In June, as the fight over the repeal of the Affordable Care Act reached its climax, then-White House spokesperson Sean Spicer delivered a warning. “It’s not a question of Obamacare versus the AHCA,” he said, referring to the GOP alternative, the since-failed American Health Care Act. The question, Spicer said, was between repealing Obamacare and moving to single payer.
History may prove him right. When the battle over the ACA is finally over, the fight for what comes next will revolve around the bill introduced Wednesday by Sen. Bernie Sanders, aiming to create a universal Medicare program. It’s the most fleshed-out single-payer proposal ever introduced in Congress.
The campaign for the Vermont independent’s bill will start with the backing of at least 15 Democratic co-sponsors and 24 progressive and health care advocacy groups, numbers that will only grow in the coming days and weeks.
Read a chapter-by-chapter summary here or the executive summary here. See the funding options here.
The bill starts by sweetening the pot for seniors who may be wary about welcoming the rest of the country into their warm pool. It eliminates copays and deductions, except for name-brand drugs when generics are available, and adds dental, vision, and hearing aid coverage to Medicare — huge benefits that have long been a goal of public health advocates.
At the same time, people up to age 18 would be eligible for coverage in the first year. In year two, the eligibility age of 65 would be lowered to 45. The next year, it would drop again to 35. In year four, the age restrictions would be eliminated.
Importantly, Sanders’s bill repeals the Hyde Amendment, which restricts federal funding for abortions, as it relates to universal Medicare. That means that those covered would have full access to the entire suite of reproductive health care services, including abortions. His is the only single-payer legislation currently on the table that moves so strongly in the direction of reproductive freedom.
The history of the New Deal expansion shows that once benefits have been enacted, they are difficult to take away. Opponents of Social Security, Medicare, and Medicaid have been working to cut or privatize all three since the day each was enacted, but instead all have grown over time. (The major exception was Aid to Families with Dependent Children, better known as welfare, which was repealed in 1996.)
By phasing in coverage, Sanders makes universal Medicare harder to repeal and easier for the public to understand. Everyone gets that transitioning to Medicare when one turns 65 is a relatively painless process. Under Sanders’s plan, people would begin transitioning after the first year, at age 45 instead of 65. That’s not complicated.
The coverage for dental care will also be life-changing for millions of people who live in pain — some of whom, unable to afford proper dental care, are even forced to change their diets.
The new Medicare bill leaves the Veterans Administration in place and allows tribal health care systems to continue operations. It would allow doctors and providers to opt out of the system on an annual basis, meaning that a private system would exist alongside the public system.
The bill does not include an explicit funding mechanism. However, on Wednesday afternoon, Sanders’s office released a document laying out several options for financing the plan. The document is more or less a menu of various revenue mechanisms for the federal government to choose from. As the bill is debated in committee, Sanders said, senators can debate the various funding ideas.
The list includes, for instance, both household and employer-based premiums. The document proposes a 7.5 percent income-based premium on employers and a 4 percent income-based premium on households. Together, it estimates these two proposals would raise $7.4 trillion over ten years.
The document also notes that Medicare for All would eliminate various tax breaks that currently subsidize our current health financing system. This would raise $4.2 trillion over a decade.
Then there’s a large list of non-health care related taxes: everything from making the estate tax more progressive to taxing large financial institutions to establishing a wealth tax on the top 0.1 percent.
Sanders’s bill already has the backing of Democratic Sens. Elizabeth Warren of Massachusetts, Kamala Harris of California, Cory Booker of New Jersey, Al Franken of Minnesota, and Kirsten Gillibrand of New York, suggesting that the Democratic nominee for president — if they come from the ranks of politicians rather than Hollywood (Oprah, The Rock, etc.) — will more than likely back Sanders’s bill.
Presuming the Senate won’t move on the bill, its first real legislative debate would come if Democrats take the House of Representatives in 2018. Democratic members would face pressure in 2019 to study the bill in House committees and pass a version of it as something of a dry run. If Democrats follow a midterm wave by taking the White House in 2020, they’ll be positioned to move early on health care.
In 1993 and again in 2009, taking on health care at the front end of a Democratic administration turned out badly from an electoral perspective, but Democrats, if Wednesday is any indication, may believe the third time is a charm.
Update: September 13, 2017
This story was updated to include Sanders’s financing plan.
Update: September 17, 2017
This story originally said that the fight over the Affordable Care Act was over. Senate Republicans are now vowing to take one more shot at it.
Top photo: Sen. Bernie Sanders, I-Vt., speaks during a news conference on Capitol Hill in Washington on Dec. 7, 2016.
Sanders health care bill: A cover for Democratic Party deals with Trump
https://www.wsws.org/en/articles/2017/09/14/sand-s14.html
The Democratic Party’s deceitful game
http://www.salon.com/2010/02/23/democrats_34/
I am afraid that many of us share the Sane-progressive’s utter disillusionment with Bernie Sanders. Although I am in favor of a single payer system (medicare for all), I am not at all convinced that Bernie’s efforts are not a form of mid-term political back burning that is cynically designed to dampen popular enthusiasm for a single payer healthcare system with a predictable failure. Meanwhile, Sanders once again shores up his reputation as the dems most progressive candidate in preparation for his role as a 2020 lightening rod.
Too little, too late. Sad, tragic Dems. Who’d have thought theirs would be the first of the “two” political parties to die?!? 2018 – expect another Republican sweep. The Democrats have nothing to offer, least of all this hail mary from hell.
And the next step for The Intercept if it as an organization it supports Medicare-for-all is to use the reality-based journalism it is (mostly) known for and actively investigate and publish counters to the avalanche of distortion, propaganda and bullshit that is coming against MFA, and against Bernie, and dare I say against the Senators who co-sponsored it.
Only the true believers are going to buy into this, unless you confront Medicare’s existing problems honestly.
The program is popular. Do NOT confuse popular with well-run.
It’s popular because for your garden-variety beneficiary it pays claims without too much hassle. That sounds great at first glance, but it’s not sustainable to run a system that pays claims first and sorts out the details later – the infamous “pay and chase” method, which never seems to go away no matter how many press conferences are held promising it’ll go away.
There’s tens of billions a year being lost to fraud and bill-padding, spent on unnecessary treatments, and piddled away by clerical errors. That’s money that could be spent on people’s actual needs.
What, did you think the word “military” was the only one that could appear before “-industrial complex”? Any sufficiently large program develops its own political gravitational field which will fight tooth and nail against effective oversight, no matter how many press conferences are held promising effective oversight.
It’s not responsible to expand Medicare from 60 million recipients to 330 million recipients without fixing its problems, and it’s doubly irresponsible to react to the losses with “nothing to see here, move along.”
Sanders is either stupid or dishonest. We all know that the federal government will never have our best interests at heart. All of the developed Nations of Europe have good to excellent health care SERVICES . That is the difference. The EU “Federal government” has no system. The individual Nations are sized like our States, not our total union. When the system is designed for and run by the State, closer to the patients/ taxpayers, it works well. The word “Insurance” should never be used. The Services are run at cost. No profits are added. Taxes pay the costs of operation and co-pays keep over consumption to a minimum. That is the way the French system works and the California system could do likewise.
“The campaign for the Vermont independent’s bill will start with the backing of at least 15 Democratic co-sponsors ”
Big whoop: they’re out of power, so it’s a cheap shot. (How many are leadership? Pelosi is still against.) Remember how many times the Republicans “passed” Obamacare repeal – when Obama was there to veto it? But when it would have been signed, no dice. Just couldn’t do it – because the insurance companies would have cut off the money spigot. That’s what it is: a subsidy to Big Insurance.
Now the Democrats are on board – when it doesn’t matter. Wait till they’re in power; then we’ll see if THEY’re prepared to cut off the money spigot. You’ll have to have them by the political very shorty hairs before that happens.
I have several concerns over the sudden embrace of single-payer/Medicare for all by the Democratic establishment.
1. The corporate/establishment Democrats are going to slow-walk this to death. They’ll study and debate it until it dies and crow about how they were for it, but it was just impossible to get done.
2. The insurance industry and Big Pharma will launch a vicious disinformation war to kill it and limit support in Congress.
3. It’ll get amended and watered down until it is essentially ‘weak tea’ and virtually useless.
4. Congress will have a bright idea to cushion the insurance industry’s demise by contracting with them to administer the program, for a lucrative fee, rather than having government employees do so, as is the case now.
All true. Don’t forget that new interest groups will spring up. All the bill-pushers will sudden;y realize how expendable their current jobs are now. They will fight to protect themselves. But it is worth it just to keep the debate going. If we can just get people to admit that the current inefficient system is really just a rent extracting, jobs program in disguise it may be worth it.
One detail here smells like Democrats looking for a lost cause yet again. I mean, if Sanders were serious, why would he throw the Hyde Amendment into the mix just to give the other side something else to rally around? I bet Medicare doesn’t pay for too many abortions right now!
You can call elective abortion a kind of “family planning”, you can call it a clever social engineering scheme to save future parents a lot of money (for poor people), but you can scarcely call it medicine. A bill meant to pass would not be dragging this ball and chain.
Right, this is obviously grandstanding.
Just like California Democrats in the legislature sent single payers repeatedly to Schwarzenegger knowing full well he would veto, and just like the California Democrats in the legislature put the kibosh on single payer this year knowing that Brown would have to veto it, nothing these Democrats say can be taken seriously, that is why the electoral base dropped out from under the party after Obama ran center left and governed center right.
Yes.
Only, on most issues. Obama was to the right of George II; only the “identity” issues that the Big Money doesn’t care about were at all left, and then reluctantly.
Welp, if Franken is in, it must be more DNC hooey.
http://www.alternet.org/economy/sanders-legislation-nationwide-healthcare-wont-include-how-fund-it#15052695885402
1. Medicare is NOT a “single payer” system.
2. Single payer healthcare coverage will not be allowed until
the majority of politicians implement single payer funding for their
political jobs. Even then, it is highly UNlikely that they would
be capable of implementing something which is so decently
“UN-american.” As long as the majority of politicians use private
corporate money to manipulate the voters, they will find a way to
prevent single payer medical coverage.
3. With the implementation of “Medicare for all,” it would almost
certainly involve a higher proportion of required private insurance
and higher costs than Medicare now has been manipulated to
increasingly include (since the time when the Clinton administration
helped begin gutting Medicare from what it used to be).
Medicare is increasingly manipulated by private corporate insurers.
This agenda by Sanders and Company smells. If you do not suspect
that you are being manipulated, then you are quite gullible.
The democrats are a corporate owned party. Sanders can pretend
otherwise until Hell freezes over, but the Clintonian
neoliberal/conservative corporate agenda of total control is what
is really running this show.
The ONLY single-payer branches of the faking U$A are the military and
the spying agencies. They are what is sanctified and they will never
surrender to any notions about being a healthier society.
Beware of fakers bearing “gifts.”
A clarification.
When I referred to the military and the spy agencies as being
“single-payer,” I was NOT limiting it to healthcare. Their budgets,
as far as they can be deciphered through the abundant loads of
taxpayer money which are repeatedly dumped on them, are
the most enormous form of a single-payer operation on this planet.
My wife is on disability and just got medicare. You almost have to add a private insurance carrier to it because the basics are not very much. Then you have to make sure your doctor/hospital takes medicare. Its good but its not a panacea.
have a disability and try to get affordable insurance..if you are disabled medicare is a panacea..take it from someone who was 63 when the disability hit…
So this is how they win again, the Democrats.
Obama had big plans (ACA) that got diminished and savaged. I’m not certain of the motives, and need a very good analysis of this plan. I am not suspicious of Bernie Sanders, just the others in the Democratic party. I would have preferred a Campaign Finance bill first.
But my daughter just had a 10 minute sonogram that cost $1711.00.
*The conservatives will savage this due to their extreme (not so extreme anymore) suspicions of gov’t run programs & irresponsible spending (ie defense spending). How will they keep prices down ?
Good beginning, I’m going to read more. Thanks R.G.
“The bill starts by sweetening the pot for seniors who may be wary about welcoming the rest of the country into their warm pool. It eliminates copays and deductions, except for name-brand drugs when generics are available, and adds dental, vision, and hearing aid coverage to Medicare where it didn’t exist before — huge benefits that have long been a goal of public health advocates.”
Was wondering about this, so thank you for the info. Have said since I was eligible that Medicaid needed improvement. Still better than for profit BS.
No politician (Obama, for instance…he couldn’t because…well…pharma does make political contributions…) in America has EVER done anything to bring down the costs embedded in our insane for-profit healthcare system. America: exponentially more expensive, outcomes on a level with Macedonia…
Health care for all citizens is predicated on the belief that humans need health care. However the majority of elected whores for wallstreet thieves obviously do not believe that the US is populated with humans. Some may argue that it is the elected whores for wallstreet thieves who are not human.
There are times when I think a significant percentage of the American population doesn’t see the rest of the world as fully human.
So it’s probably only natural that its hubris-on-steroids ruling class would feel the same way about just about everyone else, United States citizens or not.
Well said, Ken!
I’m a Canadian citizen who has never known anything other than a medical system that doesn’t charge for its services. At all. Ever. Even if you are diagnosed with a life-threatening condition that could cost six or even seven figures to treat.
And all I know about the American system is what I’ve read over the past 20 years – that a lot of Anericans spend a lot of time worrying about how to pay the astronomical bills that often come with their medical treatment for that same life-threatening condition, co-pay or no co-pay.
There’s no doubt the United States is much wealthier than Canada, even taking into account its much larger population, so the money is obviously there for a free medicare for all system.
But our two countries have such different focuses on our respective roles in the world that I can’t see the United States with a universal medicare type system anytime soon.
Just as one example, Canada spends a ridiculously low amount on its military, which obviously leaves money in the pot for for other expenditures, such as universal health care.
Some Canadians are happy with this and others aren’t. But even most of the unhappy ones aren’t willing to give up universal health care if that’s what it would cost to have a more robust military.
The United States, on the other hand, spends more on its military than it does on just about any other major expenditure, which obviously means there’s less to go around for social programs such as universal health care.
It’s going to take a grassroots approach and many years to get the ball rolling on universal health care in the United States, in my opinion.
I realize the polls show a majority of Americans say they want universal health care. But I’m not at all sure, if push comes to shove, that it would still be a majority once people realize that everyone will have to share in the financial burden of putting such a system in place, and maintaining it.
Nothing is free, and few social programs can be put into place without providing the proper funding for them.
And that means higher taxes for everyone. And from what I’ve been reading about the United States for most of my life, fighting higher taxes is the hill a lot of American voters are willing to die on.
If this is going to go anywhere more must be explained on the affordability of it for the government. How will it be paid for?? Understandably, this is just a first draft bill but there really isn’t a lot of meat on the bone, no great specifics, for how it will be cost effective. There also needs to be some revisions to the current Medicare payment structures! The bill says it will use the current payment structure but medical providers will not be in favor of this. There are only a small percentage of providers accepting Medicare recipients due to the payment system. The entire payment system needs to be reviewed and possibly revised before it’s backed by all providers. I am all for Universal Healthcare!! We need a comprehensive study of at least two top universal health systems to understand what works and what doesn’t; and revise this bill accordingly to give our country the absolute best system we can have. In doing so, opponents will not have anything to oppose!! It will be worth the wait if they can get this right!!!
It really doesn’t matter who is backing it. It matters who is paying for it. And if the answer is no one then it really doesn’t matter.
Here is your answer, and if one looks at the personal cost of co-pays (gone from Medicare) ,Insurance Premiums, Bills from medical care etc., and employers being relieved of the burden (both financially and administrative) of providing access to healthcare for their employees at a cost of only 6.2% in taxes. Health care providers, Hospitals and Clinics would no longer have to have entire departments dedicated solely for the administration of insurance coverage (legal dept. too) , saving a lot of money, it is a great boon to all.
Except, of course, for those that capitalize on suffering by a population captive to Private interests’ benefit.
“The program would pay for doctors’ visits, hospital stays, preventative and mental healthcare, and prescription drugs—while expanding Medicare to include vision, hearing and dental care. To pay for the expansion, the bill would levy a new 2.2 percent income tax on all Americans and a 6.2 percent tax on employers—who would no longer be required to provide health insurance to workers. The measure would also raise taxes on the wealthiest Americans.”
https://www.democracynow.org/2017/9/13/pivotal_moment_in_american_history_sen#transcript
dream on…the whole rationale here is to provide healthcare to the indigent and needy who have no income but will be paying a new income tax of 2.2 percent… typical progressive non-sense…and a new 6.2% tax on all employers would cause most small business owners to go out of business…yeah this makes sense…dream on
Try reading the Bill it might wake you up.
First of all like other mandated govt. services those under a certain income level do not pay the 2.2% (just like they don’t pay Fed taxes at tax time) and that goes for the 6.2% tax to small businesses.
One thing you ignore is that right now they DO have to pay for employees’ health care and for big businesses they pay a LOT more than 6.2% annually right NOW.
Forget the bs about this being a “progressive” or conservative ideology because most of my family (daughter, son, grandkids) are all Canadian and from my many years living there I’ve met many conservatives ( & hard core right wing people) that vehemently argue against “progressive” ideas BUT they will NOT give up THEIR health care system, even their Conservative Party leaders protect the current system. You wanna lose in ANY election there, Conservative Party, Liberal Party, NDP or Green Party ? Run on ending the current system of health care. Tell the people you want what the people in the US have, yeah that place where the NUMBER ONE factor in the majority of bankruptcy cases in America come from MEDICAL EXPENSES. How many in Canada? ZERO.
One last thing ‘costs’? We pay more for less in health care per capita than any other industrialized Country (most have SP healthcare), in the WORLD.
Let’s say your average subscriber to ACA makes $100k per year which they don’t. So paying 2.2 in tax would amount to $2200 which doesn’t cover the current deductible for most plans let alone the insurance for most instances that would blow through that deductible for a single individual let alone a family of four. So, I really don’t care what the “bill” says, that’s just the marketing brochure . Unless the US government can mandate what hospitals and doctors can charge, it’s all a bunch of smoke.
There will not be a deductible. Horrible argument.
>” those that capitalize on suffering by a population captive to Private interests’ benefit.”
I never really considered this. My aunt works in a medical office filing and billing. Mid 50’s, high school education, (along with most of the people she works with). Everyone in her department capitalizes on suffering because of our current system. Just a small town in middle america, must be two dozen employees dealing with billing. The world will be much better when these blood suckers and the million others like them are out on their asses!
With this action, with these legislators signing on, we finally have a comprehensive path to take to relieve our poorest and most suffering citizens of their agony. We can finally begin to convert our healthcare to a logical set of methods. The poor and much of the working class do not get care because they have no money. They avoid getting help because they know the pain of bills flowing in as soon as they ask for ANY help at all. It is a sick and mean system we currently work under, and it HAS TO STOP! The current system is an ATTACK upon our most vulnerable citizens and our working class.
Thank you Bernie Sanders for all that you do to stay focused on helping the citizens of the USA. No politician in recent American history has spent so much time focused on the citizens. No politician has visibly done so much to VOICE “OUR” HOPES and DREAMS for a better tomorrow than you, Bernie. Your legislative efforts are real and substantial and this matters!
Thank you!!!!!
NJ, eh…say, didn’t Senator Cory recently claim that drugs from Canada certainly could be dangerous? I believe this comment was made in the bank line while cashing a $450,000 check from a NJ Pharma Co.
Remember, this should cost you NOTHING. The Federal government is monetarily sovereign, it has an unlimited pool of dollars. You are not monetarily sovereign, you have a finite pool of dollars. Therefore the federal government should cover 100% of the costs, no copays, no deductibles, no cost burden on you whatsoever.
And since federal taxes do not fund federal spending, there is no automatic requirement that taxes go up in order to pay. Taxes should increase (mainly on the top) in order to reduce inequality but they do not need to increase to cover the costs of public goods like healthcare.
Ryan, the fight has not begun! The Revolution has!
My comment to the NYT in Bernie ONLY addressing the Health Care problem of this EMPIRE:
Bernie’s heart is in the right place — it’s just that his understanding and “Political Revolution” weren’t.
What he needed to say was:
“We remain the only major [Empire] on earth that allows chief executives and stockholders in [all 7 sectors of this Empire] to get incredibly rich, while tens of millions of people suffer because they can’t get the [democracy] they need. This is not what the United States [started a “Revolution Against Empire” Justin duRivage] to be about.”
Bernie’s two-word sound-bite and incomplete call for a “Political Revolution” — Against what Bernie? — missed the mark in not firing a; loud, public, sustained, ‘in the streets’, but completely non-violent “Shout (not shot) heard round the world” to ignite an essential Second American people’s peaceful patriotic “Political/economic and social Revolution Against Empire” — as our forefathers started 242 years ago, and intended to be ‘perfected’ of, by and for the people.
As our forefathers fully understood, it is never treasonous, and always patriotic, to ignite a “Revolution Against Empire”
And as Pat might have shouted if Tom had taken the pain to edit his words: “Give me Liberty [from Empire], or Give me Death”
I’ll make the effort to edit some of your words. “Revolution Against Empire”, not quite accurate. “Revolution Against the British Empire” is more better(yeah, I know). These forefathers wanted their own empire from the start. White landed men were the chosen few to run this new empire. I agree with your overall premise, just wanted to correct a couple myths about “We the People”.