Kamala Harris’ healthcare plan has dropped, and it’s basically Medicare-for-all in 10 years, paid for by taxes on those making more than $100K and Wall Street transactions. It also allows private insurers to offer plans.
It seems like a reasonable plan, as do most of the others on offer by the many different candidates. But, as far as I’m concerned, the best thing Harris has said about healthcare is her response when asked how Democrats would pay for it:
Where was that question when the Republicans and Donald Trump passed a tax bill that benefits the top one percent and the biggest corporations in this country?
As soon as a Democrat proposes a healthcare plan, the media expects them begin a thought experiment in which they transport themselves to a special place east of the sun, west of the moon, north of Endor and south of Narnia, where their plan is adopted verbatim. Then they’re supposed to have instant answers to technical questions, and take the heat for any possible bad outcomes.
When Trump opens his gaping maw to sputter out a lie about healthcare, the same media just fucking nods their heads.
Any response from a Democrat on healthcare has to start with pointing out that whatever their plan says, they won’t be trying to take insurance away from Americans, as the Republicans have tried to do, again and again, for the last decade.
In short, “we’re going to cover more Americans and make it more affordable – details to come” should be a good enough “healthcare plan” when the other side is making little or no effort to do anything but prop up an expensive system that doesn’t work for a whole lot of people. Yet we’re starting down a path where we’re going to get wrapped around the axle of the little details of what Biden wants versus what Bernie wants versus Mayor Pete, etc.
Am I the only one who thinks this is a damaging waste of time?
Professor Bigfoot
No.
Baud
Agree 100%, MM. At least when it comes to reporters. We can debate merits of the details in house.
Princess
Yes, and I think we should respond, “It will pay for itself.” Which it actually might.
Butch
There are currently so many options I’ve forgotten which of the candidates responded this way, but when a reporter (I think it was Hallie Jackson) posed the gotcha “how are you going to pay for it” question, one of the candidates said “we’re already paying for it.” That’s the truth.
Ruckus
@Butch:
How are you going to pay for it is a misleading way to ask “How are the people who are getting wealthy off the suffering of others going to be able to continue to do so?”
Roger Moore
@Ruckus:
I don’t think that’s quite it. A lot of these proposals, especially the Medicare buy-in proposals, don’t do much to stop the profiteering; they’re about shifting the burden of paying for it all from poor and sick people to rich and healthy people. Since network news anchors are rich people who have great healthcare under the current system, they hate that idea.
Duane
Republicans get treated like babies.Except babies are cute, don’t intentionally hurt people, and will learn better.
Yarrow
Nope. If we’re talking plan details we’ll be losing. This election is a referendum on Trump. Keep the focus on him. Policy discussions should be wrapped up in whatever Trump has done that has hurt people/failed to do that has hurt people and how our candidate would do it differently.
rikyrah
Amene (@Ange_Amene) Tweeted:
Here are 5 things that Medicare currently doesn’t cover that Medic-aid does in all or some capacity:
Women’s healthcare
Pediatrics
Home healthcare long term
Dental
Mental health
Medicare is not some standard to acheive. https://twitter.com/Ange_Amene/status/1155904179476389894?s=17
chris
Pic of the day.
rikyrah
Amene (@Ange_Amene) Tweeted:
Medicare was designed for seniors.
There is a reason for that.
And Medicare will have to be redesigned to encompass all that. Medicaid does.
But why do that when we have a system in place that already does that? It makes no sense. https://twitter.com/Ange_Amene/status/1155904784508977152?s=17
Barbara
This is the reason my husband likes Harris. She fights back, and, importantly, doesn’t accept the ground rules laid out by the media.
@rikyrah: This list is misleading, but I will be the first to say that reforming Medicare to incorporate some features of Medicaid would be better than just sticking by the very flawed benefit design that is Medicare.
kindness
Some ‘Democrats’ love circular firing squads.
I haven’t figured what they get out of it really. Which is one of the reasons I have such difficulty understanding what is going through Bernie’s head.
rikyrah
Abubakr Al-Shamahi (@abubakrabdullah) Tweeted:
Three racist pricks decided to be big big men by throwing an ice slushie in my 62 year old mom’s face as my dad was driving in Birmingham. They’ve been in the country 40 years but nothing like that’s ever happened. But Islamophobia doesn’t exist apparently. Mama’s bruised but ok. https://twitter.com/abubakrabdullah/status/1155964308620054534?s=17
dmsilev
@kindness: Worth noting that Bernie’s Democraticness is an on-again-off-again sort of thing best described using the language of quantum mechanics. Sanders’ Cat, if you will.
MomSense
It’s not necessarily a waste of time but if it is taken too seriously it could be destructive. It doesn’t matter what the Dems propose if we don’t win the Senate. And if we get into a huge fight about 4 versus 10 years or Medicare only versus Medicare plus Medicare advantage plans and we tear our candidates apart in this primary contest – we won’t have the unity and energy needed to do the almost impossible job of winning the senate.
Eyes on the motherfucking prize, people. Eyes on the prize.
Paul W.
I don’t know that it will ultimately hurt all that much, I think a lot of primary and activist voters will be royally pissed at each other but once the bulk of the Democratic base tunes in (3rd debate, less people) they will bite their tongues because EVERYONE JUST WANTS TO WIN!
I think Kamala’s plan is a little too long, why not just set it for 6-8 years so it happens on your watch and you can guide the program home which helped cement ACA even as under attack as it is? However, it is practical, and passing that vote means you can move on to other critical issues (election protections, voting rights, THE ENVIRONMENT!) which is what has me most worried.
Anyways, looks like the current hot takes are all about “are Dems pushing so far to the left that they’re losing the election”, when what I actually wonder is are Dems doing enough (not just messaging bills) to show their voters that they will fight and we need to get elected into office for another round? Trump is being openly racist, it won’t help him in the polls and honestly masks Dems running a primary on the left (as they should).
MomSense
@rikyrah:
Like I’ve been saying since 2016 – Medicaid sounds like poor people’s insurance and Wilmer’s supporters, who skewed more affluent than Hillz’, don’t want anything to do with poor oeople’s Insurance. For a socialist, Wilmer lives proposals that benefit more affluent white people more than everyone else.
Kelly
It seems to me the problem with Medicaid for all is it is a state run program and the quality varies by state. Here in Oregon Medicaid (the Oregon Health Plan) is good insurance. I’d want a complete federal takeover to bring the low quality states up and put the entire cost in the federal budget.
cain
@Princess:
I could have sworn that Obama said the same thing about the ACA.
Yarrow
@kindness: He’s not a Democrat. He’s not in the circular firing squad. Using that analogy, he’s outside the circle shooting at Democrats.
germy
@Paul W.:
That’s an interesting point. I would hope the next Democratic president (2020) is two term to guide this through.
Baud
Obviously, if Dems weren’t serious about paying for their plans, they wouldn’t be proposing taxes to pay for them. But it’s important not to get into that because no amount of data will convince people of bad faith.
Baud
@cain:
No, the ACA was designed to be paid for by taxes. That was part of why it was such a heavy lift.
germy
Here’s how the right sees Harris’s plan:
Here’s how the left sees her plan:
Betty Cracker
@MomSense: Exactly right — Medicaid has poor people cooties, whereas Medicare does not because everyone’s mom or grandma are on it, so therefore, it is not the dole. I do not agree that this dumb pathology is confined to Sanders supporters; it’s way more widespread than that.
Honestly, I couldn’t give less of a shit how we get to a single payer system. If leveraging the “Medicare” name in the slogan makes it more palatable, so be it. There’s no one who supports “Medicare for All” who wants to use the Medicare benefits as the blueprint, thus excluding pediatric and maternity care, among other things. It’s about the payment mechanism. It’s a shorthand that people understand.
MomSense
@Baud:
The ACA still has a lot of taxes in it -even without the mandate.
MattF
@dmsilev: In fact, that cat is dead.
satby
No. And don’t ever for a minute doubt that it’s by design that the vaporware Republicans offer is accepted without much pushback while anything a Democrat proposes is subjected to a forensic analysis that would make Sherlock Holmes jealous.
zhena gogolia
@Butch:
Absolutely.
MomSense
@germy:
Assholes to the left of me, sociopaths to the right.
Here I am stuck being reasonable with you.
rikyrah
Paul Krugman (@paulkrugman) Tweeted:
This, from the Sanders campaign, exemplifies everything wrong with that campaign — smearing (and misrepresenting) a reasonable proposal that would make the US system resemble several successful European systems. Advocating pure single-payer is fine; smearing alternatives isn’t https://t.co/mofOfTcLJS https://twitter.com/paulkrugman/status/1156180284330663936?s=17
Barbara
@Paul W.: It has to be long to be done in an orderly fashion, however, if I were her I would add an “immediate sweetener” in the form of limiting balance and/or surprise billing from out of network providers for all classes of benefit types.
For those who are arguing Medicaid versus Medicare, let me just say what I always say when people gush about how wonderful Medicare is: It’s wonderful because the government supports and nurtures it in order to make it as good as it can be for those who rely on it. CMS views Medicare beneficiaries as citizens to be served and protected. Many states view Medicaid beneficiaries as a problem to be solved at the lowest cost possible. That’s the real difference, and I think it’s worthwhile for people who use Medicare rhetorically to be open to understanding that difference, and the very real limitations of the Medicare program versus other benefit plans, including Medicaid.
cain
@Baud:
Ah, ok. I must have mis-remembered then.
narya
I think it’s reasonable for the democrats to say something like, we all have the goal of ensuring that people have access to health care. We have proposed different paths to that goal, and I expect we will continue to examine the costs and benefits of each path, but that shared goal remains the same. We do not believe that people should go bankrupt because they needed medical care. We do not believe that people with pre-existing conditions should face discrimination. I respect my fellow Democrats’ approaches, and I am confident that most of our proposals would result in more people having insurance than the imaginary proposals that the Republicans tout.
Kelly
@Paul W.:
Some popular parts of whatever program we enact need to take start within a year or two of enactment. The four year lag on Obamacare was used by the R’s to make unsubstantiated BS criticisms. I’m inclined toward piecemeal fixes to existing programs. We should expect our next grip on power to be short. Removing the 400% subsidy cliff is quick. Upping subsidy levels is quick. Adding out of pocket limits to Medicare is quick. Once people have these benefits it will be harder for the R’s to claw them back. They will try.
Betty Cracker
@Barbara:
Excellent point, though, as I said at #26, I do not agree with the notion that people who “use Medicare rhetorically” don’t understand the difference in benefits; it’s shorthand for the funding mechanism. Literally NO ONE is arguing that the benefits package be extend to all as-is.
rikyrah
Kamala Harris Health Care Plan Exposes the Lie to ‘Single Payer’ Medicare
By Spandan
Barbara
@Kelly: Incorporate Medicare’s beneficiary out of pocket incremental billing protections — there are no surprise bills in Medicare.
Barbara
@rikyrah: This is totally spot on. Medicare has relied on private insurers for administration from day one, and then, for supplemental coverage, and then, for HMO alternative delivery of Medicare benefits.
rikyrah
@MomSense:
Well, you know that our Kay here has been saying that it should be Medicaid for all, and has chastised the left for running away from Medicaid, which she has seen with her own eyes be a game changer in her rural Ohio area. But, yes, they don’t like the poster children for Medicaid. Medicare has better poster children – White Middle Class folks.
But, Kay convinced me that it should be Medicaid for All.
Butch
@Ruckus: I guess I’m good at pointing out the obvious, but it bothers me because it’s so obviously asked as a “gotcha,” as in “you can’t possibly answer this question to my satisfaction no matter what you say.”
MomSense
@Betty Cracker:
The truth is that most elderly people have Medicare and Medicaid. Without Medicaid grandma won’t be able to stay in the nursing home.
low-tech cyclist
Hell yeah!
And despite being a total Warren fanboy, this sort of thing is why I’m starting to believe Harris would be the best candidate.
To quote Donald Trump from 2016, “You’re going to have such great health care, at a tiny fraction of the cost—and it’s going to be so easy.”
IOW, I disagree vehemently. The mistake of 2016 was that the Dems didn’t call out this sort of promise as being the equivalent of a cargo cult: there was no more connection between the making of the promise and the delivery of any results, than there was between natives hacking runways in the jungle of a tropical island, and planes flying in loaded with cargo.
I agree that it’s possible to get too deep in the weeds. But I think that in order to distinguish themselves from total charlatans like Trump (and increasingly the GOP in its entirety), it’s essential for Dems to provide at least an outline of how they’re going to get there from here, that people can look at and say whether it can or can’t be done.
Heated arguments in the Twitterverse about the candidates’ differing health care plans is a small price to pay for being able to draw that distinction. This time around, though, the Dems can’t forget to make it publicly and frequently.
Kelly
@Barbara: You are one of the most informative jackals on the blog. I’m 63 so my transition from Obamacare to Medicare is on the horizon. It took me a couple years to figure out Obamacare. I need to find the David Anderson of Medicare.
MomSense
@rikyrah:
I think it should be Medicaid for all, too. Hell, I betcha if we just expanded Medicaid from the lower incomes up – it would be much easier and cheaper to implement. Start with all states expanding Medicaid to 138% FPL, then 200 and so on.
The one hitch is that providers won’t like the lower reimbursement rates so we will have to deal with the cost of Medical school, and allowing providers like LNPs to operate at the limit of their certifications. We will need to readjust and have licensed nurse practitioners be a much larger share of primary care providers.
StringOnAStick
@rikyrah: From the very beginning I’ve loved the idea of the ACA and hoped it would get us to a system more like Switzerland or Germany. Everyone is covered, the cost is a payroll deduction and while insurance companies provide the coverage, they are heavily and aggressively regulated by the government so there are no “crap care” plans.
Right after the election I was going to a local political action group (it wasn’t Indivisible) that became obvious to me were all Wilmerites who wanted to bitch about D’s not going hard enough and that’s why we lost in their eyes. The main issue was Single Payer, so I brought up taking a look at the German or Swiss system, about how yes, there were insurance companies but they were highly regulated and coverage for all was guaranteed. The looks of wonder that such a thing could exist were fun. These were all “single payer or I will withhold my precious vote” types.
jl
” Am I the only one who thinks this is a damaging waste of time? ”
Probably not, but I think you are wrong. I think people want serious policy discussions, and 3 of 4 people who are at the top of the polls have spent more time on serious policy proposals. Hiding from the hard issues of delivering real relief to the deteriorating conditions for most people in this country is a mistake. This is a good time to have preliminary debates on direction for the general election. Vast majority of voters aren’t paying attention to the squabbles, and the millionaire corporate media news actor goofs are going to say the same lines no matter what happens in reality.
Barbara
@StringOnAStick: Yes, but Medicare Advantage is actually a good model for that, and so, basically, has been hiding in plain sight.
low-tech cyclist
@MomSense:
Yeppers. My wife’s 95 year old grandmother has been in a nursing home for several years now, and Medicaid is what pays for it. Medicare only covers a short period of time in such a facility – I can’t remember if it’s 30 days or 90 days, but it’s not much if your relative is going to need to be in a nursing care facility for the rest of their lives.
We really could use a more seamless system, though. The goal should be that people should not only be able to get the health care they need, but shouldn’t have to deal with the system’s complexities.
FlipYrWhig
The problem with just making big promises, and why it’s NOT a “damaging waste of time” even though Republicans get away with it and the media lets them off the hook, is that Democratic voters like to see themselves and their candidates as smart, certainly a lot smarter than Republicans. Democratic voters don’t necessarily crunch their own numbers but they like the assurance that someone has. That dynamic has a lot to do with why these things play out this way over and over and over again.
Barbara
@low-tech cyclist: It’s actually zero days. Medicare doesn’t pay for anything that isn’t calculated to provide actual medicare care. Skilled nursing facilities (SNFs) are covered, but not when they are used solely for residential purposes. Even hospice requires you to either take services at home or pay for room and board somewhere, a nursing home, residential hospice or whatever.
low-tech cyclist
@StringOnAStick:
A good short primer on this is Ezra Klein’s 2007 piece, “The Health of Nations,” which summarizes the Canadian, British, French, and German health care systems, along with our own VA.
low-tech cyclist
@Barbara: Thanks for the correction!
Betty Cracker
@MomSense: Definitely true for nursing home care, which Medicare doesn’t cover. Doesn’t change the brand perception.
Yarrow
@Barbara: Medicare coverage of skilled nursing facilities only begins after a patient has been admitted into the hospital for three days (in reality three nights past midnight). Hospitals don’t seem to want to admit patients if they don’t have to so they’ll put patients on the “observation” floor and that doesn’t count as admission for Medicare purposes.
A friend’s aunt was in observation for about a week and they wouldn’t admit her. So when they discharged her my friend had to bring her home to their house to care for her because there wasn’t any SNF coverage even though she’d been in the hospital for a week.
The Moar You Know
How uncouth of the uppity negress. You shall find me at my fainting couch, my precious pearls clutched firmly.
That is a question for a good white Republican to ask, not one to be asked of her betters by one of the lower classes.
Paul W.
@Barbara: I’m down with that, I wanted to just shorten it by 2-3 years so we can lock it and to your second point – anything that has the full backing and attention of the government intending to run it right will do well, including a slightly faster timeline.
rikyrah
@MomSense:
Tis true. The poster children for Medicaid SHOULD be Bob and Emily’s Grandma and Grandpa, who take up the largest PERCENTAGE of Medicaid Dollars…
But, we know those SHOULD BE Poster Children are hidden behind the current poster children for Medicaid:
Shaniqua, with her 3 kids by 3 Baby Daddies…
And Maria Rosa, with her 3 citizen Anchor Baby Children…….
THIS is the scam…and the reason why the left won’t fight for Medicaid for All.
Doug R
@Paul W.: Psst. It really is a 6-8 plan.
The 10 years is just to be not scary to the lead chip eating trumpers. Once the plan is on its way, if we keep the House, after a few years we can announce everything’s going well, insurers are stepping out of the way and the full plan can happen in 7 years.
jl
On second read, I may have missed Individual 1’s point.
I do agree that the Democratic candidates should all push back hard on corporate media double standard on ‘how to pay’, where the GOP is off the hook for anything they do, no matter how senseless, and the Democrats are hectored about it nonstop. They should do it up front, and I’d prefer the Jerry Brown/Barney Frank approach of directly calling the corporate media news celebs out on their double standard, to the news media celeb’s faces.
And I do agree that candidates should be very aggressive in being clear in correcting common critiques of, for example, many Medicare for All proposals that are wrong, and from some quarters, made in bad faith or for sensationalism. For example, correcting upfront attacks that, often intentionally, confuse current Medicare benefits with the more generous benefits in many proposals. But to do this, sometimes other candidates’ positions and statements will be caught up in the debate. Biden camp put out an attack on Harris’ Medicare proposal with a lot of BS in it, some of it similar to corporate media and GOP BS. No way to stop that, but calling out their BS in public, in hopes you can with the argument and make Biden pay in the debate is a good way to discourage Biden camp from doing that in future.
I think it is more difficult to separate what mistermix thinks are good things to say in the primary and bad things to say. But finding out which candidates have the ability to do it best is one reason we have primaries. So far, I think Warren and Harris are doing better than others. Which I think one reason they have risen in the polls and not dropped back into the pack, like for example, O’Rourke and Buttigeig.
germy
lumpkin
Also, remember trump making extravagant promises about his health care “plan”? Nobody ever asked how he was going to pay for it because everyone knew it was a lie.
Michael Allen
@rikyrah: @germy: Possibly a reason why we should not start out with a president who is 78 years old on their first day in office. They would be 86 at the end of a second term, and most 86 year old people, particularly men, are dead.
James E Powell
Definitely not. And I feel the same way about nearly every policy proposal. I suppose it’s the kind of thing that generates multiple diaries at the GOS, but in the larger world, the debate isn’t between various programs to address Problem A, but whether Problem A exists.
germy
catclub
@rikyrah: also long term nursing home care is medicaid, but oddly not medicare
gvg
Democratic candidates cannot get away with offering vaporware. Our voters are different than their voters. We ask questions and most of us expect reasonable answers. It is really the voters that have 2 standards, not only the media. It would probably help if our candidates could make this point more often.
I kind of disagree that the fact that the GOP tax plan and Trumps healthcare plan’s were vaporware was glossed over. I picked up on that easily and clearly and I think a lot of Democratic voters did too. The media did say it. They did not cover it endlessly like Benghazi emails, but it was said and published. Its part of why our voters chose democrats……and their voters didn’t. I don’t understand them honestly.
I will even point out that Sanders vaporware was part of why he LOST the democratic primaries.
So anyway, a democratic candidate HAS to provide smart realistic helpful plans. Republicans don’t. However it also is really pleasant for me to hear pushback and fight to the stupid republican BS. Any dem who doesn’t show some sass, is IMO not going to get any love. We are kind of tired of being trampled by the mean stupid clods. On the other hand, I do think I would like hearing from any of ours that they aren’t stubborn purists, that they will add any good ideas after the primaries and that Congress
Mart
Did you not just see Dear Leader pin the Presidential Medal of Freedom on the chest of the brilliant Yalie Arthur Laffer, whose curveth has proven that rich people’s tax cuts drive the economic engine into overdrive so they pay for themselves? (How come we are not allowed any fairy tales to be treated as conventional wisdom?)
Ruckus
@narya:
Medicare is popular now because everyone’s parents are/will be using it. Most aren’t familiar with it’s costs and limits, unless they, or someone they know are using it. So as a name, it has power. As an actual law, it has real limitations. So once again most get something, those with extra money get a lot better. Whatever we do, there will be winners and losers. How do you think that might go?
Darrin Ziliak (formerly glocksman)
Last year, I was awarded SSDI based on a heart condition and a bad knee.
Soon I will be eligible for Medicare, but to be honest, Medicare is both more expensive and offers less coverage than my state’s Medicaid plan (Indiana’s HIP State Plus) that I’m currently on. The plus level of coverage costs $20/month for zero copays on prescriptions, inpatient services, office visits, etc.
Personally I’d rather not switch and keep the HIP plan, but I think I’ll be forced to switch soon.