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:

Bloomberg reports that “health-care policy experts on both sides of the political spectrum” are debunking Senator Bernie Sanders’s (I-Vt.) claim that under Medicare for all, the “vast majority of the people in this country will be paying significantly less,” finding that “[f]or many Americans, though, that would not be true,” and “higher taxes would exceed any savings.”  They write:

Yet the 181 million taxpayers with employer-sponsored coverage could miss out on the benefits of the Sanders plan, and even those receiving Medicaid could pay more, according to health-care policy experts on both sides of the political spectrum … Sanders has proposed a wealth tax, a bank levy and premiums paid by employers and employees.  But that only raises about half of what is needed, meaning that payroll taxes and income tax increases would necessarily have to be part of the plan.  “There are likely to be a lot more losers than winners,” Brian Riedl, a senior fellow at the right-leaning Manhattan Institute.  “It’s hard to do the tax shift without making most families losers.” … Many of the 181 million taxpayers with employer-sponsored coverage are likely to see their taxes go higher than their current health care spending, because about 56% of their medical costs are covered by their company, according to the Milliman Medical Index, which tracks annual health care spending.  For example, a person making $50,000 with employer-sponsored coverage spends about $5,250 annually on health care, meaning that under Sanders’s plan, her or his taxes would be nearly double the person’s current health care costs … Those on Medicaid, the government-sponsored insurance program for the poor, are likely to see their tax burdens rise far beyond their current health spending, Riedl said.

In an interview on Sunday, ABC’s George Stephanopoulos questioned Senator Sanders on the unpopularity of Medicare for all, pointing to polling data from the Kaiser Family Foundation: “When you talk about eliminating private health insurance, support flips, you get 58 percent opposed.  It gets even worse when you tell Americans they’re going to have to pay more taxes, which you have conceded.  Look at that right there, it goes to 37 percent favor, 60 percent oppose.  So it appears you’re pushing something people say they don’t want.”

• Bolstering that point, a new CNN poll finds that “just 21% say they favor national health insurance and that it should completely replace private health insurance.  Among potential Democratic voters, just 30% feel that way.”

Perhaps this explains why, as The Hill notes, there is such a “discrepancy between those who have supported the Sanders [Medicare for all] bill on and off the debate stage,” as “[o]nly a few White House hopefuls raised their hands when asked at last week’s debates if they were willing to abolish private insurers, even though others who were on the stage have publicly backed legislation from Sen. Bernie Sanders (I-Vt.) which would do just that … [M]uch of the voting public isn’t ready to give up their private insurance.  [Senator Kamala] Harris has waffled on the issue of private insurance for months, despite being a co-sponsor of Sanders’s legislation.  But she isn’t the only candidate in this situation.”

And a report from Axios this week provides yet another reminder of the negative impacts that proposed “steep cuts” to provider payment rates could have on Americans under a new government insurance system: “Medicare for All would result in payment cuts for most providers, and a recent analysis in JAMA by Harvard’s Zirui Song takes a look at just how steep those cuts would be.  Many specialties would still take a pay cut even under versions of ‘Medicare for All’ that aren’t as full-throated as what Sen. Bernie Sanders has proposed,” which would include so-called “buy-in” or “public option” systems.

• Notably, presidential candidates acknowledged during last week’s debates that so-called “moderate” alternatives to Medicare for all – new government insurance systems such as “buy-in” and “public option” schemes – are designed to produce the same result: a one-size-fits-all health care system run by Washington, and as such would ultimately present Americans with the same high costs, unaffordable tax increases, and diminished access to high-quality health care.  Senator Kirsten Gillibrand (D-N.Y.) said: “The truth is, if you have a buy-in over a four or five year period, you move us to single payer more quickly,” adding that under such a system, “our step to single payer is so short.”  And Mayor Pete Buttigieg (D-Ind.) emphasized that a “buy-in” or “public option” system “will be a very natural glide path to the single payer environment.” 

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