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Shure writes: "Biden's new health care plan does little to address Obamacare's failures and keeps alive a predatory private insurance industry. Medicare for All is still the only plan that guarantees health care as a human right."

Joe Biden. (photo: Getty Images)
Joe Biden. (photo: Getty Images)


Bidencare Is a Scam

By Natalie Shure, Jacobin

17 July 19


Biden’s new health care plan does little to address Obamacare's failures and keeps alive a predatory private insurance industry. Medicare for All is still the only plan that guarantees health care as a human right.

fter months on the presidential campaign trail, alleged Democratic frontrunner Joe Biden has finally rolled out just the sort of health care plan everyone expected of him: a marginal improvement upon the Affordable Care Act, pitched explicitly as a safer, saner alternative to Medicare for All. Bidencare would create a public insurance option to be sold on ACA exchanges and distributed at no-cost to Medicaid-qualifying individuals in non-expansion states, as well as remove income caps for premium subsidies. In isolation, such incremental measures would slightly improve the status quo, while leaving intact the most corrosive features of the health care system that Obamacare failed to fix.

The American health care system is a thoroughly complicated colossus plagued by no shortage of problems, but most boil down to this: it’s run as a business, and patients are framed as consumers. This is why hospitals maximize revenue by building fancy new orthopedics wings adorned with philanthropists’ names, why they hire consultants to teach them new billing code tricks to get more money per patient, and why they merge with other hospitals to increase their market power. And what are insurance premiums but rent payments for a ticket into the health care system, each of which comes with its own stipulations and user fees? What is a deductible but a strategy to force customers to foot their own bill for as long as humanly possible?

Rather than upend this dynamic, the ACA made market-based health care slightly gentler by subsidizing poorer patients and halting the more galling practices of the insurance industry, like denying coverage to people with preexisting conditions. But most mechanisms for harm survived: the astronomical price-gouging, the shifting of those costs onto patients themselves, the millions of people locked out of any care at all, tens of thousands of whom will die because of it.

Bidencare concedes none of this, opting instead to hitch its wagon squarely on Obama’s legacy. “For Biden, this is personal,” his website reads, despite having privately cautioned against the ACA as vice president. “He believes that every American has a right to the peace of mind that comes with knowing they have access to affordable, quality health care. He knows that no one in this country should have to lay in bed at night staring at the ceiling wondering, ‘what will I do if she gets breast cancer?’ or ‘if he has a heart attack?’ ‘Will I go bankrupt?’ He knows there is no peace of mind if you cannot afford to care for a sick child or a family member because of a pre-existing condition, because you’ve reached a point where your health insurer says “no more,” or because you have to make a decision between putting food on the table and going to the doctor or filling a prescription.”

The whole paragraph is a brazen lie. Joe Biden does not, in fact, believe that health care is a right. The ACA doesn’t make it one. His proposed changes don’t either. Every one of the scenarios he lists off in his folksy “I’m a good person” spiel persist today, and still would under his plan. Tens of millions of uninsured and underinsured people can hardly be assumed to have “peace of mind.” Breast cancer patients delay treatment when their insurance plans have high deductibles. Medical bills are still a factor in some two-thirds of personal bankruptcies. If insurers can no longer flat-out deny patients with preexisting conditions, they can certainly still bilk them with high deductibles and coinsurance. While reporting recently on skyrocketing insulin costs, I was struck by just how many diabetes patients burdened by these prices have insurance but nonetheless struggle to pay out-of-pocket until they hit their deductible. Several of them explicitly mentioned skimping on groceries to buy insulin instead.

Truly codifying something as a right means more than just making it “affordable” to “access.” It requires public administration and financing to guarantee it universally, free at the point of use. Under the ACA, health care is still overwhelmingly distributed based on wealth rather than need. You can either uphold health care as a right, or fight for Bidencare, but you can’t do both at the same time.

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-23 # BKnowswhitt 2019-07-17 13:17
Medicare is 104 a month you are charged as a senior for PART A. YOu are responsible for part B .. need private insurance for that .. so then Medicare for All would also require all to have some private insurance .. learn something instead of complaining ..
 
 
+6 # Texas Aggie 2019-07-17 15:22
And under Medicare for All that would be eliminated, no?
 
 
+3 # futhark 2019-07-17 16:04
BKnowswhitt is substantially correct. I've been on Medicare for almost 5 years now and still find it a bit daunting trying to figure out what is and what is not covered. I pay the $104/month in quarterly installments, since I don't qualify for Social Security. Rather than expand this complex and somewhat outmoded model of providing medical insurance to all citizens, why not take a look at what other countries are doing that may be simpler and more efficient? Medicare is great compared with just letting everyone scramble for what they can get out there, but I'm certain that better models exist for the public at large.
 
 
+4 # lfeuille 2019-07-17 21:41
Medicare for all is not the same program as traditional Medicare. There are no premiums or copays and no premiums It is tax financed and it covers things left out of traditional Medicare. I don't know why so many people haven't realized that yet. Before commenting, read the legislation.
 
 
+7 # WorkingClass 2019-07-17 16:54
BKnows - you really need to do a little research before you post. You are wrong on all counts. Most people pay zero for Part A. If you do pay a premium for Part A it will be on a sliding scale based on how many quarters you paid Medicare taxes. The standard premium for Part B in 2019 is $135/month and its deductible is $185/year. You also pay 20% of the Medicare approved cost for doctor services under Part B. That is the reason those who can afford it buy supplemental insurance to pay that 20%. What some are proposing, Medicare for All, is not Medicare as currently structured. They just borrow the name Medicare. The new Medicare would be a single-payer system. Private insurance would be phased out entirely. I do agree with one statement you made "learn something...."
 
 
+3 # futhark 2019-07-17 20:12
WorkingClass - you are the one who needs to do a little research before you post. Fact is that if you are a Social Security recipient, a portion of your monthly benefit is diverted to pay for your Medicare Part A. As a California public school teacher, I paid into Medicare for years, but due to the convoluted and patently unfair laws concerning Social Security, since I am receiving a State Teacher's Retirement Benefit, I am disqualified from also receiving Social Security. Therefore, I must pay my monthly charge for receiving Medicare A on a quarterly basis. Believe me, it only gets more complicated.

My wife receives the Social Security Retirement Benefit, but her monthly allotment is greatly reduced by the the amount deducted for Medicare Part A. The just has to be a simpler way to do this.
 
 
+4 # chapdrum 2019-07-17 21:03
As known to some, when you need prescription drug coverage, you are obliged to buy supplemental private insurance, a provision specifically installed by the Republican Party. It's about family values.
 
 
+3 # jimallyn 2019-07-17 21:03
Quoting BKnowswhitt:
so then Medicare for All would also require all to have some private insurance .. learn something instead of complaining ..

That's great advice: learn something! And YOU are the one that needs to learn something. Here's a quote from the summary of the current Medicare For All bill, H.R.1384:

"This bill establishes a national health insurance program that is administered by the Department of Health and Human Services (HHS).

"Among other requirements, the program must (1) cover all U.S. residents; (2) provide for automatic enrollment of individuals upon birth or residency in the United States; and (3) cover items and services that are medically necessary or appropriate to maintain health or to diagnose, treat, or rehabilitate a health condition, including hospital services, prescription drugs, mental health and substance abuse treatment, dental and vision services, and long-term care.

"The bill prohibits cost-sharing (e.g., deductibles, coinsurance, and copayments) and other charges for covered services. Additionally, private health insurers and employers may only offer coverage that is supplemental to, and not duplicative of, benefits provided under the program."

The ONLY reason you would need private insurance is if you wanted to be covered for things like cosmetic surgery which is NOT medically necessary. Similar language is found in every version of the bill dating back to its first introduction in 2003. Feeling foolish now?
 
 
-4 # BKnowswhitt 2019-07-18 23:52
Everyone should have access to healthcare. Dems had the best shot with Obama and House and Senate .. they needed 60 votes to pass what was put together by Max Baucus and the Finance Committee. That is how it works. They could modify the plan but not change it. It involved private insurers. Joe lieberman was the 60th and final vote they needed to pass it. He refused to allow Medicare as an option to private insurance which would have driven down the costs of 'ObamaCare' .. so they had to leave it out .. this is what Medicare For All will be up against. It will not pass no matter how good it looks on paper .. and it has to be paid for .. everything the senate passes has to have written into it how the funds will be derived .. with O Care it was put on young single males working .. not fair at all .. if the Dems were any good they would go back and fight to modify that and take off on it .. but they aren't and don't have a plan .. and Bernies will never get off the ground ..
 
 
+5 # lfeuille 2019-07-17 21:37
Wrong. Read the bills. Medicare for all is now not just a slogan. There are bills in congress. There would be no need for private insurance. There are no co-pays or deductibles. And it covers things left out of traditional Medicare like hearing, vision and dental.
 
 
-2 # ansleypk 2019-07-17 14:29
Thank you BK. I was wondering if I'm the only one who understands this. There is no such thing as getting rid of private insurers. The candidates (and others) who think Medicare for all means getting rid of private insurers either don't have medicare or are lacking in knowledge. I go to Europe twice a year. A friend of mine in Ireland has the state sponsored healthcare AND private insurance. I have medicare AND a secondary via Blue Cross Anthem, which fills in for the medicare holes. We need to spread the word and those candidates who are pushing for Medicare for all need to understand it does not and should not end all private insurance companies.
 
 
+3 # lfeuille 2019-07-17 21:43
Wrong. Read the corrections above. Medicare for All is a single payer system. It is not the current Medicare program.
 
 
-5 # ansleypk 2019-07-17 14:31
One more thing. I wish people like this writer could debate without calling "the other" a liar or accusing him or her of a scam. You are no better than Trump in this respect. Enough with the degrading and name calling. I've had it and won't be reading you again.
 
 
+17 # Reductio Ad Absurdum 2019-07-17 14:36
Not true. Improved Medicare for All covers more than just Medicare part A; it covers part B, dental, hearing and vision, but it does it better with no copays, premiums or deductibles. And it does all this for slightly less money than what we, as a nation, are paying now — by re-directing money from profit gouging, waste, redundancy, inefficiencies, etc. And it could significantly curtail the annual increases in healthcare costs.

Medicare for All is a comprehensive, clean-sweep system replacement for our miserably failed healthcare system, a system so broken it needs to be thrown out and totally restructured in a moon-shot-worth y effort. Any nibbling around the edges will only postpone any viable system-wide solution for ten years, and in doing so will only perpetuate the financial hardships, illness and deaths in the interim.

We need the healthcare equivalent of a national interstate highway system, not more two-lane blacktop side roads.

For more info go to http://pnhp.org, the website of Physicians for a National Health Program.
 
 
+9 # PABLO DIABLO 2019-07-17 15:03
VOTE PROGRESSIVE.
 
 
0 # chapdrum 2019-07-17 21:00
Perhaps we can start to deconstruct the scam by not using the absurd term "Bidencare."
 
 
0 # lfeuille 2019-07-17 21:50
This is very discouraging. Most of this tread has been taken up not with discussing the benefits of Medicare for All, but in correcting misconceptions about the basic nature of the program. Some of it possibly intentional. Once more "Medicare for All" is not traditional Medicare extended to everyone. It is a totally different program.
 
 
-5 # BKnowswhitt 2019-07-17 22:40
You will pay the 104 a month either from your SS check auto deduct you have no choice .. you can thank the politicians on both sides of the fence who differ little .. Trump was a Dem before he is a REpub .. europe after WWII united and in the rebuild they started social healhcare for all .. USA was big fish in pond .. eco leader .. so working with plenty of jobs low inflation we went with employer sponsored insurance ... now rising costs make that impossible .. what will come down the pike will be a two tier system involving insurance .. those with dough have to pay til their dough is gone .. others opt in .. it does cover below poverty line .. which is humane .. right now those working poor make a little too much and are screwed . that needs to be fixed ..
 
 
+5 # Ahimsa 2019-07-19 08:48
"What is a deductible but a strategy to force customers to foot their own bill for as long as humanly possible?" --YES-this is what I have been trying to say for a while. Then, after the deductible, you have an 'out of pocket" , which is designed to guide you toward 100 percent coverage. Yet it is hefty, and is literally still just that; "out of YOUR pocket". Then,at the moment you have full coverage, you have about thirty days of it before the next billing cycle starts you back to square one. No thanks Gropin' Joe...this proves you don't give a shit about the middle and lower class..
 

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