Status Updates From Medicare for All: A Citizen...

“Either way, the urgent problem of providing accessible, affordable, dependable, and equitable healthcare to Americans at scale remains. As we hope we've demonstrated, M4A is a viable solution to that problem.”

“However, the public consensus may be shifting again. The Great Recession exposed many Americans to a level of poverty and insecurity that hadn't been seen in America since the Great Depression—which the New Deal was originally created to solve. Rising inequality paralleling the Gilded Age has left a large swath of the country without stable, secure employment or basic access to healthcare.”

“the public conversation about M4A may be about more than just healthcare…Empowered by the idea of promoting "the general welfare," American government as we know it today emerged from a bipartisan consensus around the critical role of government in providing basic public goods that grew out of the Progressive Era in the 1910s and 1920s and took hold during the New Deal in the 1930s and 1940s.”

“And the politics are treacherous. Passing M4A would require standing up to deeply entrenched private interests in order to launch a massive reinvestment in government public goods.”

“M4A could cost the American people less overall by eliminating much of the bloated overhead needed to prop up our current system and by cracking down on the industry's ability to charge high prices for care. By trading insurance premiums for taxes and slashing out-of-pocket costs, M4A has the potential to put more money into the pockets of most American families.”

“But if M4A happens, it will be because the American public decides that we can, in fact, have a more just, equitable, and sustainable system—that we can rise beyond the insecurity that says that the status quo is the best we can have, and choose to engage in the work of creating the system.”

“M4A is possible. But it is not inevitable. If it happens, it will have been because the right policy choices attracted the right coalition, which used the right tactics to elect the right officials in the right moment for change.”

“M4A is premised on the idea that government can take bold action to promote the general welfare. Reforms to our political institutions are of the same spirit, aiming to restore the people's faith in the government that the Constitution erected in their name.”

“Beyond opposition from those who profit from the status quo, a more complete answer requires us to confront the ways in which the views of the people do and do not get transmitted into American government. … in the weeks and months leading up to an election, public opinion can shift based on the messages and arguments to which voters are exposed. Because of…Citizens United…corporations can spend unlimited sums…”

“Let's pause for a moment and zoom out. Having laid out the battle that will ensue between the big organizing of the M4A movement and the big money of its opponents, as well as the treacherous maze that awaits M4A in the legislature, it's worth asking a simple question: if most Americans support M4A, why is it so difficult to pass? ”

“These tactics also reveal a connection between corporate opposition to health reform and centrist Democratic opposition. For progressive Democrats who rely on a progressive base to get elected—perhaps from a deep-blue district the scare tactics and media campaigns of the corporate opposition are less of a threat, because public support for M4A is firmer.”

“Grassroots organizing will be critical to to passing M4A in two ways. First and most obviously, it will be critical in driving consensus on the policy among the public. At its best, organizing puts the message in the mouth of the most trusted informant of all, the public itself. It empowers people to commune around the ideals of the world they want to live in together.”

“In fact, when it comes to shaping lasting changes in popular support, organizing may actually be more powerful than political connections or financial resources. To appreciate the power of organizing to shape our perspectives on an issue, consider the change in public attitudes toward same-sex marriage.”

“If any universal healthcare plan is to pass in Congress, the linchpin of its success will be a grassroots constituency that builds popular support for the policy and harnesses the excitement of supporters into an organized movement to drive the political process toward reform. Whether M4A or a public option, success or failure will depend critically on the strength of the movement behind it.”

“M4A has a political advantage over more incremental reforms as a policy to organize around. M4A is a simple policy that expresses a clear moral value: healthcare is a human right. And it has the potential to deliver truly life-changing benefits to millions of Americans. Despite its other political vulnerabilities, there is no doubt that M4A has the potential to excite a broad swath of the American public.”

“What would it take to strengthen the consensus on M4A and build the political will for reform? There is only one foreseeable possibility: a popular national movement pushing for M4A. Quite simply, there is no other force strong enough to overcome the partisan attacks and the deep-pocketed opposition from industry.”

“If history is any guide, a serious push for M4A will require electing a president who makes M4A a significant piece of her platform. But even if and when voters elect a pro-M4A president, passing a Medicare for All bill will require a supportive Congress.”

“opponents seek to reframe that conversation away from the merits of M4A and toward the attacks against it: that M4A would take away your private insurance, raise your taxes, let the government control your healthcare, and take away jobs. Over the years powerful organizations have targeted the American public through… massive media campaigns that shift the national conversation and sour the public mood…”

“American history is filled with steady support for national health insurance, punctuated by periods of rising public support and intense political interest. However, these surges are quickly met by a clear counterforce from the opponents of health reform. To appreciate these dynamics, consider the last major effort for healthcare reform: ACA…passed on a party-line vote...Democrats controlled both houses of Congress”

“Medicare today also doesn’t cover vision, hearing, and dental care. … Under current House and Senate M4A bills, all these types of care would be covered—and this could have a sizable impact on seniors’ quality of life (and support for M4A).”

“One of the pain points for seniors is the…rapidly increasing cost of prescription drugs. Although only about 12 percent of Americans are over the age of sixty-five, they account for 30 percent of all prescription drug use. Seniors on Medicare need to buy separate prescription drug coverage … If M4A provides a robust prescription drug benefit that provides drugs at low cost, it could…earn support from seniors.”

“negotiations over healthcare take up such a large proportion of collective bargaining efforts, separating health insurance from employment would free up space to negotiate a broader suite of benefits and focus on wage increases. In the words of union president Sara Nelson, "What we legislate, we don’t have to negotiate."”

“Medical liability costs tend to be substantially lower in countries with single-payer healthcare. Under M4A, one opportunity to build support among physicians would be to offer malpractice insurance through Medicare. In Canada, for example, nearly 95 percent of physicians are covered by the Canadian Medical Protective Association, which is a nonprofit organization established by the Parliament of Canada…”

“Pramila Jayapal…, said: "Five years ago, physicians were not necessarily with us. But as people have gotten more and more frustrated with having to advocate with the insurance company on behalf of their patient, I think they’ve gotten very, very frustrated at how much time they’re spending doing that and how little time they’re spending doing the thing they actually went to school to do: provide quality care.”"

“Specialties that can use the threat of surprise billing to collect higher fees, like radiologists and emergency physicians, could also see M4A as hazardous to their earnings… Medical student debt also remains an important source of insecurity for young physicians concerned about potential changes in compensation resulting from M4A.”

“the pandemic threw into sharp relief many of the trends driving doctors toward M4A, including the growing recognition that practicing physicians have interests that are separate from (and sometimes at odds with) the interests of the healthcare corporations that increasingly employ them”

“more doctors are now employees of large healthcare corporations, rather than employees of other doctors.”