On February 27, H.R. 1384 was introduced in the 116th Congress, which proposed an ambitious Medicare for All plan. The ambitious nature of the bill comes from a new Democratic majority in the house and a growing progressive wing within the Democratic Party. The house bill goes a step further than the current Medicare for All bill in the Senate. Both plans gradually expand the age constraint of Medicare to include everyone, and both add to the medical care that Medicare covers. Specifically, both plans guarantee what all Americans will receive at the government’s expense: emergency surgery, mental health costs, dental and vision care, and everything currently covered by Medicare. The House bill adds on long term care, and while the Senate bill would be phased in over four years, the House bill would be phased in over two years.
Rep. Pramila Jayapal, the sponsor of the bill, has done many interviews making her case for her bill as the way to move the US forward, and is always asked the obvious question – How are you going to pay for all of this? Her response is that peer countries spend less and get better health outcomes, because of reduced administrative costs. She also says that taxes will be raised on millionaires and billionaires, and tax loopholes will be eliminated. As a result, the average family would pay 14% less on healthcare, doctors’ wages (besides specialists) would go up or stay the same, and everyone in America would have more options for which hospitals and doctors they wanted to see.
If this sounds too good to be true, that’s because it is. In politics, a politician has no incentive to give a fair and balanced analysis of a bill they propose, in the same way that a used car salesman is always going to give you a one-sided analysis of the facts if you’re thinking about buying his car. Concerns that have been raised about this plan include the practical feasibility of transferring 180 million Americans who have private insurance off their insurance and to government care. Rep. Jayapal says that you can still see whatever doctor you want, but doesn’t address the concerns about wait times, or how hospitals and doctors will react to the new health care landscape. David Brooks wrote an article in the New York Times titled: “Medicare for All: The Impossible Dream,” where he lays out the practical obstacles. https://www.nytimes.com/2019/03/04/opinion/medicare-for-all.html
Regardless of these obstacles, many of the democratic presidential hopefuls have embraced the progressive wing of the party and the Medicare for All platform with it. You can be sure that the specifics of what exactly is included in that term are going to be fiercely debated through the primary process, as there is a wide spectrum of Democratic proposals. But despite Rep. Jayapal’s assurances that she’s going to see her bill all the way to the finish line, it is unlikely to get far. First it would have to pass the house, then the senate, and then signed by the president. The earth would have to shift on its axis for that to be a reasonable path for this to become the law of the land. Perhaps it is better to see this bill as a tool in moving the conversation forward in what Americans want in their health care system and what they don’t.