The coming major fight over Medicare for All

Thanks to a sustained effort, the idea of Medicare for All as a way to introduce universal health care coverage has become part of the mainstream conversation. It is no longer seen as the fringe issue it was portrayed as when Bernie Sanders spoke in favor of it just a few years ago during his campaign for the presidency. It played a big role in the congressional elections and Lee Fang and Nick Surgey have obtained a document that outlines how the health industry is gearing up to launch a fight against it.

At least 48 incoming freshman lawmakers campaigned on enacting “Medicare for All” or similar efforts to expand access to Medicare. And over the last year, 123 incumbent House Democrats co-sponsored “Medicare for All” legislation — double the number who supported the same bill during the previous legislative session.

The growing popularity of “Medicare for All” in the House has made progressives optimistic that the Democratic Party will embrace ideas to expand government coverage options with minimal out-of-pocket costs for patients going into the 2020 election. But industry groups have watched the development with growing concern.

Over the summer, leading pharmaceutical, insurance, and hospital lobbyists formed the Partnership for America’s Health Care Future, an ad hoc alliance of private health interests, to curb support for expanding Medicare.

The campaign, according to one planning document, is designed to “change the conversation around Medicare for All,” then “minimize the potential for this option in health care from becoming part of a national political party’s platform in 2020.”

The health industry lobby is targeting so-called ‘moderate’ Democrats to try and thwart the progressive agenda. What they are worried about is that while their profits are safe while Republicans control the senate and White House, that situation may change in the near future.

For industry opponents of expanded government health insurance, there are two main challenges. One is combatting growing public support for the idea. The other is shaping elite opinion within the Beltway.

Over the last two years, several opinion surveys show rising support for expanding Medicare. In March, the Kaiser Health Tracking Poll found that 59 percent of Americans support the idea, and by August, a poll conducted by Reuters-Ipsos found an astounding 70 percent of Americans support “Medicare for All,” including a majority of self-identified Republicans.

As is usual with industry efforts to maintain the status quo, these groups are using fear of change as their main messaging, warning people that they risk losing whatever coverage they have now, even though it may be lousy and highly precarious because it depends on their employment status. The health industry has friends in the top echelons of the Democratic party, which has long been in the pockets of the health insurance industry lobby, and in the so-called ‘think tanks’ that shape public opinion.

The Partnership has tapped consulting firms with deep ties to Democratic officials. Forbes-Tate, a lobbying firm founded by former officials in President Bill Clinton’s administration and conservative Democrats in Congress, is managing part of the Partnership coalition. Blue Engine Message & Media, a firm founded by former campaign aides to President Barack Obama, has handled the Partnership’s interactions with the media.

The Partnership plans to form a speakers bureau of former Democratic elected officials who can leverage the media to make the case that expanding Medicare is bad politics and policy. The memo names former Democratic Majority Leader Tom Daschle, now a health insurance lobbyist at the law firm Baker Donelson, as one such potential surrogate.

The main argument put forward by these people is not new. They are resurrecting the idea of ‘socialized medicine’ as a fear tactic, the way they did with the Affordable Care Act. But supporters of Medicare for All feel good about their chances.

Adam Gaffney, president-elect of Physicians for a National Health Program, a national coalition that advocates in favor of “Medicare for All,” said he is not surprised by the messaging.

“What we’re seeing is the wages of success: With single payer on the rise, it was only a matter of time before the insurance companies, big pharma, and other big-money groups came out swinging,” said Gaffney, who also serves as an instructor at Harvard Medical School.

“The smear of ‘socialized medicine’ has been used a thousand times and has lost its bite,” he added.

“In terms of tactics, it sounds like they will just be updating the same lines they used in the 1990s to sideline reform efforts and in the ACA fight to keep single-payer health care off the table,” said Eagan Kemp, a health care policy advocate with Public Citizen. “The Partnership for America’s Health Care Future would be more accurately titled the ‘Partnership for Profiting Off America’s Health Care.’”

Private health care interests will certainly have much more money, media attention, and political resources with which to campaign. Advocates, however, are hoping Americans see past the public relations smokescreen and support health care as a human right.

“There is no brand loyalty to insurance companies, which are rightly seen as parasitic,” Gaffney, the PNHP leader, said.

“Once single payer is widely understood as a program that covers everyone, that doesn’t impose copays and deductibles, that has more comprehensive benefits than existing plans, and that doesn’t employ restrictive insurance ‘networks,’ support will only grow,” he added.

This is going to be a big issue in the next Congress. Just as the Republicans kept bringing up bills to repeal Obamacare, you can expect Democrats , now that they control the House of Representatives, to bring up bills expanding health care and forcing Republicans to defend their votes against it.


  1. lanir says

    The argument they put forward that really jumps off the page for me is when they imply Medicare for all invited the government into the exam room to tell your doctor how to treat you.

    Just how bad do they think we are at logic? The government would simply be taking over the role of health insurers. And they most definitely do make those same choices for your doctor’s. It’s especially egregious with mental health, where they seem to have blithely setup arbitrary limits. They are not accountable now to anyone or anything aside from government regulations and their sole motive is higher profits. Government would at least nominally be interested in long term health and I can vote to replace Congress or the president if they mess up my healthcare.

    The other end of that argument is equally uncompelling. Mostly my medical doctors just do what makes sense to them and payment is an afterthought unless I bring it up. When that does happen, we still put our heads together and find the best solution available.

    All the arguments they make are like this. They fall apart the minute you think about a real visit to a medical provider and what would change.

  2. jrkrideau says

    The horrors of a single-pay health care

    I live in Ontario.

    I realized, late yesterday afternoon, that my medical clinic was holding its annual flu vaccination clinic on Wednesday and today (Friday).

    So, this morning I walked down to the clinic, showed the receptionist my medical card, and sat down. I noticed that there were posters around saying, “If you cannot make the vaccination clinic, call us for an appointment” or “Let your nurse give you the vaccination”.[1]

    After the long wait of over 5 minutes I was called in to the nurse’s office and showed my medical card again so the woman on the computer could update my medical records.

    I got my shot, went out to the waiting room and sat down for a few minutes to check that there was no allergic reaction. I, then, departed to one of my favourite coffee shops.

    The whole thing must have taken at least 15 minutes. It was a terribly traumatic experience with those long wait times.

    The Ontario system could be better in any number of ways but compared to some of the horror stories I read from the USA, it is not bad at all.

    1. I have noticed that all you need to do is sit down in an examination room and someone shows up brandishing a needle. I think the last time I had an appointment I got diphtheria and tetanus shots.


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