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The Politics: A Liberal Perspective ! The Medicare-For-All Act of 2017 (Part 2)
Sep 19, 2017 12:52:26   #
Doc110 Loc: York PA
 
09/17/2017 The Medicare-For-All Act of 2017; The Politics (Part 2) A Liberal Perspective !

Lambert Strether
https://www.nakedcapitalism.com/2017/09/medicare-act-2017-politics.html

Bernie Sanders conveniently omits funding mechanism from his single-payer plan
https://www.reviewjournal.com/opinion/editorials/editorial-bernie-sanders-conveniently-omits-funding-mechanism-from-his-single-payer-plan/


First, ZOMG!!! Dental !!!!!!

Besides being medically bad for you, poor teeth are a class marker that make it hard to get a job.

http://abcnews.go.com/Health/Dental/ways-poor-dental-care-makes-sick/story?id=15402772
https://www.nbcnews.com/feature/in-plain-sight/bad-teeth-broken-dreams-lack-dental-care-keeps-many-out-v18906511

I don’t think the Acela riders know what a huge difference dental would make in the flyover states, out in the colonies.

To me, this is huge (and an obvious vote-getter; who wants to depend on charity or the ER for dental care?

http://www.washingtonpost.com/sf/national/2017/05/13/the-painful-truth-about-teeth/?utm_term=.494532e12233

So pay attention, Sherrod!)

Second, the more complex issue of abortion provisions. From ReWire:

Sanders’ ‘Medicare for All’ Covers Abortion Care, Ends Hyde Amendment
https://rewire.news/article/2017/09/13/sanders-medicare-covers-abortion-care-ends-hyde-amendment/

Under Title VII, “Universal Medicare Trust Fund,” the text of Sanders’ bill appears to reference Hyde as one of the “restrictions that shall not apply.”

Specifically, “any other provision of law in effect on the date of enactment of this Act restricting the use of Federal funds for any reproductive health service shall not apply to monies in the Trust Fund”—

Meaning that Hyde couldn’t apply to Medicare funds.

Another section of the bill includes “comprehensive reproductive, maternity, and newborn care” within the scope of Medicare for All’s coverage.

Reproductive rights and justice advocates in August told Rewire that it’s just as important for Universal-Health-Care proposals to spell out abortion care within the scope of covered services as it is to end Hyde.

Their consensus now is that the bill’s “comprehensive reproductive care” includes abortion care, and they praised Sanders for it.


“Insurance coverage of abortion is critical to ensuring women can access the services they need, helping to protect women’s health and economic security,” Rachel Easter, the National Women’s Law Center’s counsel for reproductive rights and health, said in an email.

That recognition emerged during the drafting of the bill, which was “written to cover abortion, explicitly,” a Sanders staffer told Rewire Editor-in-Chief Jodi Jacobson.


From a purely political standpoint, one can only wonder what Clinton supporters who were able to swallow Clinton’s “never, ever” on single payer feel about abolishing the Hyde Amendment (which the ACA did not do.

Hillary Clinton: Single-Payer-Health-Care will "never, ever" happen
https://www.cbsnews.com/news/hillary-clinton-single-payer-health-care-will-never-ever-happen/

As Obama signed an Executive Order making sure the Hyde Amendment applied to Federal subsidies in his signature legislation).

Does Obamacare provide federal subsidies for elective abortions?
https://www.washingtonpost.com/news/fact-checker/wp/2015/01/26/does-obamacare-provide-federal-subsidies-for-elective-abortions/

I’d think they’d get on board the Bernie-Care train immediately, but what do I know?


Politics of the (Lack of) a Funding Proposal

Finally, Bernie-Care has been criticized because it lacks an explicit funding mechanism.

VT Digger:
Sanders unveils ‘Medicare for all’ to cheers, but dim prospects
https://vtdigger.org/2017/09/13/sanders-unveils-medicare-for-all-to-cheers-but-dim-prospects/#.Wb6050m0mNY

Observers said that the lack of a clear funding mechanism is a major weakness of Sanders’ new bill.

Gerald Friedman, an economics professor at the University of Massachusetts who has worked with Sanders on this issue.

Said that though he sees it as positive that many senators are getting behind single-payer, it is not very meaningful without a funding plan.

“Honestly this is not serious,” Friedman said.

“It’s a bumper sticker that ‘We want Single-Payer,’” Medicare-For-All, Government-Health-Care.

Without a proposal, he said, critics will say that Sanders is not serious about the proposal.

That it’s so expensive that supporters don’t want to discuss it, or that proponents couldn’t come up with a way to fund it — which, Friedman said, is not true.

“If you put out numbers, you’ll be criticized,” Friedman said.

“If you don’t put out numbers, it’s even worse.”

(As far as Friedman’s “not serious” comment, I hope you are convinced from the rest of the post that Bernie-Care has been carefully crafted to achieve the ends it achieved.

Another way of saying that is to ask:

“Would sixteen Senators have signed onto the bill if the funding mechanism were there?” I think the answer is no.)

I disagree, for several reasons.

1. First, Friedman is wrong; the Sanders white paper that accompanies the bill proposes several serious options.

2. Second, when making a sale, the price is part of the close. You don’t lead with it.

(Unless, I suppose, that’s your only selling point, which is not the case with Bernie-Care).

3. Third, the whole “Pay-Go” discussion, by design, is a recipe for setting winners and losers against each other from the start, which isn’t a recipe for passing the bill.

4. Fourth, as MMTers know, the political class doesn’t understand how taxes work anyhow.

If straightening them out is prerequisite for passing the bill, we’ll never get anywhere.

5. Fifth, this is an objection that can’t possibly be made in good faith:

Every other industrial nation has been able to afford “Universal-Health-Care, and several have adopted the single payer approach;

Last I checked, Canada hasn’t collapsed from fiscal exhaustion induced by funding its Medicare program.

So we can do it. Let the detail people figure out how.

In summary, I think it makes very good sense to take an approach programmers call “separation of concerns”;

Separate what the bill can do (save hundreds of billions of dollars and thousands of lives) from how to pay for it (a Beltway discourse that has any number of pathologies).

And if there are any wonks out there who operate in good faith, they’ll be getting on the Bernie-Care train by proposing funding mechanisms themselves, instead of whinging that Sanders didn’t pick one.


Conclusion

In summary, Bernie-Care could be said to be aspirational; after all (even though a reasonable number of Republican voters support Medicare-For-All, too) the bill won’t pass this year or even next year.

But I’m amazed and happy to see that single payer is finally “on the table” in the Senate, after Obama and the career “progressives” successfully kept it off the table in 2009.

For the next few months, at least, that’s victory enough.

In my next post, I’ll take a more detailed look at Bernie-Care as policy.


NOTES

[1] As Ian Welsh wrote: “The left must be seen to repudiate Obama, and they must be seen to take him down.

If the left does not do this, left wing politics and policies will be discredited with Obama.”

That didn’t happen with Obama. It did happen with Clinton.

[2] Of course, there’s always the scenario where the Democrat establishment, having hazed over the distinction between:

a. Medicare-For-All and

b. “Universal-Health-Care,”

c. Government-Health-Care

d. Conclude with a sigh that Bernie-Care is such a “heavy-lift” they can’t pass it.

And “reluctantly” go with some horrid bipartisan compromise, hoping to kick the can down the road for another eight years like Obama successfully did.

But politics ain’t beanbag!

If the left has real power, betrayals will be seen as punishable, even by opportunists.

(In retrospect, it was good that the left roughed Booker up on his pro-Big Pharma vote on drug importation.)

Slammed by left, Booker to join Sanders on drug imports
https://www.usatoday.com/story/news/politics/onpolitics/2017/02/27/booker-to-join-sanders-on-drug-imports/98500374/

Reply
Sep 19, 2017 14:54:17   #
Manning345 Loc: Richmond, Virginia
 
Will this bill support infanticide and euthanasia, or they a follow-on act? Will it cover ambulance service, and medivac helo services? Will it cover long-term care of the elderly? Will it cover literally all medical services such as transgender operations? Will it cover cosmetic operations such as breast augmentations, and face lifts?

Any one of these services could break the bank. I suspect, but haven't the data to prove, that even the basic services covered will also break the bank.

Reply
Sep 20, 2017 18:06:11   #
payne1000
 
Manning345 wrote:
Will this bill support infanticide and euthanasia, or they a follow-on act? Will it cover ambulance service, and medivac helo services? Will it cover long-term care of the elderly? Will it cover literally all medical services such as transgender operations? Will it cover cosmetic operations such as breast augmentations, and face lifts?

Any one of these services could break the bank. I suspect, but haven't the data to prove, that even the basic services covered will also break the bank.


Haven't you noticed that the bank has already been broken by the endless wars justified by endless lies?
It's way past time our government did something for the majority of Americans instead of sending them overseas to be killed or maimed in wars to make the privileged few richer.

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