World's Best Healthcare (If You Can Afford It)

Here are the choices, as Warren sees them:

Option 1: Maintain our current system, which will cost the country $52 trillion over ten years. And under that current system –

24 million people won’t have coverage, and millions can’t get long-term care.

63 million have coverage gaps or substandard coverage that could break down if they actually get sick. And millions who have health insurance will end up going broke at least in part from medical costs anyway.

Together, the American people will pay $11 trillion of that bill themselves in the form of premiums, deductibles, copays, out-of-network, and other expensive medical equipment and care they pay for out-of-pocket – all while America’s wealthiest individuals and biggest companies pay far less in taxes than in other major countries.

Option 2: Switch to my approach to Medicare for All, which would cost the country just under $52 trillion over ten years. Under this new system –

Every person in America – all 331 million people – will have full health coverage, and coverage for long-term care.

Everybody gets the doctors and the treatments they need, when they need them. No more restrictive provider networks, no more insurance companies denying coverage for prescribed treatments, and no more going broke over medical bills.

The $11 trillion in household insurance and out-of-pocket expenses projected under our current system goes right back into the pockets of America’s working people. And we make up the difference with targeted spending cuts, new taxes on giant corporations and the richest 1% of Americans, and by cracking down on tax evasion and fraud. Not one penny in middle-class tax increases.

That’s it. That’s the choice. A broken system that leaves millions behind while costs keep going up and insurance companies keep sucking billions of dollars in profits out of the system – or, for about the same amount of money, a new system that drives down overall health costs and, on average, relieves the typical middle class families of $12,400 in insurance premiums and other related health care costs.

She framed it as a choice — good! It’s irritating that candidates who advocate for a complete overhaul of our shitty, inefficient, expensive healthcare delivery system are accused of engaging in radical pipe dreams, whereas it’s not considered “radical” to accept the status quo or actively make things worse, as Trump is doing.

People who want to keep private insurance without a “radical” overhaul are accepting a situation where tens of millions go without insurance, people die due to lack of insulin, infant mortality rates are rising, life expectancy is decreasing, redundant insurance bureaucracies dream up arcane ways to withhold care to fund fat cat CEO salaries, etc., etc., etc.

If Warren and Sanders have to defend the costs of M4A — and it’s fair to ask them to do that! — people who want to keep private insurance companies in business should have to describe in detail why it’s necessary to put up with the rent-seeking inherent in the current system. Maybe they’re right and incrementalism is the only way to go! But they shouldn’t get a pass on making that case. Warren throws down that gauntlet here:

Every candidate who opposes my long-term goal of Medicare for All should explain why the “choice” of private insurance plans is more important than being able to choose the doctor that’s best for you without worrying about whether they are in-network or not. Why it’s more important than being able to choose the right prescription drug for you without worrying about massive differences in copays. Why it’s more important than being able to choose to start a small business or choose the job you want without worrying about where your health care coverage will be coming from and how much it will cost.

Every candidate who opposes my long-term goal of Medicare for All should put forward their own plan to cover everyone, without costing the country anything more in health care spending, and while putting $11 trillion back in the pockets of the American people by eliminating premiums and virtually eliminating out-of-pocket costs. Or, if they are unwilling to do that, they should concede that they think it’s more important to protect the eye-popping profits of private insurers and drug companies and the immense fortunes of the top 1% and giant corporations, rather than provide transformative financial relief for hundreds of millions of American families.

And every candidate who opposes my long-term goal of Medicare for All should put forward their own plan to make sure every single person in America can get high-quality health care and won’t go broke – and fully explain how they intend to pay for it. Or, if they are unwilling to do that, concede that their half-measures will leave millions behind.

And make no mistake – any candidate who opposes my long-term goal of Medicare for All and refuses to answer these questions directly should concede that they have no real strategy for helping the American people address the crushing costs of health care in this country. We need plans, not slogans.

Warren says she’ll release details of how to transition to the plan here:

In the weeks ahead, I will propose a transition plan that will specifically address how I would use this time to begin providing immediate financial relief to struggling families, rein in out-of-control health care costs, increase coverage, and save lives. My transition plan will take seriously and address substantively the concerns of unions, individuals with private insurance, hospitals, people who work for private health insurers, and medical professionals who worry about what a new system will mean for them. It will also grapple directly with the entrenched political and economic interests that would spend freely, as they have throughout modern American history, to influence politicians and try to frighten the American people into rejecting a plan that would save them thousands of dollars a year on premiums and deductibles while making sure they can always see the health care providers they need with false claims and scare tactics.

The Bernie Bros on Twitter are already yelling “sell-out” over the transition. I wonder how Sanders will respond? He probably won’t. IIRC, he indicated he wasn’t planning to get into the weeds, but Warren sort of had to, being the Plan Lady and all…

Anyhoo, Krugman made a great point on Twitter about Warren’s plan. It’s de-Twitterized below:

There will be endless arguments about whether her cost estimates are too low and her revenue estimates too high, but they were put together by knowledgeable people — including former top Obama officials. This is a real plan, not a trickle-down fantasy… Will the plan be debated on stage? I hope not. The issues are far too technical to settle in sound bites and one-liners. And frankly, the Dem debates have already devoted too much time to health relative to other issues…

My sense is that while Warren’s embrace of Medicare for all was a questionable political decision, she has now passed an important test: providing a plausible way it could happen without big middle-class tax hikes… Maybe we can now starting talking about things that are much more likely to happen in the near future, like child care, or where the president has a lot of discretionary power, like environmental protection.

What he said. I look forward to Warren’s transition plan and hope it explicitly acknowledges that M4A is the goal — the starting point around which to build consensus and push legislation — and that achieving it would require huge Democratic majorities, which can only be delivered by an enthusiastic and engaged electorate.

In past speeches and writings, Warren has said rooting out corruption and reducing the influence of wealthy special interests in government would be her top priority because nothing else is possible without that. She has also said that “big, structural change” of the type she’s advocating will take a movement, not an election. She’s right.