What Does Bernie’s Medicare For All Bill Mean?

By now, I’m sure everybody has heard of the Medicare for All bill introduced by Senator Bernie Sanders (I-Vt.), but just in case you’ve been vacationing on the surface of the moon (I hear it’s lovely this time of year), here’s a little background.

Medicare for All has long been one of Sanders’ pet projects. He introduced the same bill in 2013, but while the 2013 version of the bill had zero co-sponsors, the 2017 version has 16 total co-sponsors in the Senate. (Meanwhile, in the House of Representatives, a similar bill has been introduced by Rep. John Conyers of Michigan; that version has 118 co-sponsors.)

Now, before we get too excited, it’s important to keep one thing in mind: Sanders’ bill doesn’t have a prayer of becoming law; Sanders knows it, as does everyone who supports it. This bill is similar to the ones that the GOP passed repealing Obamacare throughout President Obama’s term: it’s less a realistic policy proposal and more a litmus test for party politicians.

As I noted recently, supporting single-payer offers nothing but political upside for the Senators (including Cory Booker, Kamala Harris, and Elizabeth Warren) who are exploring a presidential run in 2020. Co-sponsoring the bill is an acknowledgment of the strength of the Sanders wing of the party, and it sends an implicit signal that these potential nominees are keen to avoid the mistakes made by Hillary Clinton in the 2016 Democratic primary. By jumping aboard this bill now, potential 2020 candidates can establish a record of supporting single-payer.

Democrats also benefit from the introduction of this bill in a more subtle way: it is absolutely toxic to the GOP. I’ll get to the details in a minute, but broadly speaking, where you stand on this bill is a good indicator of where you stand in the debate over whether or not universal healthcare (not “access” to healthcare, but actual healthcare) is a right. The GOP can’t let this bill go unchallenged; if they were smart (spoiler alert: they aren’t), they would avoid talking about it as much as possible.

They can’t agree with it, since that would only strengthen Sanders’ position; therefore, their only option is to attack it. But in order to do so, GOP legislators have to take the position that their constituents do not deserve universal health care.

About those details…

In essence, the bill would provide a healthcare card for everyone in America, including the roughly 30 million Americans who currently don’t have insurance. This card would allow an individual to go to any doctor or hospital in the United States without having to worry about whether the doctor/hospital is partnered with their particular insurance company.

Opponents of the legislation have claimed that single-payer will cost more and cover less than their current insurance; the specific coverage limits are unclear, but unless you happen to be ultra-wealthy, you would likely pay less in taxes to fund universal single-payer coverage than you currently do in payroll deductions for private insurance.

These same opponents also like to argue that “the government shouldn’t run healthcare,” which is a blatant misrepresentation of how single-payer works. The government would not “run” healthcare, just as your checkups aren’t performed by an agent from your private insurance company. The government would simply pay for your healthcare.

Finally, by establishing a single-payer system, drug prices would likely decrease; the reason they’re so high now is because they have multiple payers all offering different incentives for keeping the prices up. By eliminating all but one payer (as is the case with Medicaid), drug companies would be more likely to offer discounted pricing in order to keep their one client.

I suppose there are some among us who might decry the inevitable damage the poor, vulnerable private insurance companies will endure, but be honest with yourselves: would dealing with a government payer really differ all that dramatically from a private insurance company? It’s a labyrinthine process no matter how you slice it. (Also, for what it’s worth, part of Sanders’ proposal includes simplifying the healthcare system to reduce the burden of paperwork and forms on the individual.)

The Sanders bill is going to fail; there’s no question about that. And though we may not see Sanders’ bill ever come to fruition, there’s a better-than-average chance that a more moderate bill (like the one Connecticut Senator Chris Murphy is crafting, which would allow everyone the option to buy into Medicare rather than using private insurance or none at all) will get through. Politics is about optics more than anything else: by setting a high standard of expectations, Sanders is potentially softening up the GOP’s defenses. By itself, Murphy’s forthcoming bill would likely be dismissed, but by introducing it on the heels of Sanders’ bill, Murphy’s could look like a more “reasonable” piece of legislation — especially if it addresses the GOP’s inevitable excuses for not supporting the Sanders bill.

What happens next remains to be seen, but the increased amount of support and attention that Medicare for All has received means this discussion will continue for a long time. That’s not a bad consolation prize.

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