Sen. Bernie Sanders, I-Vt., will introduce legislation on Wednesday that would expand Medicare into a universal health insurance program with the backing of at least 15 Democratic senators – a record level of support for an idea that had been relegated to the fringes during the last Democratic presidency.
“This is where the country has got to go,” Sanders said in an interview at his Senate office. “Right now, if we want to move away from a dysfunctional, wasteful, bureaucratic system into a rational health-care system that guarantees coverage to everyone in a cost-effective way, the only way to do it is Medicare for All.”
Sanders’ bill, the Medicare for All Act of 2017, has no chance of passage in a Republican-run Congress. But after months of behind-the-scenes meetings and a public pressure campaign, the bill is already backed by most of the senators seen as likely 2020 Democratic candidates – if not by most senators facing tough reelection battles in 2018.
The bill would revolutionize America’s health-care system, replacing it with a public system that would be paid for by higher taxes. Everything from emergency surgery to prescription drugs, from mental health to eye care, would be covered, with no co-payments. Americans younger than 18 would immediately obtain “universal Medicare cards,” while Americans not currently eligible for Medicare would be phased into the program over four years. Employer-provided health care would be replaced, with the employers paying higher taxes but no longer on the hook for insurance.
Private insurers would remain, with fewer customers, to pay for elective treatments such as cosmetic surgery – a system similar to that in Australia, which President Donald Trump has praised for having a “much better” insurance regimen than the United States.
But the market-based changes of the Affordable Care Act would be replaced as Medicare becomes the country’s universal insurer. Doctors would be reimbursed by the government; providers would sign a yearly participation agreement with Medicare to remain with the system.
“When you have co-payments – when you say that health care is not a right for everybody, whether you’re poor or whether you’re a billionaire – the evidence suggests that it becomes a disincentive for people to get the health care they need,” Sanders said.”Depending on the level of the copayment, it may cost more to figure out how you collect it than to not have the copayment at all.”
As he described his legislation, Sanders focused on its simplicity, suggesting that Americans would be happy to pay higher taxes if it meant the end of wrangling with health-care companies. The size of the tax increase, he said, would be determined in a separate bill.
“I think the American people are sick and tired of filling out forms,” Sanders said. “Your income went up – you can’t get this. Your income went down – you can’t get that. You’ve got to argue with insurance companies about what you thought you were getting. Doctors are spending an enormous amount of time arguing with insurers.”
(c) 2017, The Washington Post · David Weigel
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