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Tag: single payer
Bernie Sanders Should Stick To The High Road

Bernie Sanders Should Stick To The High Road

Bernie Sanders started his campaign stumping for his ideals without savaging the likely Democratic nominee, Hillary Clinton. That was an attractive combination.

Now that he’s done a lot better than anticipated (though way down in delegates), his people are wondering whether he has made a mistake by not lunging for Clinton’s throat.

The answer is no. He’d be even further down, because virtuous politicking has been the source of his charm.

Sanders has never been much of a team player. He is an independent, not a Democrat, but Team Democrat has respected his candidacy. And it has given him a platform he’d never have gotten on his own.

But the welcome mat shows holes. The impressive sums Sanders raises go to his campaign only. Clinton raises money for her campaign and for other Democrats down the ticket. Adding to an unpleasantness, the Sanders camp lashes out at Clinton’s fundraising as somehow sordid.

Exactly how are you going to get your liberal priorities passed without a friendlier House and Senate?

Not Sanders’ problem. Never has been. And that accounts for his modest accomplishments in Washington.

The Sanders campaign prides itself in speaking “the truth,” so here’s some:

Sanders did not fight alone for single-payer health care. He failed to attract a single co-sponsor for his recent single-payer bill, his fans explain, because the health care industry intimidated lesser liberals in the Senate.

But John Conyers proposed single-payer in the House and gathered more than 90 co-sponsors. (Conyers endorsed Clinton in the Michigan primary.)

Sanders recently accused Clinton of taking “significant money from the fossil fuel industry” — a claim for which The Washington Post awarded him three “Pinocchios.”

Oil and gas doesn’t even make the list of the top 20 industries contributing to the Clinton campaign. Fossil fuel money accounts for only 0.15 percent of her campaign and outside PAC sum. But Sanders gooses the numbers by dishonestly labeling donations from lobbyists who also work for other industries as fossil fuel money.

Sanders portrays himself as a one-man army fighting Wall Street abuses in the Senate. Actually, the one-man army has been one woman, named Elizabeth Warren.

Before joining the Senate, Warren championed the Consumer Financial Protection Bureau — detested by predatory lenders for shielding the little guys. Clinton was among the bureau’s most enthusiastic boosters and pushed other Democrats to sign on.

Sanders would have certainly won the financial industry’s enmity if it took him seriously. The Wall Street Journal’s editorial page virtually ignores him, turning its wrath on the far more dangerous Warren.

Now, Clinton’s $225,000-per-speech fees from Goldman Sachs are fair game for the political opposition. But then the opposition has to show what Wall Street got in return other than her insights and her company.

A quid pro quo is hard to pin down. For example, the head of the D.E. Shaw group has given more than $800,000 to the Clinton effort. His company holds much distressed Puerto Rican debt and opposes letting the island file for bankruptcy. Clinton is for it.

Do note that the financial services industry is among New York state’s largest employers and is No. 1 for payroll. Clinton represented the state, and senators do confer with large hometown employers.

Speaking of which, Sanders waves his fist against wasteful military spending but voted to fund the $1.2 trillion F-35 fighter — one of the most expensive, most cost-overrun and most plagued weapons systems in U.S. history. Seems the maker, Lockheed Martin, employs a bunch of Vermonters.

Sanders looks best when he conducts politics from the high road. He’d do well to stay there for the sake of his legacy.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators Web page at www.creators.com.

Photo: Flickr user Matthew Baldwin. 

Sanders’ ‘Medicare For All’: The Devil Is In The Details

Sanders’ ‘Medicare For All’: The Devil Is In The Details

Bernie Sanders is a proud and self-described socialist, a veteran Vermont senator who wants to bring some European ideas to the United States. One of those ideas is a single-payer health care system: a government-funded program in which the patient bears little to no cost. Sanders describes it as “Medicare for all.”

It’s an excellent idea. The United States is the richest country in the world, and it ought to grant every citizen guaranteed access to doctors and hospitals. That’s what Canada, Japan and the countries of Western Europe have all done.

But Sanders is vague — and his supporters quite naive — about the prospects of bringing a single-payer system to the United States. He insists that he could accomplish that in a prospective first term “if many millions of people demand it.”

Here’s the rub: They won’t — at least not in the systematic and sustained manner that would be required to bring about that sort of, well, revolutionary change to the American medical-industrial complex.

There’s a reason that the U.S. doesn’t have “Medicare for all”: politics. Do Sanders and his supporters remember the epic battle to pass the Affordable Care Act?

Democrats have been trying to pass a version of universal health care since the days of Franklin Delano Roosevelt. But conservatives have fought every proposal that would increase access for ordinary Americans, including Medicare; Ronald Reagan, then a neophyte political activist, toured the country campaigning against it.

Bill Clinton made universal health care a cornerstone of his presidential campaign in 1992, and he appointed his wife, Hillary, to head a task force to propose legislation after he won. They tried mightily to pass it, but conservatives denounced it, and the insurance industry spent millions to defeat it.

That’s why President Barack Obama brought the insurance industry on board when he started toward the Affordable Care Act. He knew he needed their support to have a prayer of passage. So the ACA preserves the business of selling health insurance through private companies.

Still, it has helped millions of families; nearly 9 million more Americans had health insurance in 2014 than the year before, according to government data. Moreover, the ACA prevents insurance companies from banning patients because they are sick and prohibits insurers from placing “lifetime caps” on the amount of money any person can collect for health care.

Would a single-payer plan have been even better? You bet. But listen to Obama’s former aide, David Axelrod, describe the difficulties of trying to pass such a proposal.

“I support single-payer health care, but having gone through health reform, we couldn’t even get a national consensus around the public option! It was Democratic votes that were ultimately missing on that issue,” Axelrod remembered. (The public option was a proposal for a government-run health insurance plan to compete with private health insurers.)

History shows that Obama and his allies spent months trying to make the ACA more palatable to conservatives to entice a few GOP votes. Actually, the mandate requiring that all adults have health insurance was originally a conservative idea. While the federal government provides subsidies to help families with modest incomes buy insurance, it doesn’t pay the full cost. (Obamacare also sets aside billions for states to expand Medicaid, but the Supreme Court made that optional, and many states have refused to expand.)

Still, the ACA did not get a single Republican vote in the end — not one. Republicans are still trying to repeal the law, taking more than 60 votes in Congress and going to the Supreme Court with challenges. Most of those Republicans will be easily re-elected to Congress.

Given recent history, it’s clear that Sanders’ plan would face very long odds — and that’s before details become clear. The Vermont senator proposes an extraordinary range of patient care — dental and vision coverage, mental health care, long-term care — while, he says, saving trillions of dollars. Many health care experts say that can’t be done, so health care spending would likely increase. You don’t have to be a conservative voter to fear where that would lead us.

If Vermont’s audacious senator has a plan for overcoming an ultraconservative GOP caucus in Congress, a right-leaning U.S. Supreme Court, and millions of voters who still flinch from the word “socialist,” he ought to lay it out. It would be quite a revolutionary plan, indeed.

(Cynthia Tucker won the Pulitzer Prize for commentary in 2007. She can be reached at cynthia@cynthiatucker.com.)

Photo: Democratic U.S. presidential candidate Senator Bernie Sanders speaks at the PBS NewsHour Democratic presidential candidates debate in Milwaukee, Wisconsin, February 11, 2016. REUTERS/Jim Young

Sanders’ Single-Payer Plan Is A Distraction

Sanders’ Single-Payer Plan Is A Distraction

If you’ve successfully landed on the beaches, but your forces are still taking heavy fire, what do you do? Do you concentrate on trying to hold the line and make further advances or do you sit in a circle and design a better landing craft?

The problem with Bernie Sanders’ health care vision isn’t the vision. His raw outline for a greatly simplified and less expensive health-care system is excellent in theory. The problem is the politics — the reality of which battle-scarred Hillary Clinton clearly has the better grasp.

This was the message Clinton tried to convey in the Sunday Democratic debate. Her most potent point on health-care reform centered on recalling the “public option” fiasco during the fight for the Affordable Care Act.

The public option was to be a government-run health plan competing with the private offerings in the health-care exchanges. It was a no-brainer to keep the insurance companies on a shorter leash. But, as Clinton noted, “even when the Democrats were in charge of the Congress, we couldn’t get the votes for that.”

John E. McDonough, a health policy expert at Harvard, has also been through the health-care wars. As a Massachusetts state legislator, McDonough led an unsuccessful campaign to bring single-payer to his liberal state. In a recent New England Journal of Medicine article, he explained why a similar effort in Sanders’ own state of Vermont failed.

Vermont was the great hope for we fans of single-payer. (I was waving pompoms.) The state is progressive and one footstep from Canada. Gov. Peter Shumlin was totally onboard. He spent four years trying to make a single-payer plan happen. Three major-league studies showed that it was economically feasible.

But even in Vermont, a clear public mandate for single payer never materialized. A rebellion against it almost cost Shumlin the governor’s job.

Asked about this on Sunday, Sanders took a swipe at Shumlin (who has endorsed Clinton).

“Let me just say that you might want to ask the governor of the state of Vermont why he could not do it,” Sanders responded. “I’m not the governor. I’m the senator from the state of Vermont.”
Yes, and as senator from Vermont, Sanders introduced several single-payer bills that went nowhere. The most recent one, the 2013 American Health Security Act, attracted not a single co-sponsor.

The plan Sanders released two hours before the debate remains too sketchy for a reliable independent analysis, according to McDonough. But lack of detail isn’t his biggest concern. It’s opening a new front in the battle to defend Obamacare.

“Republicans sent a bill to the President’s desk last week that would eliminate health insurance for 22 million Americans by 2018,” McDonough wrote me. “This is not beanbag. It’s the real deal, and we have to focus where it matters the most.”

“Bernie wants to lead us on a distraction tour while Republicans want to kill the progress we have made.”

How far have we come? Thanks to Obamacare, almost 18 million formerly uninsured Americans now have health coverage. A report just out of Georgetown University has the rate of uninsured Hispanic children falling to a historic low.

Insurers can no longer turn down people with pre-existing conditions. And important politically, Obamacare has demonstrated that universal coverage is doable without creating mass unemployment or “exploding” deficits. On the contrary.

Making Obamacare more Medicare-like through incremental steps may not feed the romantic urge to reinvent health-care reform from scratch, but there’s no other road, not in the America of 2016. Finally, let’s not forget that vanguard of reform is still on the beaches and taking fire.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com.

Correction: The health policy expert at Harvard is John E. McDonough, not Thomas. We regret the error. This article has been updated to reflect that change.

Photo: U.S. Democratic presidential candidate Senator Bernie Sanders listens to a question during the Democratic presidential candidates debate at St. Anselm College in Manchester, New Hampshire December 19, 2015. REUTERS/Brian Snyder

Obamacare After Obama

Obamacare After Obama

The morning of the recent Republican debate, the U.S. Census Bureau reported that the number of uninsured Americans in 2014 had dropped by about 9 million from the year before. This was thanks, of course, to the Affordable Care Act.

So it did cross one’s mind that at least one of the Republican presidential candidates might lend a kind word to Obamacare. After all, some of the largest gains in health coverage were among moderate-income families, a group including much of the Republican base.

A futile hope. Not even Govs. John Kasich of Ohio and Chris Christie of New Jersey — who, to their credit, had accepted the law’s expansion of Medicaid coverage in their states — offered a shred of praise. Instead we heard vows to basically blow it up, the main difference being the number of dynamite sticks to use.

Grudging appreciation for Obamacare has also extended to significant parts of the Democratic base. In the 2012 election, many Democratic candidates actually avoided discussing it. You see, a flood of anti-Obamacare propaganda — which Democrats had neglected to counter — caused support for the program to swoon in the polls.

The new Census Bureau numbers show that African-Americans and Latinos have enjoyed an especially sharp rise in health coverage under Obamacare. And that makes it painful to contemplate these groups’ dismal turnout in the 2014 midterm elections.

Back then, the newly won guaranteed health coverage was under grave threat. Republicans had tried to repeal Obamacare dozens of times. Had a case before the U.S. Supreme Court gone badly, the program could well have been destroyed.

You’d think that low-income Americans would have marched to the polls waving Obamacare flags. Problem was their so-called advocates had moved on to immigration and income inequality and saw the elections as an occasion to blame Democrats for what they held was inadequate progress. They forgot there was something precious to defend — and that Obamacare was a huge advance against said inequality.

Nowadays, Hillary Clinton not only is waving the flag but has hired a brass brand to march behind it. We await the details of her proposals for improving the program. Same goes for Joe Biden, should he choose to run.

Sen. Bernie Sanders, the Vermont independent seeking the Democratic nomination, gives Obamacare two cheers but not enough credit. In a recent CNN interview, he said he wants a “Medicare-for-all single-payer health care system.”

Expanding Medicare to everyone happens to be a super idea. But we must note that Medicare is not single payer. It is a multi-payer program combining government and private coverage. As such, Medicare is more like the top-ranked French and German health care systems than it is the good, but not-as-good, Canadian single-payer program.

Because Medicare has strong public support, Medicare for all can be imagined. It would be a very hard political sell, however. Recall that Democrats couldn’t even get the “public option” past Congress. That was to be a government-run health plan to compete on the new insurance exchanges with the private ones.

Sanders’ own Vermont tried but failed to put together a modified single-payer health plan. If Vermont can’t do single payer…

Suffice it to say, it would take a master politician to get a greatly expanded Medicare passed in this country. A master politician Sanders is not. But may his vision live on.

Happily, Obamacare now seems safe. Its imperfections well-documented, it remains a work in progress. But whoever is the next president should be grateful to have a universal health care program on which to build.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators Web page at www.creators.com.

Photo: Michael Moore via Flickr