IT’S NOT PRACTICAL. IT’S NOT TACTICAL.
Medicare for all is a great slogan. It implies healthcare for all without giving away all the Devilish details. Most people in this country get their healthcare through their employer; private insurance company healthcare. And most of these people are pretty well covered. They don’t want Medicare. They will be pretty upset, rebelliously upset if told that they would lose this benefit like Kamala Harris implied at a recent town hall. Hell, many people were upset with the Affordable Care Act which generally made their insurance better. Change is not easy, especially with something as personal as healthcare. The opposition stoked fear effectively and it would be even more dramatic if you were to take away all private insurance. The tactics of doing and saying this would be an insurmountable obstacle to election nationally, and in all but the most liberal of districts, locally.
Secondly, most private insurance is better than Medicare which covers hospital and doctor visits. With Medicare you need a Medigap plan which can be expensive or a Medicare Advantage plan which is an HMO that limits your choices. The candidates talk like it will now cover everything and no one will have to pay for it. And you know Americans are a suckers for a free lunch. Fifty six percent of the population support Medicare for All, but that number drops to 37% when told that their taxes might go up or there would not be private insurance available.
Practically, the expenses haven’t been worked out. How much will it cost? How are we going to pay for it? Real numbers are not available and comparisons are difficult since there are many variations being promoted. And also the implementation is far from being discussed in detail. Remember the ACA rollout and the computer crash that started it? Big programs come with bugs and unforeseen problems. Does anyone seriously think the whole country could be put on one health care program at the flip of a switch?
Thirdly, I believe in universal healthcare. But we already have a deeply ingrained system. It’s a seriously flawed system but too ingrained to rip out and start over. It has to be fixed, incrementally. The ACA was a start. People are accepting of that now, even after a decade of unjust criticism and abuse. It need some adjustments and improvement that the Republican congress refused to make. But it is on the right track and needs to be expanded.
There are many models for universal healthcare implemented around the world. Google it. A government service model like the UK’s National Health Service is only one type. Some are a combination of public and private insurance. Most work better than our hodge-podge. And in most countries medical costs are better controlled. Ours are at least double anyone else’s. How are we going to change that?
Fourth, there is too much money, too many special interests, too much propaganda invested in the Insurance industry to overcome politically. This would be a Sisyphean task that would doom the party attempting it. Our political system is inherently corrupt as it feeds on money and influence. We the People have to really get worked up to be heard. And we have to have some of the power players on our side like when they tried to take away pre-existing condition protection.
Incremental change is the most logical way of improving our healthcare delivery; expanding it so that everyone is covered. Unfortunately INCREMENTAL CHANGE does not make such an inspiring campaign slogan or bumper sticker. If that’s what you mean when you say Medicare for All, I can go along with it.
Democrats need to win the White House in 2020. That’s the most important thing if anything Progressive is to be accomplished. To promise great changes all at once will scare a lot of people. Call them ignorant; call them gullible; call them deplorable. But remember to call them voters.
I don’t want to relive 1972 where a fine Liberal Democratic presidential candidate was creamed by a sleazy, corrupt Republican crook.
My advice to all the 2020 candidates: Be Practical. Be Tactical. Be Smart.
:>Howard Flantzer
hf48blog 