Democrats — especially on the presidential debate stage — have been throwing around the term “Medicare for All” for quite some time, confusing the American electorate on the different policy proposals the umbrella phrase could be referring to.
To set the record straight, a panel of elected leaders and policy experts Tuesday hosted a discussion in a San Jose union hall to unravel one presidential hopeful’s policy plan for a nationalized health care system.
The three-person panel, hosted at Laborers Local 270 and moderated by Ryan Skolnick, a community organizer for the California Nurses Association, included Silicon Valley Congressman Ro Khanna, California Assemblymember Ash Kalra and Jennifer Holm, a California Nurses Association Board Member.
Democratic contenders vying for the nation’s highest office have spewed promises to provide Americans with some form of national health care coverage, often hashing out their differences in plans on the debate stage.
While various proposals are floating around, ranging from a single-payer, public option to a full-blown government-run plan, one contender’s ambitious bill has stood out as it aims to turn the country’s current system on its head — presidential candidate Sen. Bernie Sanders’ “Medicare for All.”
Khanna, a rising star in the Democratic Party, has championed Sanders’ bill, calling the proposal a matter of “political will.” He also serves as the Vermont senator’s national campaign co-chair.
“My view is this is no longer an intellectual argument — it’s a political argument. We have to stand up to the few special interests that are standing in the way with public policy,” Khanna said. “The economics are so clear.”
Currently, the existing Medicare system — a 55-year-old program that only applies to seniors 65 and older and people with disabilities — covers a limited range of health care services such as inpatient hospital stays, medical supplies and hospice care.
But Sanders — a staunch progressive falling to the far left of his challengers — wants to change that. In April 2019, Sanders introduced “Medicare for All,” a bill that proposes to create a national health insurance program, extending beyond the scope of the nation’s existing Medicare program by providing coverage to everyone and including dental, hearing, vision, long-term care, mental health services, substance abuse treatment, reproductive and maternity care to name a few — at zero cost.
That means no premiums, deductibles or co-payments for patients. Everything from prescription drugs and doctor visits to emergency room stays would be covered under the plan, eliminating the need for private health insurance companies.
But the plan comes at a cost to taxpayers, even Sanders admits, and is expected to cost trillions of dollars.
Holm, a nurse herself, said the current health care system is “heart-shattering” because it allows someone to lose a limb for a treatable infection or forces parents to “do the math” on whether or not they can afford to save their child. Currently, the number of uninsured Americans climbed to 27 million in 2018, according to federal data released last November. Skolnick added to that sentiment, claiming employer health care costs will double over the next decade, posing a larger threat to the average American in need of health care.
“It doesn’t have to be this way,” Holm said, adding that Medicare for All would benefit health care professionals, such as nurses, by reducing bureaucratic processes, billing paperwork and the ethical strain they face when patients can’t pay for the services they provide.
But in the crowded auditorium Tuesday, many questioned the plan’s practicality and what it would cost taxpayers, challenging the idea that a dominant single-payer plan was a viable solution to the country’s fragmented system.
“Ultimately, I think ‘Medicare for All’ is the right answer for our country. However, how to get there is what I’m concerned about,” said Victor Saka, 73, a San Jose resident of more than 40 years. Saka said he supports expanding the current Medicare system as a public option, but is on the fence about Sanders’ plan.
“If we find a way to transition into Medicare for all who want it, I think it reduces the risk of failure,” he added.
Under the current system, a variety of health care payers come into play — statewide programs such as Medicaid, federal government care such as Medicare or private insurance companies provided for by employers or the individual. To quell some of those concerns, Khanna said the proposed plan would not happen overnight — instead following a four-year period where a new age group would gain coverage incrementally.
Holm said a variety of solutions could help pay for the plan’s hefty cost, averaging to about $34 trillion dollars over ten years, including a progressive payroll tax, a tax on Wall Street transactions or a new nationwide tax.
Democrats running on health care have sparred with one another over a host of different policy proposals. While the Democrats’ goal is to reach a point where each American is covered, the remaining presidential candidates have endlessly bickered about how to get there.
Some have proposed plans to replace all private health insurance companies with a single government provider, such as Sanders, while others have debated a public option, where an individual can choose to buy into a government run plan like Medicare instead of being forced into it. This alternative would allow people to choose a government-run option or continue to pay for private insurance.
Despite the audience’s apprehension, the panel said it was important to focus on the facts, instead of relying on misinformation as competing proposals dominate the headlines.
For Kalra, the reason to support “Medicare for All” is simple — it’s about saving lives, he said.
“Having our country represent the values and ideals that we espouse to — about having liberty, freedom, happiness and caring for one another — well, we’re not living up to those ideals as it applies to our healthcare system,” he said.