Hillary Clinton distorted the meaning of single payer health plans in the second Democratic debate and is continuing to attack Sanders’ progressive agenda on the campaign trail. Politico reports, “Three days after the fairly cordial second Democratic debate, Clinton’s campaign is mounting an attack against Sen. Bernie Sanders for proposals to raise taxes on the middle class that were part of the national single-payer health care bills he introduced in Congress.”
As Jonathan Cohn, Why is she talking like a Republican? He also points out, “This is why Hillary Clinton makes so many progressives queasy.”
Sanders’ campaign responded:
“On Medicare for all, the middle class would be far better off because it would save taxpayers money,” Sanders spokesman Michael Briggs said in response to Clinton’s latest line of attack. “More people would get better care at less cost. Didn’t she used to be for that? We wouldn’t throw money away on costly premiums for profit-making private insurance companies. Pharmaceutical companies would no longer be able to rip off Americans with the most expensive prescription drugs in the world. Didn’t she used to be for that?”
“Secretary Clinton has singled out Senator Gillibrand and praised her [family leave] legislation which, it turns out, Secretary Clinton now refuses to support because of the way it’s paid for,” Briggs added, noting it requires a small tax hike on the middle class. “No wonder people have their doubts about her.”
His campaign web site has further information:
What’s the Truth About the Clinton Campaign False Attacks?
The truth is that a single-payer plan will save American families money and provide universal health care.
Under the legislation offered by Sen. Sanders in 2013, families with taxable income under $250,000 a year (individuals under $200,000) would pay a tax of 2.2 percent of taxable income.
That means a family with a taxable income of $100,000 a year would pay $2,200 a year – but would be relieved of paying any private health insurance premiums and any copayments or deductibles.
A family making $50,000 would pay $1,100 a year.
The page also notes that, “The Clinton campaign received more contributions from the pharmaceutical industry than any other – Republican or Democrat – through the first six months of the campaign.”
Clinton’s attack sounds like a repetition of attacks on Sanders in The Wall Street Journal in September. Physicians For A National Health Program responded:
In a front-page Wall Street Journal article a few days ago, the projection was made that a single-payer national health insurance program (NHI), as part of the presidential campaign of Senator Bernie Sanders (I-VT), would cost $15 trillion over ten years. Accurate though that figure is, this under-researched article conveys disingenuous misinformation to a broad readership that might be inclined to dismiss such a program as too expensive to even consider.
This article is irresponsible in what it doesn’t say— what the savings would be of reining in our current wasteful, overly bureaucratic profit-driven medical industrial complex, and the benefits that NHI would bring to our entire population compared to what we have now or have ever had.
Thanks to a landmark study in 2013 by Gerald Friedman, Professor and Chairman of the Department of Economics at the University of Massachusetts, we have a solid financial analysis of the costs and benefits of a single-payer national health plan. With NHI, $592 billion would be saved annually by cutting the administrative waste of some 1,300 private health insurers ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). These savings would be enough to cover all of the 44 million uninsured (at the time of his study) and upgrade benefits for all other Americans, even including dental and long-term care. A single-payer public financing system would be established, similar to traditional (not privatized) Medicare, coupled with a private delivery system. Instead of having to pay the increasing costs of private health insurance, so often with unaffordable deductibles and other cost-sharing, patients would present their NHI cards at the point of service without cost-sharing or other out-of-pocket costs. Care would be based on medical need, not ability to pay…
There is far more on this in the full post. Common Dreams adds:
Sanders’ embrace of a single-payer system—also widely backed by the American public—earned him the endorsement of the National Nurses United (NNU), the nation’s largest organization of nurses. NNU Executive Director RoseAnn DeMoro said in August that his ” issues align with nurses from top to bottom,” including his “insist[ance] that healthcare for everyone is a right not a privilege.”
There is added irony in that this is yet another flip-flop from Hillary Clinton. She has flip-flopped on some selective economic issues to try to attract progressive support, and she has flip-flopped on gun control. As I recently posted, some of her statements on gun legislation were like the views from Sanders which she attacks. At other times she has taken a more conservative viewpoint. As Martin O’Malley pointed out during the second debate, she has held at least three views, portraying herself “as Annie Oakley and saying we don’t need those regulations.” Clinton has also supported a single payer plan in the past. This is from Clinton in 1994, both supporting single payer and showing no objection to a general tax to fund it (emphasis mine):
..I believe, and I may be to totally off base on this, but I believe that by the year 2000 we will have a single payer system. I don’t think it’s — I don’t even think it’s a close call politically.
I think the momentum for a single payer system will sweep the country. And regardless of the referendum outcome in California, it will be such a huge popular issue in the sense of populist issue that even if it’s not successful the first time, it will eventually be. So for those who think that building on the existing public-private system with an employer mandate is radical, I think they are extremely short-sighted, but that is their choice.
There are many ways to compromise health care reform, and I don’t think that the President could have been clearer in every public statement he has made that he has one bottom line. It is universal coverage by a date certain. And he has basically told the Congress, you know, you’ve got different ways of getting there. Come to us, and let’s look at it. There are only three ways to get to universal coverage. You know, a lot of people stand up and applaud universal coverage, and they sit down, and you say, “Well, how are you going to get there?”, and they don’t want to confront that there are only three ways.
You either have a general tax — the single payer approach that replaces existing private investment — or you have an employer mandate, or you have an individual mandate. And there isn’t any other way to get to universal coverage. The market cannot deliver universal coverage in the foreseeable future, and any compromise that people try to suggest that would permit the market to have a few years to try to deliver universal coverage without a mandate that would take effect to actually finish the job will guarantee a single payer heath care system.
Or maybe we are just dealing with ignorance of the topic as opposed to flip-flopping. Physicians For A National Health Program pointed out her confusion on Medicare for All as a model for single payer plans displayed in an interview in The New York Times in 2008:
Q: Last question. You talked earlier in the interview about how your plan maintains the private insurance system. But in October, at the forum of the Kaiser Family Foundation, you were asked whether your plan to make government insurance, a Medicare-type plan, available to all was a backdoor route to a single payer system, and you said, “What are we afraid of? Let’s see where the competition leads us.” So is it okay with you if the market ultimately dictates that the U.S. system sort of morphs into a single-payer system? And if so, doesn’t that arm the Republicans with exactly what you were talking about, this claim that it’s socialized medicine?
MRS. CLINTON: No, because I think what we would be offering would be a Medicare-like system, which is something people are familiar with, and you know whether we would call it Medicare 2.0 or whatever we would call it. And we’d see whether people want that or not. And where it morphs to, I think this whole system will morph. I mean, look at where Medicare started and where it is today. In large measure, some of the problems we have are because of the way it evolved. But I think from my perspective, having this Medicare-like alternative really does answer the desires of people. And there’s a significant minority who want quote a single-payer system. It at least gives them the feeling it’s not for profit, they’re not paying somebody a billion dollars for raising their premiums 200 percent and all the rest of the problems that we face with the for-profit system. You get the costs of overhead and administration down as much as possible. I believe in choice. Let Americans choose and what better way to determine that than letting the market have some competition and you know see where it does lead to.
Q: And if the choice is a single-payer system, that’s fine by you?
MRS. CLINTON: You know, I think that would be highly unlikely. I think that, you know, there’s too many bells and whistles that Americans want that would not be available in kind of a bare-bones Medicare-like system but I think it’s important to have that competition.
By Don McCanne, MD
Competition between a bare-bones Medicare-like plan versus private bells-and-whistles insurance? What kind of framing is that!?
In her proposal, is she really advocating for a public Medicare-like option that provides only bare-bones coverage? That’s certainly not the model that single payer advocates propose.
Is she suggesting that the private insurance industry will be able to provide us with an insurance product that includes all of the bells and whistles at a premium that is affordable? If such a plan were to be offered it would have a very small market limited to only the wealthiest of us. Insurers typically shun small markets.
On this issue, at least, it looks like Clinton has been moving to the right over the years.
I could understand a politician not pursuing a single payer plan because of the political obstacles in getting it passed. It is a totally different thing when Hillary Clinton repeats right wing talking points to attack Sanders for desiring a single payer plan, especially when she once had a far more liberal view on the subject.
Update: Nation’s Largest Organization of Nurses Joins Liberal Writers In Protesting Hillary Clinton’s Attacks On Bernie Sanders