Medicare for All

And the Two Issues that Bookend the Debate

Medicare for All could eliminate the private health insurance industry

Health care, and how to pay for it, is a big issue on the campaign trail because it is a big issue for just about everyone in America.  Elizabeth Warren and Bernie Sanders both support Medicare for All.  They both want single payer, through the government, instead of the current mix of public and private insurance.

Medicare for All seeks to deal with problems associated with our current health system - rising costs, denied treatment and medication, and personal bankruptcies caused by medical expenses.  It introduces a big, contentious issue (beyond higher taxes) - eliminating an entire industry in a short time.  

From a New York Times March 23, 2019 article titled "Medicare for all Would Abolish Private Insurance.  'There's no Precedent in American History'", authors Reed Abelson and Margot Sanger-Katz write:  "But doing away with an entire industry would also be profoundly disruptive.  The private health insurance business employs at least a half million people, covers about 250 million Americans, and generates roughly a trillion dollars in revenues.  Its companies' stocks are a staple of the mutual funds that make up millions of Americans' retirement savings."

And yet, because private health insurance companies are in business to make money, customers are often denied coverage.

From a March 19, 2019 article in InTheseTimes.com titled "Yes, We're Coming for your Private Insurance Plan", author Natalie Shure writes:  "The reliance on private insurance creates structural obstacles to reform.  For instance, a piecemeal web of competing insurance plans makes it difficult for any given insurer to command any leverage in negotiating prices with healthcare providers and drug companies."

There are other reasons why healthcare, in its current form, is so expensive in the U.S.  One driver of these costs is lack of transparency.  From a July 31, 2018 Wall St. Journal article titled "Why Americans Spend so much on Health Care - in 12 Charts", author Joseph Walker writes:  "Among the reasons is the troubling fact that few people in health care, from consumers to doctors to hospitals to insurers, know the true cost of what they are buying and selling.  Providers, manufacturers and middle men operate in an opaque market that can mask their role and their cut of the revenue."

Walker continues:  "One reason prices are rising:  Hospitals are becoming more consolidated and are using their market clout to negotiate higher prices from insurers."

Supporters of Medicare for All assert that only the federal government is large enough to bend the cost curve down.

Medicare for All may very well be able to erase many of the problems found in the current health care system.  In the plans supported by Bernie Sanders and Elizabeth Warren, though, it introduces a huge, troublesome issue - eliminating an entire industry and the jobs that go with it.

Is Joe Biden going to save the Democrats in 2020?

What is his compelling message?

Is Joe Biden a knight in shining armor?

Joe Biden has been leading by double digits in the polls for the Democratic Presidential nominee since before  he announced his candidacy.  Elizabeth Warren is inching up, but still has a lot of catching up to do.

Oddly, Biden doesn't seem to have a positive reason for running.  Mostly he wants to defeat Trump.  He also doesn't have large, enthusiastic rallies, as some of the other candidates do.

A 9/3/19 article in the New York Times by Mark Leibovich titled "So Why's Joe Biden want this job?  Um, tough one" discusses "the paradox of the leading candidate not having a compelling reason to run.  When asked by a reporter why he wanted to run, Biden responded with "I think it's really, really, really important that Donald Trump not be re-elected.""

If Joe Biden had not been vice-president during Obama's term in office, would he be leading in the polls now?  Is his implied promise to return America to the halcyon days before Trump enough to beat Trump?  Is it even enough for him to get the nomination?

Thinking about the candidates in the most superficial way possible, I could not say what Biden stands for beyond defeating Trump.  Elizabeth Warren wants to stop corruption in Washington D.C., offer Medicare for all, and help people with onerous student loan debt.  Bernie Sanders also wants Medicare for all, a $15 minimum wage, and to help people burdened with college loan debt.

I looked at the websites of the three top candidates.  Biden, by far, has the most detailed and expansive plans for topics ranging from health care to education to criminal justice reform.  No one could accuse him and his team of skimping on the depth and breadth of his positions.  Notably, he doesn't say how he would pay for anything.  And he still doesn't seem to have "that vision thing" (thank you George H.W. Bush).

Biden's website opens with:  "Our Best Days Still Lie Ahead."  The three pillars that support this statement are:  1.  We've got to rebuild the backbone of the country, the Middle Class.

2. We've got to demonstrate respected leadership on the world stage.

3. We've got to make sure our democracy includes everyone.

I cannot seen any reasonable person disagreeing with these statements.  I cannot see, anyone either, being propelled into the streets to support them. 

Elizabeth Warren's website has an urgent sounding headline:  "We will Save our Democracy."  (If we need to save it, it must be in peril - a lot of people are thinking that.)

Warren's website, despite her mantra "I have a plan for that" is much less detailed than Biden's.  Unlike Biden, she says how she is going to pay for everything.

What Warren's site lacks in details it makes up for it with arguments that many will find visceral and compelling.  For instance, one of the items on the site is:  "Rebuild the Middle Class", followed by "After decades of largely flat wages and exploding household costs, millions of families can barely breathe.  It's time for big, structural changes to put economic power back in the hands of the American people."

This phrase delivers a punch to the gut (mine, at least).  I didn't experience that on Biden's website.

Ironically, the nerdy, wonky Elizabeth Warren seems to "feel your pain" (thank you, Bill Clinton), more than the touchy, feely Joe Biden.  The next debate may shed light on whether Joe Biden has a different rationale for running for president, and, if it even matters in the long run.