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Foresight 2020: Medicare for All

Physician's assistant Erin Frazier checks a young boy at a community health center for low-income patients in Lakewood, Colorado.
Physician's assistant Erin Frazier checks a young boy at a community health center for low-income patients in Lakewood, Colorado.

We all need health care, but we’re divided about how to get it. The 2020 presidential candidates are no different than the rest of us andjust as divided. Some, like Senators Elizabeth Warren and Bernie Sanders, support Medicare for All.

The majority of the remaining field of potential candidates prefers a public option.And we’re breaking down the details of these plans in-depth as part of our continuing elections series, Foresight 2020.

What key similarities and differences exist between the candidates? How likely are certain plans to succeed when confronted with the current Congress? And what could it mean for you and your pocketbook?

Our guests helped break some of the specifics down, and we started with Democrats. The following is based on comments our expert panel made during the show, not exact quotes.

Remind us what Medicare for All is again? 

Dan Diamond, Politico: Starting with the caveat that the exact shape of this proposal depends on which candidate you ask, Vermont Senator Bernie Sanders says Medicare for All is a universal, single-payer health insurance program. Every American would be on this plan, and it would cover things beyond Medicare as it stands now. It would also have new power to negotiate with the private sector to negotiate drug prices and cut out administrative bureaucracy. It’s a dramatic and expensive plan. Sen. Sanders is a major supporter of this plan, and Massachusetts Senator Elizabeth Warren is too.

Note: They disagree on how to finance the plan.

Okay, so not everyone is proposing Medicare for All. What do more moderate Democrats want? 

Rachana Pradhan, Kaiser Health News: Candidates like former South Bend, Ind. Mayor Pete Buttigieg, Minnesota Senator Amy Klobuchar, former Vice President Joe Biden and billionaire and former New York City Mayor Mike Bloomberg support a public option. That’s a government-run insurance option that people could buy into and programs like Medicare and Medicaid would all continue to exist.

Proponents of it say that we don’t need to start from scratch and that it’s a way to build on what we have. But Medicare for All proponents say that the public option plan wouldn’t cover everyone, and now’s the time for a bigger change.

What are the president’s proposals?

Rachana: The president has doubled down on lowering the costs of prescription drugs. He’s very opposed to Medicare for All and the public option, and he thinks there are ways to bolster the system we already have. 

What does it mean to live without health care? Didn’t people get covered under Obamacare? 

Noam Levey, Los Angeles Times: People are living without health care are rationing care, they’re making decisions to go without the care that they need, they’re usually hit with thousands and sometimes tens of thousands of bills. 

Panel: The number of people who are uninsured has definitely gone down under the Affordable Care Act. But it’s not at zero, in part because not every state has expanded Medicaid to allow people to purchase health insurance on the exchanges.

Would a proposal like Medicare for All ever pass in Congress?

Noam: No. The Affordable Care Act, for all of the vitriol that it has inspired, was a modest change to our existing health care system. Democrats had 60 votes in the Senate and a big majority in the House, and it barely got across the finish line.

Dan: I think reporters should learn from 2016 and say that we can’t predict the future. I would not say never, but the odds are against. If there’s a dramatic event, and Bernie Sanders rises to the Oval Office with overwhelming support–anything could happen. 


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Héctor Alejandro Arzate, Morgan Givens