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Here's the Health Care bill we should be debating

Date: 2017-Jul-03           Author: Rob Dennis

The Senate Republican health care bill finally was released from the Legislation Protection Program - and immediately got whacked.

It wasn't a clean kill. This tax cut for rich people masquerading as a health care plan still could stagger back into our lives after the July 4th recess. In the meantime, Democratic leaders need to start pushing a plan of their own.

In expressing his support for the Senate bill, Republican Sen. John Thune issued what he intended as a warning. "If we don't get this done and we end up with Democratic majorities in '18, we'll have single payer," Thune said.

If only.

It's not just the Republican majority that's preventing government-run health care coverage from even being debated. There's a bill for single-payer health care sitting in Congress today, but we certainly haven't heard much about it from the Democratic leadership.

In the House, Rep. John Conyers has proposed single-payer legislation every year since 2003. The most recent iteration, the Expanded & Improved Medicare For All Act, has 113 Democratic co-sponsors - more than half of the party.

The legislation would establish a program that would cover "all medically necessary care." It would be paid for by a tax on the top 5 percent of earners, a progressive tax on payroll and self-employment income, and other taxes on unearned income and stock and bond transactions.

House Minority Leader Nancy Pelosi claims to be in favor of a single-payer system, yet she is not a co-sponsor of Conyers' bill. During last year's presidential campaign, she slapped down Sen. Bernie Sanders' plan for a single-payer system as "something that is never going to happen." Why?

A generous interpretation is that she is withholding her support as part of some grand political strategy. A less generous but more plausible answer involves the millions of dollars in campaign contributions that she and other Democrats have received from the insurance industry.

The Democratic establishment appears to have learned little from the 2016 election. It remains far more comfortable cozying up to wealthy donors and running against the Republican agenda, rather than pushing the policies that would help most Americans.

If Democrats want to be credible representatives, they need to be more than obstructionist Trump haters, the new party of no. Certainly they need to fight against many of the policies of Trump and the Republican Congress, but they also need to stand for something. And there's no more important issue than health care.

Sen. Elizabeth Warren argues that Democrats should back a national single-payer plan in the 2018 and 2020 elections. She's right.

Whether such a measure is politically viable at the moment is irrelevant. It's where the country should be heading, and we'll never get there unless some of our leaders actually start leading. This is not an either/or scenario. Having a vision for the future doesn't prevent you from negotiating pragmatically in the present.

The Republican bill is so terrible, and so deeply unpopular, that there's a rare opportunity for an outbreak of bipartisanship in Congress.

Democrats can simultaneously run on single payer while working with moderate Republicans for sorely needed improvements to Obamacare, which amounts to a moderate Republican policy anyway. The Democrats' starting position in these talks should include a Public Option.

Obamacare helped millions of people get access to health care, but it wasn't the real solution. Rather, it was a step toward the universal system that Americans really need. And want.

An Economist/YouGov poll found that most Americans support expanding Medicare to provide health insurance to every American - even when it is framed as a "government plan that is financed by taxes" without mentioning the savings on premiums and out-of-pocket costs that would offset the tax hikes, resulting in an estimated 95 percent of Americans paying less for care.

The central ideological argument over whether health care is a right or a privilege appears to be largely over. Now we're haggling over details and perception.

Every industrialized country other than ours provides health care for all its citizens. Other countries spend far less money than us and achieve far better health care outcomes. Models vary and no system is perfect, but many countries use some variation of single payer. The Australian health care that President Donald Trump is so fond of is essentially a single-payer system.

This is an issue where Trump's lack of ideology or understanding of health care policy could actually prove useful to Americans. All he cares about is winning.

He threw a party in the Rose Garden for Repbulican House members when their health care bill passed, and then threw those same House members under the bus only weeks later by calling the bill "mean" when it turned out to be about as popular as cholera.

If Senate Majority Leader Mitch McConnell fails to get the votes on the Senate's bill, Trump might just decide on a whim to switch his support to the Democrats' plan. If they have a plan.

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