The Right Way To Do Medicare For All

With the debate about single-payer Medicare For All increasing in recent months, it is important to know a crucial detail about it.  While the main thrust of the debate lately has been how to "pay for" it all, and exactly which taxpayers will bear the brunt of it, the truth remains that our Monetarily Sovereign federal government by definition has infinite money, and thus does NOT actually need any taxes to pay for it (or anything else, for that matter), since federal taxes do NOT actually pay for federal spending at all.  That is in fact a Big Lie, and has been false ever since we got off the gold standard in 1971, yet for some reason most Americans seem to not have gotten the memo yet.

Notice how nobody seems too worried about how we are going to "pay for" the military with its truly massive price tag, after all.  That is in itself a kind of tacit admission that the Big Lie is in fact a lie, and that the emperor isn't wearing any clothes.  So no reason for all of this silly handwringing and harrumphing about how to "pay for" Medicare For All.

Yes, Virginia, we actually can have free and comprehensive health care for all Americans, period, with no deductibles, copays, cost-sharing, premiums, or taxes.  In fact, being the richest country in the world, we can aim even that much higher still than all of the other countries that currently have single-payer healthcare.  All we have to do is stop believing the Big Lie that federal taxes pay for federal spending.

So what are we waiting for?

And So We Learn What the Republican Alternative to Obamacare Really Is

In case you missed it, the Republican replacement for Obamacare is basically Obamacare-Lite, which is a giveaway to the rich and the insurance industry, who will see gratuitous tax cuts, but not so much for We the People, who will see less healthcare coverage overall.  Officially called the American Health Care Act, this bill does the following, among other things:

• Replaces the unpopular individual mandate with a "continuous-coverage" provision that allows insurers to impose a 30% surcharge on customers with more than a 63 day gap in coverage
• Replaces the income-based and price-based tax credits with (weaker) flat tax credits that vary only with age of the customers
• Phases out the Medicaid expansion after 2020, pissing off both Democrats and Republicans in the process
• Jettisons the employer mandate (a relatively minor component of Obamacare)
• Removes the Obamacare taxes (that fell primarily on the wealthy)
• Scraps the tax deduction cap on executive pay for health insurance companies
• And of course, defunds Planned Parenthood, despite the fact that the funds really go to birth control, STD tests, and cancer screenings.

Outside of Trump loyalists, generally the only people who really support the bill are the greedy insurance industry.  The American Medical Association and many others have come out against it, given that it will most likely reduce coverage and increase costs across the board.  Ironically, some of those most hurt will be Trump's white working-class supporters, especially in the red states.  In other words, it is at best a solution in search of a problem, if not a new problem in itself.  At worst, it's classic Trumpian chaos manufacture.

There is some nuance that we should note, however.  The very fact that the insurance industry is not worried about an impending "death spiral" should the bill pass is a good indication that we shouldn't worry about that either.  If there is in fact one, it would likely be a result of weakening the subsidies and other aspects of Obamacare, not a result of replacing the individual mandate with the surcharge for not maintaining continuous coverage.  The effectiveness of that provision, for all its flaws, is likely equivalent to that of the mandate it replaces, thus largely preserving that particular "leg" of the "three-legged stool".  The TSAP does support that particular change to the law, even though we oppose the rest of the Republican bill for the most part.

The TSAP, as you know, supports single-payer healthcare for all as the only real alternative.  We also support a public option as a steppingstone to this ultimate goal.  But as long as those are not on the table, we do not believe that we should rip out the heart and soul of Obamacare as the Republicans are trying to do, as that will result in disaster and chaos, doing far more harm than good.  We do support making any incremental improvements in the meantime, however, so long as they do not lead to a significant number of Americans losing health coverage, especially for the most vulnerable members of society.  Every Republican alternative to date, including this one, has failed to meet this standard, and thus we will oppose it.  Because people literally die as a result of losing their healthcare.

One thing is for sure.  This replacement should indeed be called Trumpcare, or perhaps Ryancare.  That way, they get to OWN it.  BIGLY.  Believe me.