July 26, 2019 | Updates

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:

Senator Cory Booker (D-N.J.) became the latest Democratic presidential hopeful to confirm that a new government insurance system known as the “public option” is designed to lead to Medicare for all, meaning it would ultimately subject Americans to the same high costs, unaffordable tax increases, loss of consumer choice and diminished access to high-quality health care.  In an interview with Dana Bash of CNN, Booker said“Medicare for all is what we should be going for, but the first step getting there has to be showing that we can create a public option, or allowing Medicare to be available for more people.”
Joining a growing group of experts who confirm that the “public option” would ultimately lead to a one-size-fits-all, government-run system, the Pacific Research Institute’s Sally Pipes explained how the “public option would gradually destroy the private insurance market — and ultimately result in single-payer healthcare.”

Biden’s public option would be able to under-price private insurers for two reasons.  First, it wouldn’t have to break even, much less make a profit.  Federal taxpayers would be called on to fill in any gaps in the program’s finances.  Second, it would pay doctors and hospitals Medicare’s rates, which are lower than those for private insurance  Many Americans who shop for coverage on the individual market would therefore opt for the low-cost public option.  Employers may be tempted to scrap the coverage they provide and dump their employees into the public option, too … Many would love to offload that cost onto their employees, with assistance from taxpayers.  As enrollment in the public option swells, doctors and hospitals would need to raise the rates they charge private insurers in order to balance their books.  Insurers would raise premiums in response, and yet more people would jump to the public option.  The cycle would repeat, until private insurers found themselves without any customers.  Eventually, the public option would be the only option. 

Meanwhile, The Washington Post reported that “Democrats in swing districts are increasingly worried that the outspoken embrace of Medicare-for-all by Bernie Sanders and other top Democratic presidential hopefuls could hurt their chances of keeping the House in 2020.”

That pitch does not sit well with many Democratic House members, especially those in centrist districts who helped deliver the House majority to Democrats in 2018.  “I think it’s a losing message for 2020, and I think the Democratic presidential candidates have to realize that this is not a far-left country nor is it a far-right country,” said Rep. Anthony Brindisi (D-N.Y.), speaking in the Capitol that afternoon.  “I think we’re all very vulnerable the further to the left some of the presidential candidates go.”  Brindisi, who unseated a Republican in a central New York battleground district last November, is the kind of freshman Democrat whose fate is likely to determine whether the party retains its majority in the House … That surge from the left puts Brindisi, Schrier and other Democratic centrists in a tough spot.  The more than 40 Democrats who took House seats from Republicans in 2018 are by definition from swing districts, and their voters generally favor a more cautious approach.

And labor leaders are warning that a “Democratic nominee who supports replacing private health insurance with a government-run system would lose union voters in battleground states.”

Labor leaders in heartland battlegrounds said rank-and-file members support former President Barack Obama’s Affordable Care Act, which includes private plans, and are jealously protective of expansive health benefits won in tough negotiations with corporate employers … “We don’t support the ‘Medicare for all’ structure.  We certainly aren’t in support of a government-control, government-run system at the expense of those that currently have employer-provided, or union-negotiated, plans,” said Harold Schaitberger, general president of the International Association of Firefighters … Ditto, said Gary Steinbeck, an official with the AFL-CIO labor council in Mahoning and Trumbull counties in Ohio … “The members have a comfort level with private insurance, and to eliminate that would be a problem,” said Steinbeck, who spent a quarter century with United Steelworkers.  “It would definitely create a problem trying to get votes from labor folks.”

Finally, as some candidates and lawmakers continue to push risky proposals to expand Medicare, the Partnership for America’s Health Care Future issued a reminder that the program’s trustees warn it is already at risk ahead of its 54th anniversary later this month.  A recent report from the trustees paints a picture of its future described in news reports as “troubled,” “shaky,” “grim” and “sobering.”



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