Prominent liberal think tank Center for American Progress (CAP)’s Medicare Extra for All proposal lays out a blueprint for achieving universal health care coverage. It blended the branding of Medicare for All plans and the blueprint proudly asserts “health care is a right.” As an architect of several state and federal Medicare for All plans, I’m thrilled to see CAP join this fight.



The problem? CAP’s proposal doesn’t fix the big, underlying issues.



Right now, for-profit drug companies, hospital systems, and insurance companies hold America’s health care system hostage. They add little value, create and artificially inflate the cost of care to boost their profit margins.

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According to Congressional Budget Office (CBO) data CAP cites, administration in the private insurance system eats

consumes an

incredible amount

of doctors, nurses and other medical professional's time.



Instead of simply replacing the private insurance system, CAP establishes its “Medicare Extra for All” public program as a parallel track, leaving the for-profit health care industry in place.

This significantly limits the savings we could achieve by streamlining our health care system and weakens Medicare’s negotiation power over the cost of care and prescriptions. Hospitals, doctor’s offices and outpatient centers would still need to maintain the expensive bureaucratic systems required for dealing with private insurers.

CAP’s plan allows private employers to choose between private health insurance or CAP’s publicly funded option. Because most companies would decide based on price, employers with relatively older and less healthy employees would funnel their workers into the public system, while those with younger and healthier workers would continue to cover their own, less expensive, employees.

This imbalance would significantly inflate the cost to taxpayers and undercut the savings that could otherwise be realized in a single, unified system.

CAP wants to keep the dead weight of America’s for-profit health-care system to make the plan more politically viable to members of Congress than a true single-payer system. But there is little reason to think that insurance and pharmaceutical lobbies won’t fight just as hard against CAP’s plan, which would undeniably be a disaster for their bottom lines.

CAP’s plan does have real merit. The Medicare Extra for All program would be available to all Americans regardless of income and employment status. Many of the poorest Americans would be able to use the plan with zero or limited copays and deductibles.

Moreover, the fact that such an influential policy organization is conceding to many of the core arguments of single-payer advocates represents a huge step forward. It shows that every day our movement grows, and we get closer to achieving affordable, quality health care for all.

But at the end of the day, we can’t build the health care system we need on the foundation of a broken, profit-driven system. I am encouraged by CAP’s position, but we need to do more. Americans deserve it.

Dr. Gerald Friedman is a professor of economics and an undergraduate program director at the University of Massachusetts Amherst. A graduate of Columbia and Harvard, he has drafted funding plans for both statewide and federal single-payer systems, and is on the Board of Advisors for the Business Initiative for Health Policy.