Sen. Bernie Sanders, I-Vt., and his “Medicare-for-all” plan emerged victorious in New Hampshire’s presidential primary. Sanders captured more than one-fourth of voters in the Democratic primary, about 40 percent of whom said health care was the issue that mattered most when choosing a candidate.
Close on his heels are the Democratic moderates: Sen. Amy Klobuchar of Minnesota and former South Bend, Ind., Mayor Pete Buttigieg. Both have criticized “Medicare-for-all” and endorsed a “public option” – a government-chartered insurer that would compete against private health plans.
But there’s little daylight between Sanders, Klobuchar and Buttigieg on health care. Each candidate’s plan would eliminate private health insurance in the United States. The only difference between them is when it would happen.
Exit polls showed that nearly six in 10 New Hampshire primary voters favor “Medicare-for-all.” Unsurprisingly, Sanders claimed a plurality of these folks – 39 percent.
On the flip side, Buttigieg and Klobuchar each grabbed about one-third of the 37 percent of voters who oppose “Medicare-for-all.”
It’s easy to see why even many Democrats oppose “Medicare-for-all.” It would outlaw private insurance and force every American into a new government-run health plan. Taxpayers would be on the hook for more than $40 trillion in new federal spending over a decade.
Neither of those propositions is terribly popular. Nearly 60 percent of Americans oppose a “Medicare-for-all” plan that would eliminate private health insurance. A similar percentage oppose a plan that would force Americans to pay more in taxes.
That’s why the moderates are promoting the public option. They’re catering to the 87 percent of New Hampshire primary voters who support the idea – 54 percent of whom do so strongly. Public option supporters promise that they’ll guarantee Americans access to affordable coverage without taking away the private coverage that millions of Americans have and like.
Thirty-six percent of Buttigieg’s New Hampshire supporters oppose single-payer and favor a public option, as do 43 percent of Klobuchar’s voters.
But the public option would result in a government takeover of the health insurance system, just like “Medicare-for-all.”
The public option would have the luxury of paying health care providers at Medicare’s rates, which are about 40 percent less, on average, than those paid by private insurers.
To prevent providers from rebelling, the public option’s proponents would require doctors and hospitals to accept the new plan’s beneficiaries if they wanted to continue participating in other government programs, like Medicare.
Private health plans can’t dictate what they’ll pay providers. They have much less negotiating leverage with doctors and hospitals. So they would face higher costs than would the public plan. Covering those higher costs would require higher premiums.
Consumers would respond by jumping to the public option. As the number of people in each private insurer’s risk pool dwindled, they’d have to raise premiums further, to protect against the possibility of one catastrophic claim wiping them out. That would send yet more privately insured people into the embrace of the public option.
Eventually, private insurers would not have enough customers to stay in business. The public option would be the only option.
Given that reality, it’s no wonder Sanders ally Rep. Alexandria Ocasio-Cortez, D-N.Y., came out earlier this month with tepid support for a public option. “The worst-case scenario? We compromise deeply, and we end up getting a public option. Is that a nightmare? I don’t think so,” she told HuffPost.
The battle lines appear to have been drawn in the Democratic presidential primary. It’s Sanders versus the slightly more moderate Buttigieg and Klobuchar. But on health care, the candidates are all heading toward the same place – where government has complete control of our health coverage.