As the Iowa caucuses draw near and as Bernie Sanders closes in on Hillary Clinton in the polls, Clinton has started “attacking” (media word) Sanders’ proposals for providing universal health care through a Medicare-for-All plan.
The corporate media largely covers the horse-race aspect of this as an entertainment item. Here is a look at the substance of Clinton’s assertions.
Medicare For All
Sanders has proposed replacing “Obamacare,” the Affordable Care Act mandate to purchase insurance from private companies, with a Medicare-for-All, “single-payer,” “universal heath care” plan. In other words, he proposes to extend (and expand) the current Medicare system to cover every American so they can stop having to locate and purchase private insurance policies. Sanders’ plan would also end the need for other government health programs, including Medicaid and the Children’s Health Insurance Program (CHIP).
Medicare for All is very popular, especially among Democrats. The December 2015 Kaiser Health Tracking poll found that 58 percent of Americans support it (34 percent strongly), with 81 percent of Democrats and 6 in 10 independents saying they favor the idea. “This is compared to 34 percent who say they oppose it, including 25 percent who strongly oppose it,” the poll said. Among Republicans, 63 percent say they oppose it.
Proposing Medicare for All is not just the right policy for the country, it is very smart politics.
Clinton claims that Sanders’ plan would require a big tax hike. Politico reports this claim, in “Clinton hits Sanders on middle class tax hikes“:
“Bernie Sanders has called for a roughly 9-percent tax hike on middle-class families just to cover his health-care plan,” said Clinton spokesman Brian Fallon, referring to legislation Sanders introduced in 2013, “and simple math dictates he’ll need to tax workers even more to pay for the rest of his at least $18-20 trillion agenda. If you are truly concerned about raising incomes for middle-class families, the last thing you should do is cut their take-home pay right off the bat by raising their taxes.”
More recently, Clinton’s daughter Chelsea claimed that Sanders’ Medicare-for-All plan would “dismantle Medicare” and “strip millions and millions and millions of people off their health insurance.” (Clinton later stood by her daughter’s statement.) The Huffington Post reported:
“Sen. Sanders wants to dismantle Obamacare, dismantle the [Children’s Health Insurance Program], dismantle Medicare, and dismantle private insurance,” she said, according to an account from NBC News. “I worry if we give Republicans Democratic permission to do that, we’ll go back to an era – before we had the Affordable Care Act – that would strip millions and millions and millions of people off their health insurance.”
The Clinton campaign also said that Sanders’ plan would “send health insurance to the states, turning over your and my health insurance to governors” including Republican governors like Iowa’s Terry Branstad. “I don’t believe number one we should be starting over. We had enough of a fight to get to the Affordable Care Act. So I don’t want to rip it up and start over,” Clinton said.
Sanders Campaign’s Response
Sanders campaign spokeswoman Ariana Jones responded:
“It is time for the United States to join the rest of the industrialized world and provide health care as a right to every man, woman, and child. A Medicare-For-All plan will save the average middle-class family $5,000 a year. Further, the Clinton campaign is wrong. Our plan will be implemented in every state in the union regardless of who is governor.”
Sanders himself explained his health care plan and his strategic thinking behind it in an interview Wednesday with MSNBC’s Chris Hayes. The claim of $5,000 a year in savings for average middle-class families refers to the plan’s elimination of ever-increasing private insurance premiums, co-pays and deductibles that people currently have to pay under Obamacare. People would end up paying less and in many cases much less – an average of $5,000 each year. Companies would also no longer have to provide health insurance coverage for employees.
On the claim that Sanders’ has a “$18-20 trillion agenda,” switching to Medicare for All would replace the current costs of Medicaid, CHIP, Obamacare and other healthcare programs. Sanders’ plan would actually cost fewer trillions in the future than continuing the current system. The large “trillions” figure is misleading because it does not take into account the cost of the current system of Medicare for people over 65, Medicaid, CHIP, current Obamacare subsidies and other government health programs that would be replaced by Sanders’ plan. Left alone these would add up to more than Sanders’ plan.
Since Sanders’ plan also removes private-company profits from the system, this “Sanders agenda” amount is actually lower than the cost of continuing with the current system. (It also includes Sanders’ plans to repair the country’s infrastructure, cut college costs, and the rest of his proposals. Note that Sanders has outlined specific revenue sources to cover the costs of the proposals.)
The claim that Sanders’ plan would “strip millions and millions and millions of people off their health insurance” is perhaps the most misleading and disingenuous claim of all. People would not be “stripped” of their insurance; everyone would get Medicare instead so people would not need “insurance.” Clinton’s “strip” wording here implies that millions of people would lose health care, when in fact they would only lose the need to pay insurance premiums, co-pays and deductibles.
Sanders responded to this respectfully, saying, “As much as I admire Chelsea Clinton, she didn’t read the plan.”
Clinton’s accusations over Sanders’ Medicare-for-All proposal are not based on the actual policy proposals. They misrepresent the positions and are misleading at best. Some call this “blatantly dishonest.”
“Muddying the waters” by implying that “millions and millions and millions” of people will be “stripped” of their insurance, when the proposal actually replaces insurance is the kind of politics-of-the-past that people have rejected, even come to despise. Telling people they will have to pay a “tax” when the proposal actually reduces the amounts people will pay out of their pocket is misleading at best.
These accusations come out of an old style of politicking that is void of substance and depends on manipulation of people’s understanding of issues. Misleading people by misrepresenting the policy positions in this way borders on a character attack instead of contrasting policy positions. It is a politics of personality versus the politics of issues that Sanders is popularizing.
Here is Clinton in 2008, talking about Democrats who attack proposals for universal health care, as Clinton has done to Sanders’ plan this year:
Sanders is campaigning on what the country should be doing. Clinton is now campaigning on why she should be president instead of on what she would do as president. She is trying to turn people against Sanders instead of winning them over to her. She is using misrepresentations and deceptions, not serious and constructive policy disputes. This should be rejected by voters.
Worse, misrepresenting Sanders’ positions in this way risks reinforcing voter apprehension about Clinton’s “trustability” as well as about the entire political process. At a time when voters crave honesty, Clinton’s attack reinforces arguments that Sanders offers an “authenticity” and consistency that Clinton does not. Clinton should return to offering policies to solve the country’s actual and important problems and stop trying to turn voters against opponents and the process itself.