Republicans are still in charge of the White House and the Senate, but the "Medicare-for-all" debate is in full swing. Democrats of every stripe are pledging support for a number of variations on the theme of expanding health coverage to all Americans.
This week, KHN's "What the Health?" podcast takes a deep dive into the often-confusing Medicare-for-all debate, including its history, prospects and terminology.
This week's panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Paige Winfield Cunningham of The Washington Post and Rebecca Adams of CQ Roll Call.
Among the takeaways from this week's podcast:
- Medicare-for-all is a new rallying cry for progressives, but the current Medicare program has big limitations. It does not cover most long-term care expenses, and includes no coverage of hearing, dental, vision or foot care. Medicare also includes no stop-loss or catastrophic care limit that protects beneficiaries from massive bills.
- Though recent comments by Sen. Kamala Harris on eliminating private insurance with a move to Medicare-for-all stirred controversy, private insurance is indeed involved in many aspects of the government program. Private companies provide the Medicare Advantage plans used by more than a third of beneficiaries, the Medicare drug plans and much of the bill processing for the entire program.
- Many consumers — and politicians — are confused by the terms being thrown around in the current debate about Medicare-for-all. The plan offered by Sen. Bernie Sanders (I-Vt.) and some of his supporters would be a "single-payer" system, in which the government would be in charge of paying for all health care — although doctors, hospitals and other health care providers would remain private. Others often use the term Medicare-for-all to mean a much less drastic change to the U.S. health care system, such as a "public option" that would offer specific groups of people — perhaps those over age 50 or consumers purchasing coverage on the insurance marketplaces — the opportunity to buy into Medicare coverage.
- Sanders' vision of Medicare-for-all is based on Canada's system. But even there, hospitals and doctors are private businesses, drugs are not covered everywhere, and benefits vary among the provinces.
- The health care industry is nearly united in opposing the talk of moving to a Medicare-for-all program because of concerns about disruption to the system and less pay. Currently, Medicare reimbursements are about 40 percent lower than private insurance.
If you want to know more about the next big health policy debate, here are some articles to get you started:
Vox's "Private Health Insurance Exists in Europe and Canada. Here's How It Works," by Sarah Kliff
The Washington Post's "How Democrats Could Lose on Health Care in 2020," by Ronald A. Klain
The American Prospect's "The Pleasant Illusions of the Medicare-for-All Debate," by Paul Starr
The Week's "Why Do Democrats Think Expanding ObamaCare Would Be Easier Than Passing Medicare-for-All?" by Jeff Spross
Vox's "How to Build a Medicare-for-All Plan, Explained By Somebody Who's Thought About It for 20 Years," by Dylan Scott
The New York Times' "The Best Health Care System in the World: Which One Would You Pick?" By Aaron E. Carroll and Austin Frakt
The Nation's "Medicare-for-All Isn't the Solution for Universal Health Care," by Joshua Holland
The New York Times' "'Don't Get Too Excited' About Medicare for All," by Elisabeth Rosenthal and Shefali Luthra
Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too.
Julie Rovner: Yahoo News' "What Trump Got Wrong About 'Right to Try,'" by Kadia Tubman
Joanne Kenen: STAT News' "The Modern Tragedy of Fake Cancer Cures," by Matthew Herper
Rebecca Adams: The Texas Tribune's "Thousands of Texans Were Shocked By Surprise Medical Bills. Their Requests for Help Overwhelmed the State," by Jay Root and Shannon Najmabadi
Paige Winfield Cunningham: STAT News' "The 'Big Pharma' Candidate? As He Runs for President, Cory Booker Looks to Shake His Reputation for Drug Industry Coziness," by Lev Facher
To hear all our podcasts, click here.
And subscribe to What the Health? on iTunes, Stitcher or Google Play.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.