Dingell and Jayapal on Single Payer Unity and the Foundationals

Congresswomen Pramila Jayapal (D-Washington) and Debbie Dingell (D-Michigan) last week introduced the Medicare for All Act of 2021, legislation that would guarantee health care to everyone in America as a human right. 

The bill had 112 co-sponsors, six fewer than the 118 co-sponsors on the bill at the end of last year.

The bill provides comprehensive benefits to all with no copays, private insurance premiums, deductibles, or other cost-sharing. 

Jayapal said the bill was signed on to “by more than half of the House Democratic Caucus including fourteen committee chairs and key leadership Members.” 

In their press statement, Jayapal and Dingell were united in their need for the single payer system, a system that would effectively eliminate for profit private insurance companies from the healthcare system, except for non covered procedures or administrative functions.

“While this devastating pandemic is shining a bright light on our broken, for-profit health care system, we were already leaving nearly half of all adults under the age of 65 uninsured or underinsured before COVID-19 hit,” Jayapal said in the press statement.

“A system that prioritizes profits over patients and ties coverage to employment was no match for a global pandemic and will never meet the needs of our people,” Dingell said in the statement. “In the wealthiest nation on earth, patients should not be launching GoFundMe pages to afford lifesaving health care for themselves or their loved ones. Medicare For All will build an inclusive health care system that won’t just open the door to care for millions of our neighbors, but do it more efficiently and effectively than the one we have today. Now is not the time to shy away from these generational fights, it is the time for action.”

But on the press call announcing the bill, Dingell and Jayapal appeared to differ on tactics. 

Jayapal was co-chair of the Biden-Sanders Unity Task Force that put forth a number of recommendations for health care reform, none of which was single payer. 

Sanders made his name on single payer, Biden was opposed.

When asked about the road forward for the single payer bill, Jayapal indicated that the leadership in the House and Senate would move to put through the piecemeal reforms – what she called “foundationals” – in the Unity Task Force report – including the public option and dropping the Medicare age to 60.

Dingell said she hadn’t decided whether she could support the step by step approach, saying “now is the time for Medicare for All.” 

As for the obstacles to pushing the Medicare for All bill through this Congress, Dingell told the story of how opponents of Social Security had burned a cross on the front yard of her late husband’s father – Congressman John Dingell Sr. – charging him with “socialism.”

Dingell seemed to be saying – there are obstacles and then there are obstacles.

When the Unity Task Force came out with its step-by-step approach in August 2020, mainstream single payer groups like Physicians for a National Health Program roundly condemned it.

“When the neoliberals commandeered the Democratic primary process and bumped Bernie Sanders out of the running, it was recognized that Joe Biden would have to do something to reunite the Democrats since the flame of the popular progressive revolution had been extinguished, and the Democrats were left with a candidate basically representing the status quo,” wrote Don McCanne of Physicians for a National Health Program. “Perhaps the greatest disappointment was that single payer Medicare for All had been removed from the agenda.”

“The report of the recommendations of the Biden-Sanders Unity Task Force is 110 pages long and covers many areas of policy. The ten page section on health care basically perpetuates the current health policies, led by the Affordable Care Act, while adding a public option and reducing Medicare eligibility age to 60. The most glaring feature is invisible – the total lack of any mention of single payer Medicare for All.”

“Single payer Medicare for All is not simply an expansion of Medicare to cover everyone. It is a comprehensive revision of the financing of health care making it universal, comprehensive, efficient, effective, equitable, accessible, and affordable for everyone, for life. The Biden-Sanders Unity Task Force proposal meets none of those criteria,” McCanne wrote.

“Biden has said that we cannot afford single payer Medicare for All, yet his model perpetuates much of the excessive spending in health care, failing to recover hundreds of billions of dollars in administrative waste. For administrative efficiency he suggests reducing paperwork through uniform medical billing, but we already have that in Form 1500. He also suggests price transparency as if Nobel laureate Kenneth Arrow never explained why health care markets don’t work. Biden’s proposals would significantly add to our health care spending, and thus would be much more expensive than an efficient single payer Medicare for All.”

“The goal of the Unity Task Force is to bring disappointed progressives back into the fold. It is likely that President Trump is going to orchestrate his own defeat, and Joe Biden will be elected by default. Regardless, it is important that progressives not give up on single payer. Assuming Biden is elected, it is imperative that we continue to educate everyone on the virtues of the single payer model. If President Biden truly understood the single payer model – and he doesn’t – he would certainly sign legislation enacting it.”

 

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