Medicare For All Dominates Democrats' Health Care Debates

Democrats are offering competing plans to provide universal health care coverage, all of which are variations on the Medicare-for-all plan that Sen. Bernie Sanders has introduced.

RACHEL MARTIN, HOST:

In large part, the Democratic presidential primary is shaping up to be a debate about the future of health care in America. Vermont Senator Bernie Sanders is responsible for that in some ways, by running on a Medicare for All plan in 2016. Yesterday, Sanders introduced an updated version of his universal health care plan.

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BERNIE SANDERS: Together we are going to end the international embarrassment of the United States of America, our great country, being the only major nation on earth not to guarantee health care to all as a right. That is going to end.

MARTIN: So how is the Sanders plan changing the political debate this time around? NPR political reporter Danielle Kurtzleben is in the studio with us this morning. Hi, Danielle.

DANIELLE KURTZLEBEN, BYLINE: Hey, Rachel.

MARTIN: So is the Sanders proposal in 2019 any different than it was in 2016?

KURTZLEBEN: I mean, it's largely the same from what everybody listening right now has probably heard. I mean, it is single payer, that payer being the U.S. government. So instead of you, your employer, the government all paying, you know, you just have the government paying. So yes, this would virtually eliminate private insurance. And also Medicare here would be a beefed-up version of what there currently is. It includes a lot of other benefits. It includes vision, dental. And the one big change from the last time that Sanders introduced this is long-term care. That's one big thing that he's added to that.

MARTIN: What do you mean? Can you just explain what that means?

KURTZLEBEN: Long-term care, you know, in community settings. It allows - it would give people the ability to pay for that long-term care, you know, for disabilities, that sort of thing.

MARTIN: OK. OK.

KURTZLEBEN: Yeah.

MARTIN: So what's the reaction to the new and improved or, kind of largely the same, Sanders plan?

KURTZLEBEN: Well, I mean, first of all, you have opponents saying this is going to cost a whole bunch. Of course, Medicare for All proponents would say, listen, this just shifts the costs from you and your employer and insurance companies to the government. So that is the big debate you're going to hear. But speaking beyond cost, President Trump, the White House, put out a statement last night, saying that - emphasizing that they think this is a Socialist plan. The White House released that statement.

And then Republicans, the RNC yesterday, was also heavily emphasizing that this would mean new taxes and that a lot of people probably won't like that. Aside from that, that this would take away private insurance, and many Americans who have private insurance do like it.

MARTIN: Right. And those two things are true. It will mean higher taxes, and it will mean private insurance goes away.

KURTZLEBEN: Right.

MARTIN: Does this make things awkward at all for some of the Democrats who are in the presidential race right now? But they were all about the Sanders Medicare for All plan back in 2016. Now they're running against him. And it?

KURTZLEBEN: Right. I mean, so for the senators who were in favor of it last time, they've signed on again this time. Those senators are Cory Booker from New Jersey, Kamala Harris from California, Kirsten Gillibrand from New York, Elizabeth Warren from Massachusetts. So those four who were running last - who are running now supported it then. They support it now.

MARTIN: OK.

KURTZLEBEN: But one big thing that is happening in this field is that you have a lot of these candidates who support Medicare for All, but what they say is, we don't just support Medicare for All. They also have other plans. A lot of them will say that, listen, I want universal coverage, but I don't - but it doesn't have to be Medicare for All. You can have people buy into Medicaid. You can have people buy into Medicare. Really...

MARTIN: You can do incremental change, which is sometimes a bad word for people who want some wholesale revolution.

KURTZLEBEN: Most definitely. And you can see that being a really big debate on the Democratic side. On the other hand, you could also say that Democrats have a lot of ideas, a lot of options, this time around.

MARTIN: Any idea about the political calculation that this comes down to? Because like we just alluded to, there are Democratic primary voters who want something big. And the incremental change isn't appealing.

KURTZLEBEN: Right. I mean, the bottom line here is that health care is touchy. Big bumper-sticker slogans tend to do well with people. You get to the particulars, that tends to upset voters.

MARTIN: NPR's Danielle Kurtzleben on NPR News.

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