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Gaffney writes: "The Center for American Progress is inching closer to 'Medicare for All' - but its version leaves some gaping holes."

Bernie Sanders celebrates the 50th anniversary of Medicare and Medicaid two years ago. (photo: Jacquelyn Martin/AP)
Bernie Sanders celebrates the 50th anniversary of Medicare and Medicaid two years ago. (photo: Jacquelyn Martin/AP)

Why Are Democratic Party Thinktanks Still Not Backing Universal Healthcare?

By Adam Gaffney, Guardian UK

05 March 18

The Center for American Progress is inching closer to ‘Medicare for All’ – but its version leaves some gaping holes

n Thursday, the Center for American Progress (CAP), a Democratic party-affiliated thinktank, launched a proposal confusingly called “Medicare Extra for All”. For proponents of a Bernie Sanders-style single-payer “Medicare for All”, this might seem like a positive development. Well, yes and no.

On the one hand, “Medicare Extra” is a step to the left for CAP, suggesting that the Democratic establishment is following the lead of its galvanized base. On the other hand, this new proposal would exact sacrifices from patients to placate the insurance industry, and could serve to divert the single-payer movement, which has been rapidly gaining steam.

A debate over the next step on health reform has roiled the Democratic party. Some, like Hillary Clinton, have advocated incremental changes to Obamacare, such as a “public option”. Others, led by Bernie Sanders, seek to replace the hodgepodge of private and public health plans with “Medicare for All” – a single-payer program covering everyone without copays or deductibles.

Though Trump’s victory might have dampened support for the more radical road, it did just the opposite. The president swore to repeal the Affordable Care Act, and try he did – but apart from felling the individual mandate, the effort flopped in Congress. He did, however, rouse millions of Americans behind the cause of healthcare justice. Single-payer bills in both houses of Congress accrued record support in 2017, including a majority of House Democrats and more than a third of Democratic senators.

The political winds had shifted: progressives were out of power, but they were coalescing around a post-Trump plan – improved “Medicare for All” –overwhelmingly popular with the party’s base: about 69% of Democrats supported it, according to a September survey.

Enter Medicare Extra. CAP’s proposal is a response to these shifting winds. The new Medicare Extra program would automatically enroll anyone without other insurance. Premiums and out-of-pocket payments (eg copays and deductibles) would continue, with limits based on income.

Employers could choose to offer private coverage, or switch their employees into Medicare Extra. Notably, private insurers would get a big slice of the Medicare Extra market, enrolling millions in “Medicare Choice” coverage modeled on today’s wasteful, privatized Medicare Advantage plans, which in effect cost taxpayers “104% of per capita traditional Medicare spending” per enrollee, as noted in the Journal of the American Medical Association.

What’s not to like?

First, there’s the proposal’s voodoo economics. The US healthcare system hemorrhages cash through useless billing and bureaucracy, the inevitable consequence of battles between our jumble of profit-seeking insurers and the country’s providers. Transitioning to single-payer could end this waste, saving about $500bn annually; multi-payer systems such as Medicare Extra that add yet another plan to the existing slew of private insurers cannot. And without these efficiencies, expanding to fully universal coverage could prove unaffordable.

Second, because the economics don’t work, the coverage is insufficient. Although Medicare Extra would be more generous than most Obamacare plans, it would still leave millions encumbered with copayments and deductibles, which force people to choose between healthcare and other necessities. Keep in mind that one survey found that almost half of Americans couldn’t afford an unanticipated $400 expense, per the Washington Post.

Indeed, under the CAP program, some might see their coverage worsen if their employer elected to transition them to Medicare Extra. Consider that large employers’ plans cover, on average, 85.4% of healthcare costs. But Medicare Extra would cover only 80% of costs, for at least some families (depending on income). Republicans would have a field day scaremongering about the government taking away your healthcare plan. While CAP touts the political advantages of their plan, it may well be a juicier target for such scaremongering than “Medicare for All”, which would cover 100% of healthcare costs.

Medicare Extra offers an inferior policy option, when a better one is on the table. Improved “Medicare for all” can affordably provide healthcare to everyone. It’s widely supported by the progressive base – and indeed by the majority of the nation in most polls. And it can serve as a powerful political promise as we wade into the profoundly consequential 2018 and 2020 election season. Democrats would be wise to unite behind it, rather than be sidetracked by CAP’s second-rate scheme. your social media marketing partner


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+5 # CDMR 2018-03-05 10:07
This sounds like an obamacare fix up. But it is good to see the center-right-wi ng Center for American Progress moving a little to the left. That is a surprise. It has defined right wing progressivism for decades. Maybe right wing progressives are waking up to where the base is.
+24 # Krackonis 2018-03-05 10:31
They are tied to corporations.

They are simply a watered down version of the other party.

They are "compromised".
+36 # Mtguide 2018-03-05 10:37
Why? Simple; they're on the take, bought-and-paid -for by the insurance companies. Until the lobbying/briber y of Senators and Congressman, AND the DNC, by the insurance companies ends, nothing willl ever change.

You may remember one of Hillary Clinton's campaign appearances, where she brayed like a jackass, "There will never ever, EVER be single payer healthcare in this country!! NEH-VERR!!!" There's your answer, right there.
+4 # jimallyn 2018-03-06 02:03
Thanks, Mtguide. I thought I was going to have to write that, and you saved me the trouble.
+21 # apotem 2018-03-05 10:46
They are DINOs :(
On the bright side - elections are in 8 months.......
+24 # chrisconno 2018-03-05 10:49
Why are the democrats trying to water down healthcare too? WHY NOT SINGLE PAYER? So many other developed nations have proven single payer works. Sure there may be some kinks that will need to be ironed out but that is no reason to throw the baby out with the bathwater.
+17 # economagic 2018-03-05 11:04
With apologies to Mr. Gaffney, this article is neither well written nor well argued. For the real deal, see Margaret Flowers' article at

The same article was picked up by another website a couple of days ago:

Dr. Flowers is a former pediatrician, retired due to burnout. She is one of the best informed and most outspoken advocates for upgrading the US health care system, the most costly in the developed world and with some of the poorest outcomes, to the standard set by all other industrialized democracies and a number of Third World countries as well.

She is also a principal (and a founder, I believe) of PopularResistan, one of several groups to emerge out of the Occupy movement (which is still alive and well), and one of the most focused and most visible.
+21 # Working Class 2018-03-05 11:22
This is no solution at all. As long as private insurance companies are left in the mix we will continue to waste an unacceptable portion of our health care dollars on non-health care items such as corporate profit and overhead. All this Medicare Extra proposal shows me is that the Dem leadership is still under the thumb of the medical-industr ial complex. Better get out and lead your base on this issue Dem leadership or you will continue to see people look at you as part of the problem - not part of the solution.
+16 # Jim Young 2018-03-05 11:59
Seems we have the Richest Health Insurers in the World.

Why don't we have anything near the healthiest population in the world?
+18 # Benign Observer 2018-03-05 12:46
The fact a neoliberal group like CAP moved at all is an indication they know change is inevitable and they want to do as little as possible. Look at the DCCC memos and the actions of the DNC.

No compromises -- single payer NOW or when Sanders takes office!
+8 # Rodion Raskolnikov 2018-03-05 14:11
Benign - yes, you are right. No compromise with the CAP or DCCC. They are not on our side. They are fake progressives. I would love to see genuine progressives just overwhelm the DCCC in the 2018 elections. This sort of thing happened to the old guard republicans when the Tea Party came along. Of course, the Tea Party was worse than the Bush republicans -- if that is even possible. But my point is that an insurgent movement can really surge up and replace a moribund party leadership. Pelosi, Schumer, Podesta, Clintons and the rest can just retire. Go somewhere and play shuffle board and leave us alone.
+2 # futhark 2018-03-05 21:55
Let's not forget that the Tea Party ceased to be an independent political entity once Sarah Palin was "invited" to be the keynote speaker at its convention in February 2010.

From that point on it became a totally controlled agent of the neocon wing of the Republican Party.
+3 # Rodion Raskolnikov 2018-03-06 18:46
furth -- yes, very correct. It got co-opted and assimilated very quickly. After all, it was a Koch Bros project, mostly.

I wonder if this would happen to independent minded and truly progressive democrats. Ro Khanna is one of these. He is very outspoken about the necessity to remain independent. He takes NO money from lobbyists, corporations, or the democratic party. He takes money only from individuals. He represents Silicon Valley in CA, so some of his supporters are quite rich, but still they can only give the limited amount.
-8 # Robbee 2018-03-06 11:32
Quoting Benign Observer 2018-03-05 12:46:
No compromises -- single payer NOW or when Sanders takes office!

Quoting Rodion Raskolnikov 018-03-05 14:11:
Benign - yes, you are right. No compromise

- don'tcha just love seeing putin's tag-team trolls here on rsn in action? - aren't they just awesome? playing off each other?

never compromise! - even when that's the only way you can improve the health of 20 million americans! - never hillary! - you bastards!

Why Are Democratic Party Thinktanks Still Not Backing Universal Healthcare? 05 March 18

evidently we the people need to deliver some remedial education

in my state dem primary robbee will vote for a progressive who proposes statewide single-payer - his dem opponent proposes to leave healthcare up to the feds, which is, to say, on a state-level to do nothing

i pray dems take our point

in any event, spite will not keep me from voting dem in the fall - robbee does not sit home while repukes plunder our democracy unrestrained! THERE IS A DIFFERENCE! NO EXCUSES!

"Next time, we must resolve to MAKE OUR VOTE COUNT!" - (caps in original) - bernie

pop quiz! - between this tag-team of note, why does rr always get the last word? is rr ranking comrade?
+4 # Benign Observer 2018-03-06 13:57
If I have your condemnation I must be doing something right.
+5 # bread and butter 2018-03-07 09:11
That's right, Robbee the Robot.

There are too many articles pointing out the fact that DNC Democrats (like you) are just Republicans in disguise.

You need to up your trolling game, if you're going to keep up with the facts you don't want the rest of us to consider.
+15 # librarian1984 2018-03-05 13:13
Oh, I think we KNOW why the DP isn't getting behind the only solution that covers everyone, costs less, delivers decent care and puts us on par with other industrialized nations: their corporate donors wouldn't like it.

I thought this article would name donors and amounts. THAT is the story. But this was, at least, truthful about the facts, and ended with the truthiest truth of all:

Enhanced Medicare for All "can serve as a powerful political promise .. Democrats would be wise to unite behind it". Amen.

People who continue to defend the party: what do you think would happen if all Democrats united to make single payer coverage central to the 2018 and 2020 campaigns? My guess is there would mile long lines of people trying to put the Democrats in office asap, that's what.

So why aren't they doing that?

The answer to that is the SAME REASON progressives aren't kowtowing to remonstrances from Tom Perez, Nancy Pelosi and even some people here at rsn.

If the Dem establishment doesn't like Bernie Sanders they could get rid of him by coopting his agenda. But it's the agenda, which helps the middle class and poor, they're so afraid of.

The price the party pays for taking corporate money is watching Americans suffer and die and they seem willing to do so. In their hearts they know they're abetting evil and corruption, selling out their constituents and seeing kids die while they pretend not to know what the right thing to do is.
+1 # economagic 2018-03-06 09:17
"Enhanced Medicare for All 'can serve as a powerful political promise .. Democrats would be wise to unite behind it.' Amen."

The picky details are critical here: With all of the "enhancements" to Medicare flying hither and thither (Jeff Bezos? Get real!), it is important to promote "IMPROVED Medicare for all," Sanders' plan, based on but not the same as the plan Conyers has been introducing in every Congress for a decade or more. Check out the links in my earlier comment, and thanks to Margaret Flowers for bird-dogging this.

Otherwise, thumbs up.
+7 # rofo47 2018-03-05 18:09
Another reason why I no longer give to the Democratic Party, and I tell them every time they ask for money. MEDICARE FOR ALL, nothing less
+7 # lfeuille 2018-03-05 19:46
It's not inching closer. It's doing everything it can think of to avoid it by proposing a phony solution that won't work but might trick some people into thinking it will.
-4 # Robbee 2018-03-06 09:13
Why Are Democratic Party Thinktanks Still Not Backing Universal Healthcare? 05 March 18

the last time a dem prez proposed single payer, in 2008, 6 blue-dog dem senators tried to keep their jobs and snatched away our prize - by the way, they lost their jobs anyway! good riddance!

now it seems one dem think tank just doesn't get it - one dem think tank just "tanked"

evidently we the people need to deliver some remedial education

in my state dem primary robbee will vote for a progressive who proposes statewide single-payer - his dem opponent proposes to leave healthcare up to the feds, which is, to say, on a state-level to do nothing

i pray dems take our point

in any event, spite will not keep me from voting dem in the fall - robbee does not sit home while repukes plunder our democracy unrestrained! THERE IS A DIFFERENCE! NO EXCUSES!

"Next time, we must resolve to MAKE OUR VOTE COUNT!" - (caps in original) - bernie
+5 # bread and butter 2018-03-07 09:15

I've asked you on numerous occasions why you speak about yourself in the 3rd person. You've never bothered answering.

Is it because, in Russia, there are no distinctions?

Do you understand American English?

You, personally, have sown more discontent with the DNC, than any Russian bot or troll who was brazenly, openly attacking Hillary Clinton.

I'm really serious. You strike me as a fraud.

I think your goal here is to piss off as many Democratic base voters as possible.

The fact that you have NO command over the English language, is widely considered one of the tell-tale signs of a true foreign "operative".
+3 # Benign Observer 2018-03-07 11:45
And the repetitive phrasing, that's supposed to be another indicator.

Another is that trolls insult commenters and start fights without ever talking about policy or issues -- much more true of Robbee and others than the people they spend all their bandwidth accusing.

Heck, I could be convinced our manic oppressor here is a bot, the posts are THAT bizarre and unhinged.
+2 # bread and butter 2018-03-07 14:57
I started out joking, but I'm beginning to really believe it. In 2016, it was VERY CLEAR that progressive websites WERE being attacked by trolls who were probably paid and were part of a coordinated effort.

Maybe they WERE Russian.

If they were, they were a lot more sneaky and intelligent than they've been accused.

Because virtually ALL of them appeared as Hillary Clinton's SUPPORTERS.

Yet, the words and actions of those "supporters", really DID turn off more voters than any transparent, stupid right-wing comments about "Benghazi".

Those commenters turned me, personally, from someone who wasn't planning on voting for Clinton (due to the unfortunate fact that I've been paying attention to her record for years), into someone with a visceral HATRED for the DNC and all it's come to stand for.

Of course, it would be easier to believe the DNC had been victimized by these "Russian" bots, if it would come out in force and REBUKE the statements made, purportedly from it's own supporters.

Instead, it didn't do that. If anything, it added fuel to the fire.

Maybe Debbie Wasserman Schulze and Donna Brazile are ALSO Russian bots!

Maybe Hillary Clinton HERSELF is one!

All I know is that, NOBODY named "Anastasia Russia-inky" made their presence known to me, sowing my seeds of discontent with the DNC. That was all done by people, who appeared to be speaking on the DNC's behalf.
+1 # PCPrincess 2018-03-08 13:20
All I need to say is: SO TRUE! Maybe that was the intention: to sow discord between the members of each party. Who knows? I'm sure there were actual Hillary supporters in the mix, but it was the work of the most vociferous of that bunch that truly turned me off and, as you say, made me ANGRY.

This was even more the case in light of having had our first chance in literally decades for a truly ethical President being taken away from us (voters) by corrupt party machinations.

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