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Gradualism and the fight over Single Payer
Well this is quite the article!
Big snippets here, make sure to read full article.
However, Hillary Clinton and her supporters are making a terrible argument for gradualism.
http://www.lawyersgunsmoneyblog.com/2016/02/gradualism-and-single-payer
For all that Bernie Sanders has been criticized for not having a detailed enough plan for his single payer proposal, the following is the grand total of Hillary Clinton’s proposals for health care reform on her website:
These random paragraphs and bullet points, needless to say, don’t exactly live up to even the basic requirements for a health care plan, let alone the more stringent standards being applied to Bernie Sanders’ proposals. And while Hillary Clinton’s campaign did send out a four page PDF last year, it’s notable that you can’t find it in the health care section of her own website, and even then it’s still rather bare-bones and small potatoes at that: three free annual doctors’ visits, a tax credit for insured Americans with high out-of-pocket expenses, improved transparency in medical bills, and so on. About the only significant element of her proposal is a “fallback process for states that do not have the authority to modify or block health insurance premium rate increases,” and even that’s incredibly sketchy.
What’s missing in all of this is a sense of directionality – how any of these changes will lead to a genuine universal health care system. There’s nothing here about covering the seven million immigrants who don’t qualify for Medicaid or health insurance subsidies, or the four million Americans who are stuck in the Medicaid gap in the red states, or the 7.7 million young people who aren’t getting health insurance from their employers and who can’t afford the premiums on the exchanges, or the 14.4 million other Americans who aren’t going to be covered either. There’s nothing here about expanding the tax credit subsidies on the exchanges to make health insurance genuinely affordable, or increasing minimum insurance standards to make insurance plans provide quality health coverage. And there’s certainly nothing here about improving on the Medicaid expansion by creating a genuine public option – let alone how we could build upon public programs to gradually achieve a single payer system. This is kind of weird when you think about it, because this is all pretty obvious stuff that even a young policy-blogging grad student like me thought of back in 2010.
And this brings me to an important topic. There are genuine limitations to the ACA, but the ACA is being used by some Democrats to block further health care reform. We see in in the national primaries, where Clinton and her surrogates argue that Bernie’s proposals for single payer threaten to undo Obamacare. But we’re also seeing it at the state level – for example, in California in 2012, California’s single-payer bill was defeated when six Democrats in the state legislature walked sideways, arguing that the state needed to focus on implementing the ACA instead. In 2014, a Democratic insurance commissioner’s initiative to give the commissioner the power to reject health insurance premium increases was defeated after a campaign that argued that this would destroy the ACA.
http://www.lawyersgunsmoneyblog.com/2016/02/gradualism-and-single-payer
For all that Bernie Sanders has been criticized for not having a detailed enough plan for his single payer proposal, the following is the grand total of Hillary Clinton’s proposals for health care reform on her website:
These random paragraphs and bullet points, needless to say, don’t exactly live up to even the basic requirements for a health care plan, let alone the more stringent standards being applied to Bernie Sanders’ proposals. And while Hillary Clinton’s campaign did send out a four page PDF last year, it’s notable that you can’t find it in the health care section of her own website, and even then it’s still rather bare-bones and small potatoes at that: three free annual doctors’ visits, a tax credit for insured Americans with high out-of-pocket expenses, improved transparency in medical bills, and so on. About the only significant element of her proposal is a “fallback process for states that do not have the authority to modify or block health insurance premium rate increases,” and even that’s incredibly sketchy.
What’s missing in all of this is a sense of directionality – how any of these changes will lead to a genuine universal health care system. There’s nothing here about covering the seven million immigrants who don’t qualify for Medicaid or health insurance subsidies, or the four million Americans who are stuck in the Medicaid gap in the red states, or the 7.7 million young people who aren’t getting health insurance from their employers and who can’t afford the premiums on the exchanges, or the 14.4 million other Americans who aren’t going to be covered either. There’s nothing here about expanding the tax credit subsidies on the exchanges to make health insurance genuinely affordable, or increasing minimum insurance standards to make insurance plans provide quality health coverage. And there’s certainly nothing here about improving on the Medicaid expansion by creating a genuine public option – let alone how we could build upon public programs to gradually achieve a single payer system. This is kind of weird when you think about it, because this is all pretty obvious stuff that even a young policy-blogging grad student like me thought of back in 2010.
And this brings me to an important topic. There are genuine limitations to the ACA, but the ACA is being used by some Democrats to block further health care reform. We see in in the national primaries, where Clinton and her surrogates argue that Bernie’s proposals for single payer threaten to undo Obamacare. But we’re also seeing it at the state level – for example, in California in 2012, California’s single-payer bill was defeated when six Democrats in the state legislature walked sideways, arguing that the state needed to focus on implementing the ACA instead. In 2014, a Democratic insurance commissioner’s initiative to give the commissioner the power to reject health insurance premium increases was defeated after a campaign that argued that this would destroy the ACA.
