It’s no secret that America has faced a crisis with the provision of healthcare over the last several decades, and that entering the fray is like Daniel entering the lion’s den, yet that debate continued last Tuesday with a Congressional hearing, by the House Rules Committee, on major health proposals; one from the Senate, and the other from the House of Representatives, with each one attempting to cover more ground, than the Affordable Care Act, from the Obama administration, commonly known as Obamacare.
While the Democrats are tied to the issue that propelled them into the majority in the House are committed to seeing that a plan be developed, the Republicans, are equally harnessed to seeing any effort, by them, defeated as a socialist effort, as they did with Obamacare, nevermind that most GOP supporters cannot clearly identify what socialism is, or isn't.
“Democrats are fully embracing socialism and a complete government takeover of the American health care system. Democrats’ radical plan will rip health care from 158 million Americans. Taxes would skyrocket and access to care would slow to a crawl,” House Republicans said in a statement the day before.
It also promised to be debatable within the Democratic party, with some presidential candidates on the left of the issue, while others are in the middle, some lined up behind Medicare for All, with others, lightly defined as “single-payer”, while still others, including leadership, want to take a more incremental approach with universal coverage as the goal.
The Democratic left has become energized on the issue, and want to see fast results, but in a body that is easily entrapped in debate, and with President Trump eager to use healthcare (despite his failings to replace Obamacare) as a wedge issue, to help ensure his re-election,and keep the insurance industry profitable, while further enriching the coffers of Big Pharma.
As Bloomberg News reported, “The House on Tuesday will gavel in the first-ever hearing on a sweeping Medicare for All proposal . . . and, if private health insurers are one day put out of business by a government-run single payer health system, they may look back at Tuesday as the beginning of the end. Yet the bill coming before the House Rules Committee won’t become law anytime soon and may never get a hearing in the committees that oversee Medicare.”
“Representative Pramila Jayapal of Washington State, sponsor of the legislation and a leader of the Democrats’ progressive faction in the House, said she’s playing the long game.
“This is first step but certainly not the last step,” she said in an interview. But, in the House, Jayapal’s bill has backing from 109 out of 235 House Democrats.”
“From my read of the room, there isn’t support for that proposal,” said Representative Ben McAdams, a freshman Democrat who represents a swing district in solidly Republican Utah. “I’m worried it causes more problems than it solves.”
Shoring up Obamacare, is the goal of Speaker of the House Nancy Pelosi, who also wants, as with most of her supporters, mostly fellow lawmakers, to lower drug costs, while letting the debate on more radical legislation continue.
Significantly, as Bloomberg noted, “The two committees with jurisdiction over Medicare haven’t agreed to hold hearings and there is no push for a floor vote this year under discussion.”
“It’s also not clear if it will be considered by the Energy and Commerce Committee, which has primary jurisdiction over health care issues,” said the Hill.
That has not deterred some, and “Things are moving at a faster pace than some had anticipated and I think that’s good,” said Massachusetts Representative Jim McGovern, the Rules Committee chairman and a supporter of the Medicare for All bill. “This is not being slow-walked, we are trying to ignite the discussion on this.”
Jayapal’s bill, H.R. 1384, is “far more generous” than one in the Senate by Sen. Bernie Sanders, “It would expand Medicare to everyone over just two years and once in place would waive all co-pays, deductibles and premiums for the insured. Unlike Medicare now, it would cover long-term nursing home care. Private insurers would be banned from competing with the new Medicare for essential services but could offer new plans for elective procedures like plastic surgery.”
There is weak support for her plan in the House and the votes, are, as of now,109 out of 235 among House Democrats.
There is good news, according to The Hill, which reported that “House: Rep. Richard Neal (D-Mass.), the chairman of the Ways and Means Committee, which shares jurisdiction on health care issues, will soon hold a hearing on the proposal.”
That may be a wise move since “Adam Green of the Progressive Change Campaign Committee organization has threatened to support a primary challenge against Ways and Means Chairman Richard Neal of Massachusetts if he refuses to hold hearings on the plan. The group also complained that Neal was moving too slowly to demand Trump’s tax returns.”
Sanders, in the lead as one of the major contenders for the 2020 Democratic nomination, “introduced his own Medicare for All bill in the Senate. Four of his Senate colleagues also seeking the Democratic nod, Kamala Harris, Cory Booker, Kirsten Gillibrand and Elizabeth Warren, have signed on as co-sponsors.”
Former Vice President Joe Biden, now a presidential contender, has taken an incremental approach, and does not support the Sanders bill, and has endorsed a public option plan, with lowered drug prices, except for people covered by a private plan.
Sensing a dust-up, “Some Democrats have said they prefer lowering the Medicare age to 55, allowing people to buy into the program or a public option to compete with traditional insurance. A group of liberals led by Connecticut’s Rosa DeLauro and Illinois’s Jan Schakowsky are introducing a bill that would allow traditional employer-based insurance to continue while enrolling the uninsured automatically in expanded versions of Medicare and Medicaid,” Bloomberg added.
Nothing is simple when it comes to healthcare legislation, as we have seen, stretching back to the days of President Truman, in 1945, whose national health insurance was defeated, in part, by the American Medical Association's accusation of “socialized medicine” and then President Johnson faced down his critics for ushering in Medicare and Medicaid, for the same reason, and President Obama was attacked by the same reasoning, for the ACA.
In Tuesday’s hearing “GOP panel members repeatedly pressed McGovern on why the Rules Committee, which is often controlled by the Speaker, was the one holding a Medicare for All hearing.
McGovern, who took over as head of the panel in January, responded by saying: “There’s a new sheriff in town. That’s why we’re doing the hearing.”
Tart replies aside, “The location underscored the divisions the Democratic Party faces in how it plans to improve a system where 29 million Americans are uninsured, and millions more can’t afford their premiums, deductibles and prescription drugs,” noted The Hill.
Despite the enthusiasm on both sides, “Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.) hasn’t committed to holding a hearing on Medicare for All, and has instead focused on bills that would strengthen the ACA.”
Another reality is that “Many Democrats are wary of Medicare for All because it would eliminate private insurance, a multibillion-dollar industry that covers 67 percent of the population,” and is also a significant employer; and, polls have shown that there is less support for the proposal, when respondents, many of whom like their employer based plan, are told that it would be eliminated.
The biggest issue, at least from the Sanders plan, is cost, and $32 trillion dollars is a hefty price tag for something that many do not fully understand, or support.
Republican witness Charles Blahous, of the Mercatus Center, has estimated that the Sanders version would require spending that amount over a decade.
All of this aside, is the human cost to those without adequate health insurance, and a recent story from NPR showed that “A study published last month in Health Affairs examined claims data from a large national insurer for 316,244 women whose employers switched insurance coverage from low-deductible health plans (i.e., deductibles of $500 or less) to high-deductible health plans (i.e., deductibles of $1,000 or more) between 2004 and 2014.”
Notably, they found that for women with possible breast cancer, those “with low incomes who had high-deductible insurance plans waited an average of 1.6 months longer for diagnostic breast imaging, 2.7 months for first biopsy, 6.6 months for first early-stage breast cancer diagnosis and 8.7 months for first chemotherapy, compared with low-income women with low-deductible plans.”
Whether, or not, these illustrative stories reach the Congress is debatable, but what cannot be ignored is the need for a comprehensive healthcare that is equitable for all all Americans.
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