Republicans are about to make Medicare-for-all much more likely

[Jimbo101]

Vox

The details of the Senate GOP’s Obamacare replacement plan remain a mystery. But the argument Majority Leader Mitch McConnell is using to push the final product over the finish line isn’t.

On Friday, McConnell reportedly “delivered a private warning to his Senate Republicans: If they failed to pass legislation unwinding the Affordable Care Act, Democrats could regain power and establish a single-payer health-care system.”

History may record a certain irony if this is the argument McConnell uses to successfully destroy Obamacare. In recent conversations with Democrats and industry observers, I’ve become convinced that just the opposite is true: If Republicans unwind Obamacare and pass their bill, then Democrats are much likelier to establish a single-payer health care system — or at least the beginnings of one — when they regain power.

“I will tell you,” says Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University, “Democratic politicians I never thought would utter the words have mentioned single-payer to me in a non-joking way of late.”

If Republicans wipe out the Affordable Care Act and de-insure tens of millions of people, they will prove a few things to Democrats. First, including private insurers and conservative ideas in a health reform plan doesn’t offer a scintilla of political protection, much less Republican support. Second, sweeping health reform can be passed quickly, with only 51 votes in the Senate, and with no support from major industry actors. Third, it’s easier to defend popular government programs that people already understand and appreciate, like Medicaid and Medicare, than to defend complex public-private partnerships, like Obamacare’s exchanges.

The political fallout from passing the American Health Care Act — which even Donald Trump is reportedly calling “mean” — will also be immense. In passing a bill that polls at 20 percent even before taking insurance away from anyone, Republicans will give Democrats a driving issue in 2018 and beyond — and next time Democrats have power, they’ll have to deliver on their promises to voters. Much as repeal and replace powered the GOP since 2010 and dominated their agenda as soon as they won back the White House, if the American Health Care Act passes, “Medicare for all” will power the Democratic Party after 2017.

[MiddleClass]

1. I am hoping people realize the danger of what Republicans are going to do to them

I am hoping and praying that people don't have to get badly hurt financially, health wise, before they see the danger.

I think Obama care and its related benefits have joined Social Security and Medicare as the third rail of politics.

Medicare for all, is gaining steam, Medicare for anyone above 55 is minimal to demand

[unblock]

2. obamacare was originally created by the heritage foundation precisely as a right-wing alternative

to "hillarycare" hillary's healthcare plan that republicans called "big government"
and medicare-for-all.

these were both left/democratic ideas and the right-wing needed an alternative, so they came up with the market-based mandate concept. later, republican mitt rmoney rolled it out in massachusetts when he was governor.


obama's adoption of this plan was part pragmatic, part triangulation.
republicans turned against the plan mostly out of rank partisan political opposition, and partly because obama funded it with taxes on the rich.


but, yeah, the whole concept for the right-wing was to get something like obamacare in place instead of the more liberal alternatives. the won that battle when obama adopted their plan. ideologically, they should simply revise the tax structure, but they backed themselves into a corner by railing against obamacare (and the mandate in particular) for 7 solid years.

in the process, they made their own right-wing plan toxic, leaving only liberal alternatives.

[JHan]

6. good post. ++++++++

[Hortensis]

7. Pubs inserted more than 200 amendments while pretending

to help put together a bipartisan bill, then on the very day it was to to be voted on not one voted for it. How it would be funded was always pretty much understood and at that point already agreed upon. Even if that was the big issue that decided matters, their nasty tricks were strictly dirty, dishonorable politics.

My healthcare savings account, which serves better as a tax dodge for my physician than as a way to pay for healthcare, is one of their contributions; Obama didn't want it but agreed.

But, you know, the Heritage plan wasn't really a "right-wing alternative." It was the MOST conservative version of genuine, workable healthcare reform that the Heritage Society back then could come up with. No huge, subsidized federal program program like this ever met criteria to be considered conservative.

Today, of course, they've become so extreme that all their planning goes to destroying all federal programs.

[unblock]

9. good points.

it would have been interesting if democrats could have yanked all the republican amendments after republicans reneged on their promises. no doubt democratic leaders wanted to strike while the iron was hot, as it was looking rather iffy for a while that we would get all our "own" people in line.

and i agree, the truly "conservative" plan was simply to leave it alone, let insurance companies continue to jack up rates, let more and more people continue to not be able to afford insurance, etc. hey, free market, yay, right?

though "right-wing" and "conservative" aren't always the same thing, and using the government to deliver customers to big industry certainly sounds right-wing, if not particularly conservative.

i'm not sure how much the original heritage plan had in the way of subsidies, i certainly have to think it didn't include much in the way of taxes, certainly not tilted toward the rich. i imagine the subsidies are also (in addition to the tax structure) part of how obama made the heritage plan more liberal.

[MiddleClass]

13. Subsidies, where strictly Democrat

The subsidies was Democrats way of making the heritage plan work for the non-rich.

I don't know about Romney's plan, my assumption as Massachusetts is all Democrats,

so I would say subsidies would be Massachusetts Democrat demand for passage.

Maybe somebody is familiar with the exact workings of Romney care.

Which was the original plan structure of Obama care.

[MiddleClass]

8. Exactly, and that's why technically unworkable

Triangulation, the art of the possible, divide opposition and conquer, all applicable.

That's why pharmaceutical, insurance premium cost control was left to the future congresses to achieve.

The Obama administration saw a way to achieve affordable healthcare for the general public using the subsidies, Republicans gave private insurance companies to offer Medicare plans under Medicare advantage that were designed to undermine Medicare. A 30 percent subsidy was directed to the insurance companies, which now subsidizes people affording their health care premiums.

Excellent summation of the history that led up to the reasons for the trouble instituting Obama care

[Cosmocat]

19. Your post highlights how absurdly this country indulges

Republican fuck wittery...

[Initech]

42. The Heritage Foundation needs to GTFO out of our government.

Fuck the Koch Bros.

[burnbaby]

3. boy medicare starting at 55

I could get into that. I don't have any healthcare now, so that sounds affordable

[MiddleClass]

10. I think that would solve our biggest problem right now

People over 55, are more in danger of being laid off in a downturn,

people over 55, find it harder to find another job because youth is cheaper, less experienced.

People over 55, run a higher risk of requiring health care coverage,

but also are healthier than 65+, so actuarial speaking their premiums would subsidize Medicare.

Which would reduce the national debt and thus be done with 51 votes.

The 3 mentioned scenarios are all detrimental to one's station in life and risk of losing everything.

Medicare at 55 would be a massive safety net that would save state governments millions

[Phoenix61]

27. People over 55 are much more likely to have a

preexisting condition.

[ehrnst]

32. That was what HRC was proposing. Gradual expansion.

Which would be more possible in this climate than trying to go full national health all at once.

But that's apparently heresy now... and you are "a shill for big pharma" or "big insurance" when you dare point out the obstacles, political, financial, and logistical to moving over to a single payer plan in under 20 years.

[geek tragedy]

4. Yeah, Democrats will be like "incrementalists, we did it your way and it failed. We're

going Medicare for all, and we'll do it through reconciliation."

[Yavin4]

5. Straight forward, direct approaches to public policy is the only way to go

There are no more political compromises any more. it's "we win" or "they win". Obamacare was a massive political compromise that was shoved right back in our faces. No more. We build a policy that we want and we fight for it without Republican support.

[workinclasszero]

11. I think Trumpcare will be the wooden stake into the republican party's

black and shriveled vampire heart.

The minute that horrible attack on the american public is passed out of the senate and onto the pussy grabbers desk to be signed into law, a massive democratic party lead movement must begin!

Single payer, universal health care for ALL Americans!!!!

Let the people have a clear, unmistakable choice! No half measures that a demagogue POS like Trump can reverse on a whim!

Can we PLEASE join the rest of the world that values its own citizens and have what should be a basic human right?

[MiddleClass]

14. While I agree with your thinking

History dictates otherwise.

Kennedy fought Nixon's offer in the seventies, demanding single-payer. Nothing happened.

Clinton, fought for socialized healthcare, nothing happened.

40 years later we still did not have universal healthcare.

Obama, divide and conquer, didn't make the perfect the enemy of the good. Universal healthcare passed,

let's make irreversible steps towards a common goal

[not fooled]

17. And another caveat

the pukes know better than to have all of the negative impacts hit at once. They will phase in the hurt gradually, and hide as much as possible, so that the underinformed and politically ignorant American public has a hard time linking cause and effect. The feeble coprolitic news media won't adequately cover or explain what's in the bill.

Just remember: raygun cut Social Security by raising the retirement age, but it didn't kick in for 25 years.



I just hope the public is so disgusted if this gets rammed through that they kick out the pukes no matter what. Unfortunately, I have my doubts--really, after raygun made clear his anti-union, anti-worker agenda, that SHOULD have been it as far as middle- and working-class voter support. Yet here we are...

[Ligyron]

22. "They will phase in the hurt gradually"

That's the real problem and it's a BIG one.

Give them 5-7 year even and it will all be Hillary's fault.

[MiddleClass]

25. Think about it, Bush called it voodoo economics in 1980

And we are not only fighting the effects of voodoo economics today,

we are fighting Reagan inspired. Paul Ryan, trickle-down economics today.

Republicans know to drop in the candy right now but dial the pain at next presidency.

We have paid for Reagan for 40 years and will be paying for a long time from now

[Jim Lane]

20. Bill Clinton did NOT fight for socialized health care.

Clinton's health care proposal was like the ACA in that it continued the reliance on insurance through the employer as the primary means of making health care available.

Furthermore, the ACA is not universal health care. Millions of people still don't have health insurance (although of course the number has been greatly reduced). Even those who have insurance don't have the kind of access to actual health CARE that they would have under socialized medicine, because of the issues of co-pays and deductibles.

[dsc]

21. that is exceptionally misleading in terms of the ACA

The uninsured come from three places, one people who would have been on Medicaid had the Supreme Court not rewritten the law, two immigrants who it was decided would not be covered, and three people who refuse to buy insurance despite the penalties. Two of those three classes can hardly be blamed on the law.

[Jim Lane]

23. I'm not assigning blame. I'm stating the FACTS about the situation under the ACA.

Under socialized medicine, as it exists in many other countries (albeit with some differences among them in terms of the specifics), there is no role or only a supplementary role for private insurance (procured by the individual or by the employer on behalf of the individual). Under the ACA, such private insurance remains the cornerstone of the system. Therefore the ACA is not socialized medicine.

It's also not universal insurance coverage, because, even without the Supreme Court ruling, not everyone would have had insurance.

Finally, it's not universal health care, because, with or without the Supreme Court ruling, not everyone with health insurance would thereby get health care.

It would be misleading to say that the ACA envisioned the "Medicaid gap" by which a few million people in Republican-controlled states would be too rich for Medicaid and too poor for ACA subsidies, and would therefore be out in the cold. Of course I did not say that.

[MiddleClass]

28. Again, clarity is welcomed

My naming convention was very loosely defined "what could be considered"

broadly generalized for a target audience that varies in their understanding of actual labels.

I would like to emphasize, the clarity/correction is highly welcomed to the point of desired.

Hopefully, the overlying point we're both trying to make, can reach a wider audience,

that again. Hopefully, will finish with a vastly better understanding of the underlying issue.

Thanks again. I would much rather be correct or corrected then personally right

[Merlot]

34. Did you forget the 4th group?

People who don't have jobs or are self employed have a hard time finding affordable insurance and ususally go without.

Those people who "refuse to buy insurance despite the penalties" are usually people who can't afford insurance.

If you don't have a job, insurance is usually not afforable. Those people who work, hvve income and don't qualify for Medicaid and can't afford an extra $800 per month for insurance go without. Not becasue they want to or some principle, but because it cost to much.

What does being an immigrant have to do with insurance? Some people come here from well to do families and can afford insurance. Others get jobsiwth coverage.

[MiddleClass]

26. Thanks for clearing that up.

Charity is always welcome, in my haste I cut corners, poetic license, so to speak.

Thanks again

[pansypoo53219]

12. but will it be funded?

[MiddleClass]

15. That's the main reason why I say lower Medicare to 55

If you keep the subsidy as is for 65+, and make 55+ at cost.

There will be no long-term deficits cost and thus be passed with 50 + vp Senate reconciliation vote

[airmid]

16. And if they do pass their boondoggle of a bill Dems will regain power.

[IronLionZion]

18. I hope our side has people writing up such a plan as we speak

because if and when the opportunity comes, we need to move fast with a well thought out plan and no time to squabble over too many details and drafting errors.

It could be John Conyers's HR 676. Or some sort of buy-in program. Or even universal coverage for major medical/catastrophic, with small stuff separate. Or lower the Medicare age. Whatever it is, out side should be well prepared and be able to defend it confidently.

[MiddleClass]

29. Exactly, no Obama care type of internal battles

We all agree not to let the perfect be the enemy of a good

everybody pulling in the same direction

[Demsrule86]

37. Do you understand that we will not get that opportunity? If we lose the ACA, we get nothing.

I hope our side is working on fight to the death to preserve ACA which is the only path to single payer.

[Ligyron]

24. Good info in this excellent thread.

[Bernardo de La Paz]

30. Republican Trump may call it "mean" but he endorsed it and was ready to SIGN it. . . nt

[More_Cowbell]

31. Some states will try to create healthcare for all

CA is working on it, and the NV legislature just passed a "medicaid for all" bill that the governor must either sign or veto by today, or it will become law on its own.

[hibbing]

33. Pessimistic

If I recall correctly, most Democratic candidates ran as far away from the ACA as possible, and not because it did not offer single payer or Medicare for all. It was because the plan was so demonized by the ruling class and their partners in the corporate media. Why didn't Democrats promote the dropping numbers of uninsured and the other benefits of some aspects of the plan? Maybe they did, but it certainly was overshadowed by negative portrayals of it. And now the narrative will be that it is collapsing because the other party is doing all they can to contribute to that. I hope I'm wrong, but that's just my feelings.

Peace

[JustABozoOnThisBus]

35. As if Democrats could ever pass Single-Payer

Insurance companies would just make contributions and job promises until they bought enough congresspeople to kill it.

It worked for pharmaceuticals during the Medicare Part D voting.

[Demsrule86]

36. That is bullshit...and any who don't fight for the death for Obamacare are foolish...we will never

get single payer for all if we lose the ACA...You would need a super super majority which is hard to get with a divided country.

[joet67]

38. This would be so much easier to do if Mitch McConnell was properly imprisoned.

I'm praying he is ensnared.

[Crash2Parties]

39. I fear their definition of "All"

If their solution is to enact Medicaire for all I fear "all" will explicitly exclude anyone who does not conform to their rather extreme moral standards. Health care like everything else they touch will become a mechanism to enforce their religious views.

Specifically, anyone who commits the sins of having a uterus but not wanting to be pregnant, &/or of being LGBT, but I'm sure there are a few other corners they'd gladly round off as well.

[MrScorpio]

40. That there is a lot of optimism about the American electorate

Maybe it's too much optimism to even be possible.

It remains to be seen.

[WestSeattle2]

41. Single payer - it's time. Cut the BS and just get it done. Constantly jerking Americans from one

health care plan to another is absurd. Find the money for your tax cut for billionaires somewhere else.