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Friday, Aug 2 2019

Full Issue

Different Takes: Let's Take The Debate About Health Care Back To Affordability; Repealing The ACA Would Hurt Millions On Medicaid In Rural Areas

Editorial writers weigh in on the debate about the future of health care.

As this week鈥檚 Democratic debates made clear, the party is divided on how to improve health care for Americans. Bernie Sanders, Elizabeth Warren and others are for a single-payer Medicare for All system. Joe Biden, Pete Buttigieg, Amy Klobuchar and others want an incremental approach building on the Affordable Care Act. But candidates who are battling over plans like Medicare for All (Mr. Sanders) versus Medicare for All Who Want It (Pete Buttigieg) versus Medicare for America (Beto O鈥橰ourke) versus BetterCare (John Delaney) 鈥 and many others 鈥 are having the wrong debate. Instead, they should be competing to find the best ways to tackle affordability 鈥 an issue they can all agree on and President Trump has done nothing about. (Ezekiel J. Emanuel, 8/2)

Repealing the ACA would deny insurance to 4 million people with behavioral health disorders. The Medicaid expansion provision of the ACA alone has resulted in significant improvements in access to lifesaving treatment for opioid use disorder, such as buprenorphine. In Ohio, Kentucky, and West Virginia, for example, Medicaid covers between 40% and 50% of all prescriptions for buprenorphine, a medication that helps individuals recover from addictions to opioids. Each of these states allowed Medicaid expansion under the ACA. While these states have the highest death rates due to drug overdoses in the U.S., their federal legislators have consistently voted to repeal the ACA and the Medicaid expansion that comes with it. (Nickolas D. Zaller, 8/2)

Even liberals say Kamala Harris had a bad second debate Wednesday as she struggled to defend her record as a prosecutor and her new health-care plan. The latter is especially revealing about the Democratic debate on health care and is worth explaining in more detail. Ms. Harris in the June debate raised her hand when the moderators asked who would eliminate private health insurance. Then she backtracked. Ahead of the debates this week in a post on Medium, Ms. Harris tried to clarify how she鈥檇 鈥渕ake transformative change for the better鈥 on health care. It鈥檚 transformative all right. (8/1)

In the wake of the second Democratic presidential debate, it is clear that Medicare-for-all has become a defining issue of the 2020 election. Earlier this year, when I introduced our comprehensive, 120-page 鈥淢edicare for All Act of 2019,鈥 I expected attacks from big pharma and for-profit insurance companies. But I did not expect misrepresentations from Democratic presidential candidates about what the bill is and is not. Let鈥檚 be clear about the scale of this crisis. The United States currently spends an astronomical $3.6 trillion per year on health care 鈥 almost double what peer countries spend 鈥 and it is set to increase within 10 years to $6 trillion annually. (Pramila Jayapal, 8/1)

Suppose you have an unhinged聽neighbor who wants to burn down your house. You鈥檇 probably spend much of your time making sure that that doesn鈥檛 happen. Drafting plans for a megamansion聽you hope to build where your house once stood聽probably wouldn鈥檛 be a priority.聽But that seems to be the approach of some Democratic aspirants for the presidency, who spent big chunks of their recent debates arguing about details of costly "Medicare for All" plans that have no chance of becoming law. Let's get real here. (8/1)

"I don't understand why anybody goes to all the trouble of running for president of the United States just to talk about what we really can鈥檛 do and shouldn鈥檛 fight for,鈥 Sen.聽Elizabeth Warren (D-Mass.) said Tuesday night, in the most notable zinger of July鈥檚 Democratic presidential primary debate. 鈥淚 get a little bit tired of Democrats afraid of big ideas,鈥 Sen. Bernie Sanders (I-Vt.), the other major candidate on the field鈥檚 left wing, piled on. This got us thinking about some big ideas in U.S聽history. Like, say, amending the Constitution to outlaw liquor. Or sending half a million troops into Vietnam. Or passing a $1.5 trillion tax cut for the wealthy in a time of massive deficits. (8/1)

鈥淐hoice鈥 has taken center stage as Democratic candidates spar over 鈥淢edicare for all鈥 versus fixing the Affordable Care Act (ACA) and keeping private insurance. There are compelling arguments in favor of each. But the argument that preserving private insurance promotes choice is not one of them. (Allison Hoffman, 8/1)

As a political matter, the challenge will be to assure Americans who, time and again, have proved apprehensive about any change to their health care coverage 鈥 however flawed or expensive. A recent Kaiser Family Foundation Health Tracking Poll found that just 51% of the public now say they favor Medicare for All. What is telling about that number is it is down from 56% in April. (8/1)

Won鈥檛聽single-payer聽health care require higher taxes? (Yes, obviously.) And won鈥檛 abolishing employer-sponsored insurance face opposition from some of the 160 million people happily on those plans now? (Almost certainly.)聽At the聽debates, in聽post-debate spin rooms and on聽Sunday TV show interviews, the Democratic presidential聽candidates are asked these questions repeatedly as if they are 鈥済otcha鈥 questions. Then they duck and weave to avoid providing the honest but damning (affirmative) sound bite, instead offering some version of: I can convince voters they鈥檇 still come out ahead.聽(Catherine Rampell, 8/1)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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