Great Ezra Klein column on why so many voters fear giving up private insurance completely

[highplainsdem]

https://www.vox.com/policy-and-politics/2019/7/29/8910387/medicare-for-all-insurance-private-abolish-bruenig

The core insight here is real: So long as a third party is providing your health insurance, you don’t have full control of its future. You may like the health plan your employer provides now, but they could change that plan, or you could change jobs, or be laid off. The problem is that point applies to public insurance too.

Imagine President Bernie Sanders passes Medicare-for-all in 2022. In 2024, amid a backlash to rising tax rates, Sanders loses reelection to Ohio Sen. Rob Portman. Working with a Republican Congress, Portman restructures Medicare-for-all in a few ways. Where Sanders included coverage for abortion, Portman bars it totally. Where Sanders designed the program to avoid copays and deductibles, Portman, a believer in health savings accounts, reworks it to frontload the cost-sharing. Where Sanders guaranteed coverage to everyone, including unauthorized immigrants, Portman restricts it to legal residents, and adds a work requirement for able-bodied adults.

If any of that sounds far-fetched, consider that Republicans were a single vote away from repealing Obamacare in 2017, and the Trump administration approved Wisconsin’s request to add premiums and a work requirement to its Medicaid program in 2018.

The skepticism Bruenig brings to private insurance is the same skepticism many bring to single-payer insurance. You like your government-provided health plan? Better cross your fingers, because your side just lost the White House, and the incoming administration wants to slash health care spending by 15 percent, drug-test all beneficiaries, and turn the whole thing over to private contractors.

He cites the NPR/Marist poll earlier this month that found that

“Medicare for all that want it” polled at 71 percent. Medicare-for-all that replaces private insurance polled at 41 percent. Supermajority support becomes a minority position.

And he concludes:

For the record, I’m not opposed to Medicare-for-all. It’s one of many health systems that I think would be a vast, vast improvement on what we have now. I want more people to have better health care, and my fear is that in treating public opinion as infinitely malleable or simply confused, Medicare-for-all’s supporters will trigger a backlash that destroys the effort, just as so many health reformers have before them.

Risk aversion here is real, and it’s dangerous. Health reformers don’t tiptoe around it because they wouldn’t prefer to imagine bigger, more ambitious plans. They tiptoe around it because they have seen its power to destroy even modest plans. There may be a better strategy than that. I hope there is. But it starts with taking the public’s fear of dramatic change seriously, not trying to deny its power.

[cannabis_flower]

1. But think about it.

Isn't it a little harder to strip away a government program than for your company to decide to change your insurance? I don't recall getting any vote at all when they changed ours at work. Sure the Democrats might not be reelected, but at least you had a vote.

[Cha]

2. yeah, why should they? Go with Biden's

Plan.

[Hoyt]

3. Medicare-for-All would be subject to political whims, just like the ACA.

[Hekate]

4. Well-spotted. In a country where Social Security is not longer sacrosanct & instead is at great risk

...from every godless, soulless, bastard on the Right including Libertarians, the average person is well advised to be leery of losing what they have in terms of health insurance.

The whims of voters who elect a Dem POTUS and then "send him a message" in the midterms are not to be trusted all that far.

[Hassin Bin Sober]

5. It would help if people on our side didn't work to raise the retirement age.

Or chain the CPI in a “grand bargain”

Or agree with Paul Ryan that social security should be part of balancing the budget.

Yeah, that would help...

[sacto95834]

6. Yes it's possible....

but I think like social security and medicare, it will become so popular that it would be political suicide to mess with it. I'm sure many Republicans wanted to do away with social security and medicare when it first passed, but it's more important for them to keep their seats in congress than to risk it.

Today, it's the 3rd rail, touch it too much and you'll feel the wrath of the voters.

[Progressive83]

7. People think they like their insurance

Last edited Wed Jul 31, 2019, 12:07 PM - Edit history (1)

I did until I was diagnosed as a diabetic. Most people get never sick enough really use it. I think most would agree MFA would be ideal, but we do need to think long and hard about our ability to lead horses to water.

[dsc]

8. One other issue is that for some minorities they remember the government

being less than benign with health care. There are people who were sterilized by government order who are still alive (many POC all poor and lacking education). LGBT people who are of a certain age vividly remember governmental attitudes towards AIDS. Women have a legitimate concert about using public health care to outlaw abortion if we get a GOP government in a country in which private medical care is banned.