THE WEEKLY SCAN: Key Stories In The Debate On America’s Health Care Future

Good Friday afternoon, and welcome to the Weekly Scan.  Here are some of the key stories you may have missed in the debate on America’s health care future:

It was a tough week for supporters of Medicare for all, as the first round of Democratic presidential debates highlighted the serious risks – both practical and political – associated with a one-size-fits-all government-run system.

On Thursday night, Senator Michael Bennet (D-Colo.) reminded fellow 2020 contender Senator Bernie Sanders (I-Vt.) that the push for state-level Medicare for all in Sanders’s home state of Vermont failed because of the massive costs that would have been foisted on hardworking families through higher taxes.

• The Partnership for America’s Health Care Future pointed out that the state’s Democratic former Governor, who ran on a platform of one-size-fits-all heath care, also acknowledged that the 11.5 percent payroll tax and 9.5 percent income tax proposed to finance the system were too much for taxpayers to accept.  As Roll Call reports, “[t]he final bill was too much for the state to bear, he said.  ‘The biggest problem was money,’ Shumlin said …  And he couldn’t promise lawmakers that they wouldn’t need to hike taxes again later to accommodate rising health care costs.  ‘I couldn’t with a straight face turn to them and say, no, we’ve got this figured out,’ he said.”

Meanwhile, Senator Kamala Harris (D-Calif.) is once again struggling to square her claim that she does not support eliminating private health coverage with her support for Medicare for all – which eliminates private health coverage.  As HuffPost reported: “After taking several seemingly contradictory positions on the issue in recent months, Sen. Kamala Harris (D-Calif.) confirmed Thursday she supports abolishing private health insurance in favor of a government-run health care program for all Americans.”  But in post-debate interviews Thursday evening and on MSNBC’s “Morning Joe” Friday morning, Harris stated that she understood the question to have been about giving up her own private insurance, adding further confusion to what is viewed as an already perplexing set of statements by the Senator as she struggles to explain her support for Medicare for all, which eliminates private coverage.

• As HuffPost continues: The question about Medicare for All had tripped up Harris at a January town hall hosted by CNN, when she first appeared to call for the elimination of private health insurance …  But at another CNN town hall in April, Harris maintained that under Sanders’ bill, private insurance companies would actually still be able to offer some policies …  Harris attempted to clear up the matter during another interview in May with CNN’s Jake Tapper, maintaining that she didn’t intend to call for abolishing all insurance companies in January, even as she reaffirmed her support for Sanders’ Medicare for All proposal … When Tapper noted Sanders’ proposal would eliminate private health insurance, Harris again maintained: “No, no, no, no, it does not get rid of insurance.  It does not get rid of insurance.”  …  In reality, Sanders’ proposal would prohibit the sale of private insurance that is “duplicative” of what the government plan would offer, as HuffPost’s Jonathan Cohn wrote earlier this month: That would effectively wipe out existing employer policies.  Private insurers could still offer supplemental plans, but only to pay for extras, like cosmetic surgery and premium hospital rooms, that the government plan didn’t cover.  Public opinion regarding Medicare for All changes depending on how it is described to voters.  When respondents in one recent poll heard that Medicare for All would eliminate private insurance, for example, support dropped dramatically, with just 37% favoring it and 58% opposing.

Leading up to the debates, the Partnership for America’s Health Care Future issued a memo outlining the dangers of so-called “moderate” fallback plans, such as “Medicare buy-in” or “public option” schemes, and on Wednesday evening issued a statement pointing out that while some of the presidential hopefuls on the debate stage were quick to acknowledge Medicare for all’s high costs, middle-class tax hikes, and threats to patients’ access to quality care, “the government-run insurance systems supported by many of the candidates making these points – such as ‘Medicare buy-in’ or a ‘public option’ – are stepping stones to a one-size-fits-all system, and would ultimately lead to the same results.”

The Partnership also launched a timely, targeted digital advertising campaign to educate the American public on the realities of government-run insurance systems.  “If you’re watching the Democratic debate online tonight, expect to see a lot of the Partnership for America’s Health Care Future,” POLITICO reported. “The group is sponsoring YouTube’s homepage in 2020 early primary states, as well as in Miami and Washington, D.C. … It also will run video ads online, including on MSNBC’s platform.”  The Partnership also launched video ads on Twitter and Facebook and sponsored a health care-themed SnapChat geofilter around the debate venue. 

Meanwhile, as news outlets drew attention to the high costs and inevitable middle-class tax hikes that come with a one-size-fits-all health care system – with The New York Times reporting such a system “would not come cheaply” and ABC News noting that “health care experts have cautioned against [Medicare for all], which some estimates say could cost the federal government $32 trillion over 10 years” – Americans and local lawmakers also expressed concerns over government insurance programs ahead of the debates.

• The Miami Herald reports that the current field of presidential hopefuls’ proposals on issues like health care are “at odds with the messaging local lawmakers and Democrats want to hear,”including Rep. Donna Shalala (D-Fla.) who said, “I have not been for Medicare for all and I think all the candidates have had trouble defending their position.” 
• Sen. Joe Manchin (D-W.Va.) warned at an event hosted by The Hill: “We can’t even pay for Medicare for some and to go Medicare for All, we can’t take care of those who are depending on it right now.”
• And in an op-ed for RealClearHealth, Catherine Prato, Ph.D., a nurse and nurse educator in the early 2020 caucus state of Nevada, urged the nation’s leaders to focus on efforts to build and improve upon what is working in health care, not pursue one-size-fits-all government insurance systems, writing: “… [W]hen you dig into their consequences, the sad reality is that these systems would not only threaten patients’ access to quality care, but could even cause hospital closures, a shortage of health care professionals and less innovation for new treatments and cures … Although often touted as less extreme, in the end, so-called “buy-in” and “public option” proposals would have the same harmful effects, disrupting the marketplaces where Americans shop for coverage and moving everyone into a one-size-fits-all system run by politicians and bureaucrats.  To put it bluntly, these government insurance programs are a slippery slope to Medicare for all.” 

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