Not only does MFA have to pass the House and Senate,

[wasupaloopa]

it has to pass a conservative SCOTUS.

Improving the ACA gets to universal coverage with affordable costs

Take on big pharma and private insurance but don’t risk losing votes by taking away employer coverage and force people into a government system.

A public option will compete with private insurance and possibly reform it.

[PatrickforO]

1. Ah, a clearer post than the one I gave the giant word-wall type response to!

I agree. I really am quite progressive, but if this country's government is working the way the founders intended, there will be vigorous debate, followed by a compromise that moves us forward.

[Hortensis]

12. Yes. The OP might have specified WHICH of several MfA's,

but yes. I really don't think anyone needs to lose sleep over the prospect of having all choice effectively stripped by legislative fiat and workplace insurance made illegal.

For that matter, a majority of our Democrats were involved in creating and/or fought to pass the ACA; most are quite knowledgeable about government healthcare programs here and around the planet, some extremely. If they were to support beginning all over from scratch as the next incremental step to universal, it'd be for good reason.

[Cha]

2. Excellent point about SCOTUS.

[thesquanderer]

10. If they really make it equivalent to today's Medicare, but for everyone...

...then I don't see how the court can rule against one without ruling against the other. Would they really make Medicare unconstitutional? If they dare to go that far, I'd predict a breakneck speed constitutional amendment to make Medicare constitutional. And most Republicans' will vote for it, like their jobs depend on it, because that will be the case.

[DrToast]

14. They can't. Just scare tactics against MFA

And I’m not even for it, but the notion that MFA would be unconstitutional is silly.

[crazytown]

3. Yep. Just like the Voting Rights Act, 1965.

We should have given up. Too risky. Work with the States to improve things on the local level.

Dream Big. Fight Hard. Win.

[mr_lebowski]

4. Apples and Oranges, and I could come up with about 10 reasons why off the top my head ...

But, here's #1:

1) There wasn't 100's of Billion$/year, and the disposition of 100's of 1000's of jobs involved.

[crazytown]

5. And I can come up with one big one

A crucial Democratic voting block, the Dixiecrats, had stymied every attempt at reform for 50 years. Democrats faced enormous opposition within their own party. That guy, Eastland, that Joe enjoyed working with in the '70s still holds the record for the longest filibuster in history. Civil rights activists paid with their lives.

M4A like civil rights is a political fight. There will be winners and losers, but it is nothing like the incredible battle against hugely powerful entrenched interests that the Democratic Party undertook, all the time knowing, in the words of President Johnson, "there goes the South for a generation".

[wasupaloopa]

16. Tagging the glorious history of passed achievements on to your 2019 plans is a sorry way

to make it look good. Lipstick on a pig comes to mind.

[crazytown]

20. "glorious history"?

get far away from me

[bluewater]

37. Are you talking about the 2019 Biden Campaign ?!?

"Tagging the glorious history of passed achievements on to your 2019 plans is a sorry way to make it look good. Lipstick on a pig comes to mind."

[KPN]

27. THIS ... and you know what? If you really want to improve the ACA, start by

seriously talking about and proposing some form of Medicare for ALL. Starting at "improve the ACA" is a good way to end up with something that might even be less than what the4 ACA was to begin with since it's almost gone already.

Let's not end up with buyer's remorse because we thought, talked and opened negotiations with incremental.

Geesh!

[emulatorloo]

29. The Public Option is a government managed program. Like Medicare.

Medicare for those who want it as Pete says.

[KPN]

32. Yes. The devil is in the details. I won't be convinced until I see those. In other words, how

much is it going to save the average enrollee compared to our current system. MFA is an avenue to controlling costs in the health industry overall, not just the health insurance industry. Will the public option do that and result in significant pocket-book savings for most? How do those savings stack up against MFA?

[emmaverybo]

6. Excellent post. NT

[mahina]

7. I don't know how affordable... we pay 500+ per month per person

And it’s threatened to double.
At least we have protection for preexisting conditions though.

[Voltaire2]

8. you cant afford any insurance after you

lose your job. Linking healthcare to employment is idiotic.

[Demsrule86]

13. If you lose your job you are eligible for medicaid expansion in the states that passes it.

The ACA can take of all that...waste of time to try to do MFA...it will never happen and will hurt us politically..reform the ACA.

[Voltaire2]

15. And not in the states that didn't.

depending on income your subsidy might make your premiums affordable, but you will still have to cough up the copays deductibles, out of network bills, and mystery we don’t cover that cost that drive actual per capita costs up around 6000. All while you are out of work.

Medical expenses are the number one cause of personal bankruptcies.

It is a shit system. Why we are defending it is a measure of how completely brainwashed we are.

[wasupaloopa]

17. A public option is not work related. If you lose your job everything gets hard to pay for not only

Insurance.

[Voltaire2]

18. under MFA you will not have these expenses

Everyone is covered, no premiums, no copays, no deductibles, no out of network bills.

[wasupaloopa]

19. That my friend is a fantasy. No you will still have costs to pay. Part A is hospital coverage

paid for through payroll deductions. Part B is doctor services the cost is taken out of social security. Part D is drug coverage paid for through premiums to insurance companies. And since Medicare only pays 80% and does not cover all procedures you need a suplimental plan paid for by premiums to an insurance company.

And Medicare has an annual deductible

[Voltaire2]

22. I am sorry that you haven't even bothered to read a summary of what MFA is.

The house and senate bills provide comprehensive universal coverage with no premiums, no deductibles, generally no co-pays, and no mystery bills. They both cover medical dental vision and long term care.

[Demsrule86]

21. A public option for those who live in states that did not expand medicaid will take care of that...

And would be way easier than starting from scratch...no matter how much some love MFA ...it won't happen. We will however reach universal coverage by building on the ACA.

[Voltaire2]

23. No it doesn't.

Your 'public option' is just another insurance policy with premiums deductible co-pays out of network bills etc. Its individual cost will be similar to existing private insurance plans. It perpetuates the current system, people with good jobs get good insurance, everyone else is up shit's creek. You lose your job, now instead of your employer sharing the cost of insurance, you are on your own, and the individual costs are huge.

[Demsrule86]

24. You can buy into medicare or medicaid...so no it is not...and Medicare has premiums, copays and

deductibles...and you need a private insurance wrap unless you are dirt poor and qualify for medicaid. A public option would have premiums subsidized as the ACA does and we need to beef it up...combined with regulation for big Pharm and insurance companies...we will never get MFA...so we need to work with what we have. I don't like MFA personally and consider it yesterday's solution...not for the 21st century...in the UK, the conservatives are cutting the shit out of their single payer plan. I have family there...so it is true.

[Voltaire2]

25. MFA has no premiums no deductibles

Very limited copays (prescriptions only) and covers medical dental vision and long term care. It is not Medicare or Nedicaid.

[emulatorloo]

30. The public option is Medicare. Government run. It isn't private insurance.

[NYMinute]

9. K&R nt

[NurseJackie]

11. Thank you!

[bigtree]

26. "Harris's idea is the truest expression of Medicare-for-all

[The Velveteen Ocelot]

28. *Any* proposal has to go through Congress, and it might not survive at all, or

end up greatly pared down. All of the plans, of all descriptions, will be sliced and diced until they're just about unrecognizable. I wish the candidates would honestly acknowledge the fact that a president doesn't have much control over legislation - they can submit bills to Congress and support or oppose legislation, but apart from the bully pulpit they got nuthin.' Getting the ACA (a much more modest law than some of the proposals being put forth by our candidates) passed was like pulling teeth, and it went through a whole lot of iterations before it finally became law. I'd like to see the candidates say something like, "I will fight tooth and nail for a plan that includes (whatever), but the ultimate decision will be up to Congress. That's why you need to vote not only for me but for the Democratic Congressional candidates in your state. This is what my plan can do for you (details), but I can't make it happen alone. Vote for me and for your Democratic Congressperson and Senator."

[KPN]

31. OK, so show us how "Improving the ACA gets to universal coverage with affordable costs"?

Costs aren't affordable for many already and haven't been even in blue States. (My wife and I pay a substantial share of my daughter's health insurance because she can't afford the coverage she needs -- and that's here in Oregon for crying out loud. How do you get to universal coverage when some can't afford it?

And oh by the way, how do you create a public option that doesn't get challenged at SCOTUS? That's a red herring argument, not a "good point".

Talking about incrementalism will get us tiny increments that don't upset the health industry apple-cart. Talking about, proposing and opening negotiations in Congress about MFA is what will get us meaningful improvement of ACA and affordable universal care -- not here's what we'd like but we'll settle for this! Geesh!

Edit: I will give you that "MFA" is not the best name for a single-payer universal health plan. I think that's why probably why Harris has adjusted her plan, even though MFA is probably the best and most cost effective way of guaranteeing access to health care as a human right. Warren and Sanders are not wrong about the role of the private health insurance and pharmaceutical industries, or about the importance of controlling costs across the full breadth of the health industry overall by regulating the profit objective.

[brush]

33. SCOTUS can not stop it from becoming a law.

Later someone with standing might try to take it to court but the Supreme Court does not have a say in what passes through what bills pass through Congress to become laws.

[in2herbs]

34. What will the supporters of improving the ACA do if the appellate court rules the whole of the ACA

is unconstitutional? The decision is pending.

[Gothmog]

35. Fighting over the details of their healthcare proposals won't help them beat Donald Trump

Link to tweet

[elocs]

36. So is it Medicare for All, or nothing? Do we hold out false hope for those who need help now

by pretending that MFA has an actual chance of passing anytime soon?
Because I hear and read lots about MFA being said by candidates who favor it, how great it is, but never an explanation of how it would become law.

[Gothmog]

38. American politics could use a healthy dose of pragmatism

Link to tweet

Most Americans aren’t philosophers, thank goodness, but we are a nation of pragmatists. And so, despite the snap to her zinger, Sen. Elizabeth Warren (Mass.) was out of the mainstream when she shrugged off criticism during the second round of Democratic debates by saying: “I don’t understand why anybody goes to all the trouble of running for president of the United States just to talk about what we really can’t do and shouldn’t fight for.”

Democrats should be demanding more answers, not fewer. Will Medicare-for-all cost key union votes in critical Midwestern states, as Rep. Tim Ryan (D-Ohio) argued during the debates? Does a free-tuition promise at state colleges and universities benefit middle- and upper-class families more than families in need? Is Warren’s proposed tax on the assets of wealthy Americans likely to pass constitutional muster, and what strategies are billionaires likely to employ to avoid it? In light of those answers, will it really pay for all that she has promised?

Do Americans support decriminalizing illegal border crossings? Do Americans oppose lawful deportations? Do Americans agree that the federal government should guarantee a job for every person? Pragmatic questions such as these are highly relevant in a representative democracy, where politics is the art of the possible.

What I don’t understand is why anybody goes to all the trouble of running for president of the United States simply to ignore questions about real-world realities and promise fights without explaining how to win them. Reality is not going to bend to a new shape come 2021 just because a President Sanders shouts at it or a President Warren fights with it.