Sen. Kamala Harris, D-Calif., with the help of her campaign, keeps trying to claim she supports “Medicare for all” while obfuscating the reality that it would essentially eliminate private insurance. She needs to stick with one clear position or she’s going to be obliterated on the issue should her candidacy gain more traction.
It initially seemed that Harris was going to take an unapologetic position in favor of eliminating private insurance, having said at a January CNN town hall, “Let’s eliminate all of that. Let’s move on.” The fact that her campaign did not protest after coverage widely described her comments as calling for the end of private insurance reinforced the conclusion that she intended her remarks to be interpreted this way.
Yet she later tried to back off the comments, particularly in an incoherent interview with Jake Tapper last month in which she tried to claim her original comments referred to getting rid of bureaucracy, and then went on to describe the role of supplemental insurance. (Click here for a more detailed examination of Harris’s statements).
Now, her campaign is pivoting off comments from Sen. Bernie Sanders, I-Vt., to claim everybody is on the same page about private insurance. Her campaign spokesman Ian Sams on Sunday tweeted, “Asked by @DanaBashCNN on @CNNSotu whether private insurance will still exist under his Medicare for All plan, Bernie Sanders says, yes, it would. Because, yes, it would. The bill expressly allows private insurance for supplemental coverage.”
More on what Sanders actually said in a bit. But first, some background.
Harris, as senator, has been a sponsor of a plan by Sanders to transition all Americans to a single-government healthcare plan under a proposal branded as “Medicare for all.” As part of that, nearly 180 million people who have private insurance through their employers or individually would lose their current coverage. While, yes, in theory there could be some room for private insurance plans in the new system, they would not exist in any meaningful way. That is, no private company would be allowed to offer a plan that duplicated any of the benefits offered by the government, and the government plan that Sanders is promising would cover just about everything. In fact, not only would it cover benefits including hospital services, doctor visits, prescription drugs, mental heath treatment, and dental and vision care, but it promises to do so without out-of-pocket expenses. That is, the plan promises to eliminate premiums, co-payments, and deductibles.
In the CNN appearance Sams referred to, Sanders actually gave a relatively honest answer as to the role of private insurance.
“Is there a role for private insurance in your ‘Medicare for all’?” Dana Bash asked.
Sanders responded, “There is a limited — no, the function of a — this system is to make money for the insurance companies. What I believe, we need a cost-effective system guaranteeing healthcare to all people. The function of the private insurance would be to cover those procedures — often cosmetic procedures — that will not be covered by the comprehensive single-payer, Medicare for all system that I am fighting for. And, by the way, when we talk about Medicare for all, we improve Medicare for seniors by covering hearing aides, by covering eyeglasses, and by covering dental care, which Medicare does not cover. And when we do all of that, because we get rid of the profiteering of the insurance companies and the drug companies and the huge bureaucratic waste in the system, we save people money on their health care costs.”
So what Sanders is doing is downplaying private insurance. He starts off by saying there would be a “limited” role, then says “no” (essentially saying it would be eliminated because it just exists to generate profits). He only mentions passingly that the only function would be to cover services such as “cosmetic procedures” (which are not generally covered by private insurance in the current system).
I would obviously disagree with Sanders, but at least he’s trying to make the affirmative case that essentially eliminating private insurance would be a good thing.
It’s just bizarre that Team Harris would react to this with a sort of, “Aha! You see! Private insurance WILL EXIST!”
Clearly, Harris is trying to walk a fine line. She doesn’t want there to be much room to her left on healthcare policy in the primaries, but she also knows that the idea of eliminating private insurance could be problematic in a general election. But her current position is a perilous one that actually undermines the cause she’s purporting to support.
To most people, concerns about the elimination of private insurance boil down to whether they would be able to keep their current private healthcare plan instead of the government-run plan. Once people start paying more attention to the debate and learn what is meant by “private insurance will still exist,” nobody concerned about losing private insurance is going to be mollified by the idea that perhaps some private insurer might want to cover “nose jobs” in the future (as Sanders once put it). Given that arguably the biggest crisis of Barack Obama’s presidency came when a few million people faced the prospect of losing their plans, having everybody lose their current plans would cause a tremendous backlash — unless you’ve already sold the public on the idea. If she keeps objecting to the idea that she wants to eliminate private insurance, it’s going to make her sound like a massive liar to people who took her to mean that they’d still be able to get basic coverage through private companies.
If Harris wants to support “Medicare for all,” she should be spending the campaign selling the public on why they would be better off with a single-government plan than on their current employer or self-purchased policies, and owning up to the effects the proposal would have on private insurance, as Sanders does. Those effects will become apparent eventually. If she’s afraid to do that, then she should back off “Medicare for all” and release her own plan that creates some sort of optional government-run plan and declare that she wants to preserve private coverage to those who want it. Sure, that would still open her up to charges that the government plan would be an effort to get rid of the private health insurance system over time, but she’d at least have a much more coherent and consistent position than she does now.