Thread: Straight talk about Sanders’ Medicare for All plan.
Sanders has been misleading people, selling snake oil, and poisoning the well.
Don’t @ me until you’ve heard me out. And to be clear, not everyone who supports SP (like me!) is a snake oil salesperson.

There’s been a nat’l SP bill introduced every Congressional cycle since 1945. Every author and every co-sponsor has considered those bills aspirational, a vehicle to start the conversation, not a realistic end point. Everyone except Sanders, and sadly, for most of 2019, Warren.

Also to be clear:
Sanders’ M4A plan is NOT the only M4A plan.
It’s NOT the only SP plan.
It’s NOT the fastest or least expensive path to a national SP system.
It’s NOT synonymous with UHC and would *prevent* 100% UHC in the US.

(Currently non-citizens get coverage through their employer or the private market. By barring private ins, Sanders guarantees at least 1% of the population can’t obtain HC coverage. Under a GOP admin, that could rise to 5% or even 10%.)

Sanders' M4A dream is appealing and (well-suited to Sanders) simple. Every person walks around with a card that gives them access to every conceivable medical service they need with no premiums, no deductibles, and no co-pays other than Rx co-pays capped at $200 a year. Nirvana!

Then Warren upped the ante on Nirvana, promising that 99.99% of the population, >330M people, will not only get HC with no premiums, no deductibles, and no co-pays but also without paying a dime in taxes. People living in SP countries almost went blind rolling their eyes so hard.

No other country on earth has the plan Sanders is proposing. No country has such generous coverage at such little cost to most individuals. That’s not bc other countries wouldn’t love a plan like his. It’s bc it’s not attainable. It’s a pipedream. #SnakeOil

Note the country with the lowest % of out-of-pocket expenses, France, is *not* a SP country and the country tied for the highest % of out-of-pocket expenses, Switzerland, soundly rejected SP in 2014 by a vote of 62% - 38%, the inverse of its early polling.

EVERY country on the list BS repeatedly tweets has a HC system that’s the very “middle ground” he says is unacceptable. Only a handful have a SP system and NONE completely ban priv ins like BS/EW are proposing. Most *depend on* private ins for at least part of their UHC systems.

Contrary to the disinfo Sanders spreads, no Dem has ever called UHC “radical” or “a crazy idea.” Now, his 2016 plan that he said would be partially paid for with more in RX savings than the entire US spends on RX, that *was* lunacy. But UHC? That’s standard Dem platform.

None of this is true. The majority of UHC countries do NOT have a national SP program. It’s NOT only supplemental ins. About 10% of people in the UK buy comprehensive private ins. Here’s why people in Finland do: https://www.theguardian.com/society/2016/feb/23/finland-health-system-failing-welfare-state-high-taxes

EVERY country on Sanders’ list grew their current UHC system slowly, over decades. Building incrementally is how they achieved universal acceptance across the political spectrum. (Taiwan implemented a nat’l SP system in one step but Sanders never includes Taiwan on his list )

There is no model, no country has accomplished it, and no one knows how much it will cost. Yet BS is out there convincing gullible people the ONLY acceptable HC system is this grand experiment that has no off ramp (yikes!) and directly impacts 330M people and 1/6 of our economy.

But suspend all logic and pretend BS' M4A plan passes. Then what. Private ins cos will sue under the 5th Amendment’s taking clause and fed courts will have no choice, due to M4A’s structure, but to put a hold on implementation until lawsuits wind their way through the courts.

His argument you’re not entirely banning private ins bc, while you’re taking over 100% of their current business, you’re allowing them to sell a new insurance product (coverage for plastic surgery and experimental treatment) will be laughed out of court. So what will courts rule?

Worst case scenario for M4A zealots: DT-appointed judges declare M4A unconstitutional.
Worst case for the rest of us: they also rule the bill’s provisions repealing the ACA stand.
Best case: courts allow M4A and award private ins cos 100s of billions in “just compensation.”

If your primary goal is to end private insurance, your choice is (a) regulate them to decrease profit and limit their market share by offering a public option OR (b) delay the implementation of M4A and pay them 100s of billions in the hope it will expedite their demise.

Think ins companies are afraid of Sanders? LOL
Ins stocks surged after he won NH. Not only do they believe M4A will help the GOP win, they’d MUCH prefer the HC debate center on eliminating them rather than limiting their market share and regulating them. https://www.marketwatch.com/story/health-insurer-stocks-surge-as-bernie-sanders-primary-win-seen-boosting-trumps-chances-2020-02-12?reflink=mw

The transition period WILL be rocky *at best.* Knowing they’re going out of business, private ins companies have NO incentive to perform well or to remain in markets that aren’t profitable. Sanders thinks they’re evil but wrote a bill dependent on them being good actors.

Contrary to what Sanders wants you to believe, every Dem supports SP programs. Every UHC proposal includes expanding Medicaid +/or Medicare. And most Dems believe we’re moving toward a national SP system. But they want it done in a smart way, not the BS way.

If you ban private ins companies from selling comprehensive coverage before the GOP fully buys into a SP system, you’re putting millions of people at risk of losing coverage they need. Who and what gets covered is left to the HHS Secretary. That’s scary af.

Even if they don’t repeal the bill, a GOP admin can eliminate coverage for undocumented residents, for trans services, for abortion and birth control. They can expand “cost containment measures” to include co-pays and deductibles. They can cut funding and hamper accessibility.

Don’t take my word for it. Look at what happens in other countries when conservatives are in power. Even though, unlike the US, none of those countries have a major political party that opposes UHC, many of them have had “austerity cuts” to their HC systems.

And no, I’m not a “corporate shill” or “want people to die” bc I want a private ins safety net to exist for vulnerable populations. Or bc I live in the real world. Weirdly, the same people throwing out those accusations are A-OK letting people suffer unless/until we get M4A.

This is where the snake oil harms people. Every person who truly cares about HC, about expanding coverage and lowering costs, knows the first step is strengthening the ACA, if only to help people while other plans are implemented +/or M4A makes its way through the courts.

Sanders’ “no middle ground” and most of Warren’s 2019 rhetoric build opposition to any and all other proposals to help people. Claiming a major obstacle to M4A is Dems “lack courage” is not only damaging to electing Dems up and down the ballot …

… costing us majorities, progressive legislation, and SCOTUS. It’s also false.
A whole lot of Dems have taken positions and votes they knew could cost them their seats (e.g., see 2010). That’s courage. And something Sanders and Warren have never done themselves.

They also blame lobbyists for private ins companies and Pharma but don’t tell you it’s *also* true they’ll lobby against *every* current Dem proposal for UHC +/or lowering Rx costs. And BS/EW never talk about THE biggest impediments to M4A or any other UHC proposal.

Impediment #1 Racism. “Ain’t no way I would ever support Obamacare. I would rather die” says Trevor (dying from liver damage). “We don’t need any more gov't in our lives. And in any case, no way I want my tax dollars paying for Mexicans or welfare queens.” https://www.washingtonpost.com/opinions/2020/01/28/how-white-identity-permeates-policymaking-outside-washington/

Impediments #2, 3, 4, 5, 6, 7, 8, and 9: also racism. I don’t know how so many M4A proponents missed it but 63M people voted for the “build a wall” guy in 2016. Racism has always been THE major obstacle to universal social programs in the US and it’s still here. Duh.

Impediment #10: The GOP. Private ins companies and pharma weren’t behind red states refusing to expand Medicaid. Or the Hobby Lobby lawsuit. To get UHC, we MUST defeat the GOP and we don’t do that by dissing the Dem Party or by lying about Democrats' commitment to UHC.

And we don’t defeat the GOP by forcing Dems to run on M4A.
In 2018, 100 new candidates followed Sanders and ran for the House on M4A. Only 6 won, all in deep blue districts with 4 replacing an original author and 3 co-sponsors of M4A, maintaining the status quo in the House.

OTOH, 53 new candidates rejected Sanders' advice and won House seats running on protecting the ACA. 40 of them flipped red seats, giving Dems the majority, moving *the entire House* left. BS is right when he says it will take *years* to convince voters to accept his M4A plan.

Sanders’ and his staff’s claims aren’t true. There will be winners and losers. Sanders refuses to say but his senior staffer says the average family will pay over $11K in taxes for M4A. That’s more than tens of millions of people currently pay for HC.

This is a lie. There’s no such provision in Sanders’ bill. The average family's “savings” he touts are largely dependent on corporations voluntarily passing *their* savings on to workers, just like the GOP’s tax scam was. Sure. That’ll happen.

M4A will NOT cover *everything.* There will be limits. Some things'll require pre-authorization. Will it cover IVF? Braces? No one knows. It’s all TBD and subject to change every year. Plan on paying out-of-pocket for anything other than basic & anything the gov’t deems elective.

There will be savings from decreasing ins co profits and reduced admin, as there will be in *every* UHC plan, but not as much as many M4A proponents think. A big part of the projected savings comes from reduced payments to providers. The consequences? TBD

BS/EW’s M4A requires 100% of HC expenses to be paid with tax revenue, including the HC expenses of the 1%, while every other UHC proposal requires people to pay what they can afford. It’s possible to have a means-tested SP system but they oppose it.

We urgently need increased tax revenue to address pandemic/economic crises, a climate crisis, a housing crisis, an infrastructure crisis, education, childcare, and increasing inequality but sure, let’s have a revolution centered on opposition to any means-tested HC system.

Sanders’ revolutionaries didn’t show up to protest GOP attempts to repeal the ACA and they haven’t shown up in red states to expand Medicaid but they’ll show up to DEMAND higher taxes on lower/middle income families and to DEMAND tax revenues pay for Bill Gates’ HC. Suuure.

The most egregious result of Sanders selling snake oil he knows won’t work is the shutting down of important conversations we NEED to have about UHC. Sadly, Warren, who’s usually open to honest debate, marched lockstep with his M4A disinfo script though most of 2019.

Missing from every debate: outcomes. Various ways to measure but note SP countries don’t rank at the top. In the WHO study, the US ranked #37. We urgently need improvement but *every* UHC plan would improve it and outcomes need to be part of the debate. https://www.who.int/healthinfo/paper30.pdf

Believing BS’ plan is problematic and won’t work in the US rn, I’ve been a proponent of Medicare for America BUT I found Harris’ M4A plan intriguing. By listening to everyday people and experts, Harris developed a SP plan that fixes the inherent flaws in BS’ plan, such as …

1) I’m not a fan of Medicare Advantage but 22M seniors like theirs and choice is imp to Americans. 2) By limiting and regulating private ins but not abolishing it, Harris more closely emulates other countries’ UHC systems. 3) Her plan is unlikely to face a 5th amendment lawsuit.

4) By leaving a private market in place, Harris provides a safety net for people whose HC coverage would be taken away or benefits cut under a GOP admin. 5) It’s the only M4A plan capable of 100% coverage. 6) It doesn’t have the “losers” inherent in BS’ plan.

7) While she successfully addressed the concerns unions have with M4A, she did it in a way that didn’t give union workers preferential benefits. Unlike BS and EW, Harris’ plan equally benefits *all* workers. 8) It’s more viable and 9) requires less tax revenue.

10) Unlike the Sanders experiment with no off ramp, Harris built in the capacity to adapt. 11) Her plan prioritizes outcomes. 12) The Harris plan is the *only* M4A plan on the table that could work in our racist and politically polarized country.

Proving how badly Sanders has poisoned the well, Harris’ carefully crafted plan was summarily dismissed by BS and his supporters and ignored by MSM. No discussion. No debate. It wasn’t BS’ (still incomplete, half-baked) plan so it wasn’t even worth a conversation.

BS’ current plan is different than his 2019 plan which differed from his 2017 plan which differed from his 2016 plan which differed from the McDermott plan BS intro’d in the Senate in 2013 which differed from the 700+ page SP amendment he co-sponsored in 2009.

Yet Sanders has successfully convinced his flock that anyone deviating from his current, nonviable, half-baked, 100 page outline guaranteed NOT to cover 100% of the population, is opposed to UHC. Even those who put in the work to fill in HIS outline are accused of corrupt intent.

Despite his claims, no Dem thinks there’s anything “radical” about UHC or a SP system. The only thing radical about Sanders is his opposition to any and all plans to help people unless the plan comes from him, no matter how flawed or unattainable his plan might be.

VT reporter Paul Heinz was 100% correct that Sanders “is so convinced that he is right about everything that when he sees a perspective that doesn't match his own, he sees it as evidence of incompetence or corruption."
And he’s convinced his supporters to believe the same.

If you truly cared about expanding HC coverage and lowering costs, you wouldn’t refuse to consider other UHC proposals, including SP proposals like Schatz’s Medicaid-based plan, or Harris’ M4A plan, or smear Warren for putting in the work to find a pay-for for *your* plan.

If you truly believe your UHC plan is the best, you’d *welcome* questions and a robust debate on the pros and cons of the various UHC proposals. You wouldn’t obfuscate … or lie … or deceive people. You wouldn’t call people who SHARE YOUR GOAL corrupt … or trolls.

Argue the merits of the various UHC proposals but don’t conflate UHC and M4A. Argue “the best” not “the only.” Don’t lie and say other candidates support the status quo. Don’t hide the cost and how it’s paid for. Don’t pretend your outline has any chance of passing as is.

If you were serious about getting a M4A bill passed, you’d write a complete bill and let the CBO score it so it could actually be brought to the floor. You’d use the taxpayer money you were given for office staff to hire HC policy wonks, not a media team to promote *you.*

People in our country need help. They don’t need people more invested in self-promotion than in doing the hard work needed to help them. They sure as hell don’t need a movement *on the left,* built on false promises and deceit, working to *oppose* any and all viable solutions.