A Proposal Designed to Confuse Public and Prevent "Medicare for All"

CAP's plan will allow private health insurers to continue to rip off the government. NIMA is a publicly-financed program without the requirement of creating profits for investors. With a low overhead, most of the dollars are used to pay for health care. The CAP plan maintains the same problems that exist with Medicare today. Private Medicare providers cherry pick the healthiest patients and those who have or develop healthcare needs wind up in the public Medicare plan. This places a financial burden on the public Medicare plan, which has to pay for the most care, while private health insurers rake in huge profits from covering the healthy with a guaranteed payor, the government.

CAP's plan will continue to perpetuate health disparities. NIMA provides a single standard of care to all people. Because all people, rich and poor (and lawmakers), are in the same system, there are strong incentives to make it a high quality program. CAP's plan maintains the current tiered system in which some people have private health insurance, those with the greatest needs have public health insurance, some people will have inadequate coverage and others will have no coverage at all.

CAP's plan will continue to restrict patients' choices. NIMA creates a nationwide network of coverage and consistent coverage from year-to-year so that patients choose where they seek care and have the freedom to stay with a health professional or leave if they are dissatisfied. CAP's plan continues private health insurers and their restricted networks that dictate where patients can seek care. Private plans change from year-to-year and employers change the plans they offer, so patients will still face the risk of losing access to a health professional due to changes in their plan.

CAP's plan does not guarantee portability. NIMA creates a health system that covers everyone no matter where they are in the United States and its territories. CAP's plan maintains the link between employment and health coverage. When people who have private health insurance lose their job or move, they risk losing their health insurance.

CAP's plan will perpetuate physician burn-out. NIMA creates a healthcare system that is simple for both patients and health professionals to use. Under the current system, which the CAP plan will perpetuate, health professionals spend more time on paperwork than they do with patients and physician offices spend hours fighting with health insurers for authorization for care and for payment for their services. This is driving high rates of physician burnout. Suicides among physicians and physicians-in-training are higher than the general population.

The new proposal is a "public option" wrapped in a "Medicare for All" cloak. It is a far cry from National Improved Medicare for All. And, contrary to what CAP and its allies will tell you, the CAP plan will delay and prevent the achievement of NIMA.

Co-founders of Physicians for a National Health Program**, Drs. Steffie Woolhandler and David Himmelstein, explained why the public option would not work in the last health reform effort:

"The 'public plan option' won't work to fix the health care system for two reasons.

"1. It forgoes at least 84 percent of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes, which would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even if 95 percent of Americans who are currently privately insured were to join the public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16 percent of the roughly $400 billion annually achievable through single payer -- not enough to make reform affordable.

"2. A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan -- which started as the single payer for seniors and has now become a funding mechanism for HMOs -- and a place to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan."

What we must do

The movement for National Improved Medicare for All experienced tremendous growth in the past few years. All of the flaws of the Affordable Care Act are becoming reality as people are forced to pay high health insurance premiums, face high out-of-pocket costs before they can receive care and have their access to health professionals or services denied. There is a strong demand for NIMA that has resulted in more than half of the Democrats in the House of Representatives signing on to HR 676 and a third of the Democratic Senators endorsing the Senate Medicare for All bill. Medicare for All is becoming a litmus test for the 2018 elections and 2020 Democratic presidential nomination.

Power holders are feeling threatened by support for NIMA. They are looking for ways to throw the movement off track and allow lawmakers who don't support NIMA to support something that sounds like NIMA. This is why they invented "Medicare Extra for All." It is common for the opposition to adopt our language when we have strong support.

This is the time when the movement for NIMA needs to remain focused on our goal of NIMA, resist compromising and escalate our pressure for NIMA. We are closer to winning, it's time to increase our efforts to pass the finish line.

Here are our tasks:

• We need to expose the reasons for CAP's proposal. It is designed to protect health-insurance industry profits.
  
  
• We need to educate ourselves and others about the reasons why CAP's proposal is flawed and deficient.
  
  

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