Democrats have decided to stop worrying and embrace government-run, single-payer health care.
On July 19, 70 House members launched a new Medicare for All caucus. A House bill to implement single-payer — H.R. 676 — already has 122 cosponsors, about two-thirds of House Democrats.
Democratic National Committee Deputy Chair Rep. Keith Ellison has become the lead sponsor of the measure, declaring Medicare for All “an idea whose time has come.”
What was once merely a dream is now, many Democrats believe, only a couple of elections away. But Medicare for All would be a nightmare for taxpayers and patients.
To take Congress, Democrats need to flip 23 House seats and two in the Senate. Many party leaders posit that nationalizing the midterm elections around health care — specifically, the promise of Medicare for All — is a winning strategy.
That number will surely increase. Old-guard Democrats are facing primary challengers on their left — and they’re losing.
In June, 28-year-old Alexandria Ocasio-Cortez, a member of the Democratic Socialists of America and enthusiastic advocate for single-payer, resoundingly defeated ten-term Rep. Joe Crowley — the fourth-most powerful House Democrat — in the primary for New York’s 14th district.
A month prior, Kara Eastman beat former Rep. Brad Ashford in the Democratic primary for Nebraska’s second congressional district, after similarly placing Medicare for All front and center in her pitch to voters.
Presidential aspirants in the Democratic Party have gotten the message. Sens. Cory Booker of New Jersey, Elizabeth Warren of Massachusetts, Kamala Harris of California, and Kirsten Gillibrand of New York are among the 16 co-sponsors of Sen. Bernie Sanders’s Medicare for All legislation, S. 1804.
Democrats have come a long way since 2009. During the debate over Obamacare, the Democratic-controlled Senate rejected a government-run “public option.”
Though many on the left wanted to create a federally-chartered insurance plan to compete against private insurers, the party’s leadership ultimately concluded that it would be too much for voters to swallow.
Now, however, Democrats are buoyed by polls that show increasing support for a full-blown government takeover of the healthcare system. A slim majority of all Americans — and 74% of Democratic voters — support single-payer, according to a Washington Post-Kaiser Family Foundation poll conducted in April.
Politicians in blue states aren’t waiting for Washington to act. The California Senate passed a bill to create a statewide single-payer system in June 2017.
The Assembly has stalled the legislation, for now, while lawmakers figure out how to cover the cost, which would reach $400 billion a year, according to the state Senate Appropriations Committee — double the state budget.
In Minnesota, both candidates for governor from the Democratic-Farmer-Labor Party favor single-payer. Maryland Democratic gubernatorial candidate Ben Jealous, the former head of the NAACP, has released one of the most detailed single-payer plans to date. It’s projected to cost $24 billion — and would thus raise the state budget of $44 billion by more than 50%.
Progressives are sparring with each other over exactly what Medicare for All entails. Hardline supporters, like Sen. Sanders, believe a government-run health plan should be fully funded by tax dollars. Patients would pay no premiums, deductibles, or co-pays except for modest cost-sharing for prescription drugs.
Of course, this plan is significantly more generous than the existing Medicare program, whose main hospital insurance trust fund is already projected to go bankrupt by 2026.
Its beneficiaries currently face considerable co-pays and co-insurance in addition to monthly premiums. More than 10 million seniors also pay for Medigap insurance to help cover co-pays and deductibles.
In other words, whatever Medicare for All proposal ultimately emerges from the progressive scrum will come with a gargantuan price tag. The Urban Institute — hardly a conservative group — analyzed the single-payer plan Sen. Sanders released during his 2016 campaign and found it would cost $32 trillion over a decade.
To control costs, the government would inevitably ration care. Patients would face long wait times, just as they do in the single-payer systems of Canada and the United Kingdom. About 10% of Britons pay for private insurance on top of their government-sponsored coverage in order to get around those waits.
Bureaucrats would declare some treatments off-limits — perhaps because of their price, or perhaps because they thought a person was too sick or old to benefit. Already, the United Kingdom denies certain surgeries to smokers and obese people.
Is single-payer inevitable? Not if enough Americans wake up and take action to derail this juggernaut.