Sen. Bernie Sanders (I-Vt.) has set the standard for Democratic presidential candidates on health care. Anytime, any Democratic candidate for any office proposes a health-care plan, the media compares it to Sanders’s signature proposal, “Medicare for all.” Sanders has inspired Democrats everywhere to speak boldly on an issue that is crucial to the lives and wellbeing of all Americans.
Medicare for all would expand Medicare to Americans of all ages and cover the costs of medical and dental treatment and prescription drugs.
It would be enormously expensive to pay for all this and the funding would come from a tax on Wall Street, big corporations as well as rich and middle-income taxpayers. This would mean higher taxes for middle-class families, but Sanders argues that their tax liabilities would be significantly less than what they pay now for health insurance premiums and out-of-pocket medical costs.
To his credit, Sanders refuses to compromise on the details of his health-care proposal. But the devil is in the details and it is rare that any president has been able to get Congress to pass any major proposal without compromising on specific elements of the legislation.
All he needs to do is ask former President Obama how much he had to give up in order to secure enough votes to goad Congress into passing the Affordable Care Act. And he had 59 Democratic senators to work with. If he becomes president, Sanders will be lucky to have 50 members of his party in the upper chamber. One of those Democrats will be Sen. Joe Manchin of West Virginia, who does not support Medicare for all.
Among the first-tier Democratic candidates, only Sen. Elizabeth Warren (D-Mass.) fully backs Sanders’s plan. However, she has suggested that she would be open to changes in order to secure support for the proposal on Capitol Hill.
While national polls show support for Medicare for all, they also indicate public resistance to giving up private health insurance plans. While Sanders and Warren support a single-payer system, the other major Democratic presidential candidates support a hybrid private and public system.
Sen. Kamala Harris (D-Calif.) has taken a long journey on the way to a position on health-care reform. Harris was an original co-sponsor of the Sanders comprehensive health-care legislation. During the first round of Democratic presidential debates, Harris threw her hand into the air when the moderator asked which candidates supported eliminating private insurance companies from the health care equation.
But the day after the debate, she walked back from that stance. She said she did see a role for private industry in health-care reform. She released her own health-care reform plan last month, which allowed continued private insurance participation in a Medicare Advantage-type program that would allow people to supplement their government-supplied insurance with private plans. Harris would pay for her plan by requiring companies to pay higher taxes for offshore profits.
South Bend, Ind., Mayor Pete Buttigieg, like Harris, calls his plan Medicare for all that want it. He would offer a Medicare public option but allow Americans to keep their private plans, if they prefer. He believes that over time, most Americans would choose the public option and private health insurance plans would die a natural death. He has issued focused plans for rural and mental health.
Former Vice President Joe Biden’s contribution to the health-care debate has been described as “Sanders-lite” or as “ObamaCare on steroids.” Biden probably likes the latter description since the ACA has become a popular program and his campaign is built on the Obama legacy. In fact, Biden dubbed his plan the Affordable Care Act 2.0.
Biden’s proposal includes the public option for health care insurance that Obama dropped from his original proposal due to congressional opposition. Federal assistance would be available to any American not covered through their employer or by Medicare or Medicaid. No American would need to pay more than 8.5 percent of their income for medical care. He would finance his plan by eliminating the cuts in the GOP tax law passed by Congress in 2017.
So, if you’re keeping score at home, only Sanders and Warren favor a completely public system of health care coverage, among the four major Democratic contenders.
Meanwhile, President Trump has stated that there won’t be a GOP plan available until after the 2020 election.
To make matters even worse, the president has asked Sen. Rick Scott (R-Fla.) to spearhead the task force responsible for developing the promised GOP proposal. It’s safe to say that the big health insurance companies will continue to make a ton of money on the suffering of Americans under any Scott plan.
Scott gained his expertise on this issue as CEO of Columbia/HCA, the largest for-profit health insurance company in the country. Scott resigned from that post under pressure in 1997 after the U.S. Department of Justice began investigating the company. DOJ ultimately fined the company $1.7 billion for defrauding Medicare and Social Security.
Instead of developing a plan in time for 2020, the president and the GOP will relentlessly attack Democrats as being socialists. The problem with their argument is that we already have socialism for seniors in the form of Medicare and Social Security.
The New York Times recently reported that Trump told GOP congressional leaders that he is open to cuts for both of the programs once he is reelected. It would be quite a gamble for Republicans to campaign in 2020 with cuts to Medicare and Social Security hanging over voters.
Any of the Democratic plans are a lot more than President Trump and congressional Republicans have to offer, so far.
Brad Bannon is a Democratic pollster and CEO of Bannon Communications Research. He is also the host of a radio podcast “Deadline D.C. With Brad Bannon” that airs on the Progressive Voices Network. Follow him on Twitter @BradBannon.