance companies but would invoke "public option" periodically tokeep the left appeased.

However, Buttigieg's Medicare For All Who Want It may be more regressive than it sounds. Neither Warren nor Sanders appeared to recognize that the South Bend, Indiana mayor clarified Medicare advocacy with "we take a version of Medicare."

But Buttigieg's version, it should be suspected, probably is Medicare Advantage- or some iteration of it- a private add-on to the traditional, immensely popular Medicare. That program is partially publicly-funded; and to the  extent that it is not, is nonetheless not funded by user fees.

By contrast, Medicare Advantage is run through private insurance companies and provides a considerable profit for those insurance companies.  When Amy Klobuchar, arguing as have other candidates, slams "kicking 149 million people off their insurance in our years," she is advocating for maintaining those individuals in the private insurance market and padding the already supple bank accounts of health insurance executives.

Both Sanders and Warren understand that.  Yet, they are playing defense, largely standing by as the warriors for the health insurance attack with virtual impunity Medicare for All. 

When Senator Sanders unveiled his single-payer health care bill, he wisely called it "Medicare for All," riffing upon one of the most popular government programs ever. If Medicare for All is a good idea, Medicare for all who want it must be at least a good idea, it would appear. As in so many cases, however, appearances are misleading.   Now Buttigieg slickly calls his program "Medicare for everyone who wants it" and Sanders, along with Warren, is stuck.

Both senators probably realize that the mayor's proposal is dependent upon the private insurance market and therefore would do little to alleviate the nation's health care crisis, but cannot afford to criticize directly a scheme with "Medicare" in it. They're in a bind.

Of course, the only two candidates with a clearly progressive view of health care have been trapped throughout the campaign by a perception not of their making.  "Build on Obamacare, add a public option," Joe Biden said Tuesday night, echoing Klobuchar's bizarre claim "the best and boldest idea here is to not trash Obamacare but to do exactly what Barack Obama wanted to do" (oh so bold). 

Neither Sanders nor Warren, mindful of the Democratic electorate's adoration of Barack Obama, has been able to utter something akin to "Obamacare was not perfect."  While that is an albatross around their neck, they should not underestimate the danger to their candidacies posed by the candidates who want to protect the private insurance industry with misleading calls for a public option or Medicare for some.

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