Medicare for All

Kamala Harris' New Health Care Plan, Like Her Old Health Care Plan, Is a Cynical, Muddled Mess

The presidential candidate is still dodging tough questions.

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Since the launch of her presidential campaign, it has been almost impossible to determine what Sen. Kamala Harris (D–Calif.) believes about health care policy. Over the last seven months, she has said that she supports Bernie Sanders' single-payer plan, and also that she opposes parts of it, that she would eliminate all private insurance, and also that perhaps she wouldn't, and then again that she would, but that actually she misheard the question and in fact wouldn't eliminate private coverage, because she would allow for supplemental insurance for cosmetic procedures, a type of insurance that does not exist.

There have always been two possible reasons for Harris' health policy inconsistencies. The first is that she had trouble explaining the nuances of her plans. Given her talents as a speaker and political communicator, that seems unlikely. The second, and more plausible, is that she simply didn't care about the particulars and was saying what she thought people wanted to hear, whether or not it added up to a coherent or defensible policy.

This morning, Harris released a plan designed to reconcile her health policy contradictions. It provides further evidence for the latter explanation. Although it resolves some surface-level problems with her messaging, as policy it is nearly as muddled and cynical as what came before.

Harris has consistently struggled to describe how she would handle private health insurance. In January, she said she supports the Sanders Medicare for All plan, which would outlaw most private health insurance in four years. Health insurance, she said, was a pain to deal with. "Let's eliminate all of that," she said. "Let's move on." The following day, facing a backlash, she hedged, saying that while she would support eliminating private health she would also back other options. Then, at last month's Democratic primary debate, she raised her hand to signal an answer of yes about eliminating private plans; the following day, she backtracked again, saying she'd misunderstood the question.

Her new plan is thus an attempt to articulate a policy that retroactively makes sense of her previous statements. It would allow private insurance carriers to compete to provide Medicare-approved plans within the structure of Medicare. It thus allows her to support a program that nominally provides for universal Medicare while also allowing some private coverage to exist.

But Harris would still eliminate the majority of private coverage as we know it. Employer-sponsored health care plans, which currently cover more than 150 million Americans, would be allowed only if they were certified as Medicare plans. That means many of today's plans would go away. So would private plans bought through Obamacare's exchanges. If you like your plan, too bad: You can't keep it.

The core political problem for Medicare for All is that a large number of Americans currently have employer-sponsored health plans that they like, and Medicare for All would eliminate many of those plans and force those Americans into government-run insurance. Harris' new plan doesn't really change this. It would still disrupt coverage for millions of people. In other words, it resolves the contradictions in her messaging, but not the deeper policy issues.

Under the Harris plan, the private health coverage that would remain would be so heavily regulated as to be effectively government-run, and the plan would still require a complex transition from the current employer-based system to one where the government is responsible for financing most health care.

Harris attempts to manage transition worries by providing for a 10-year transition, in contrast to the four-year changeover called for by the Sanders plan. But this poses different problems: It would mean that even if Harris won two presidential terms, she would not oversee the final implementation of the plan, exposing it to political upheaval. (Imagine if Obamacare had been timed to go into effect after Obama's second term.) The longer timeline could also result in the shuttering of some of today's insurance carriers before the 10-year window is up, pushing people into the new, government-provided plans before the transition is complete, which makes her promise that "no one will lose access to insurance during a transition" rather dicey.

The 10-year transition also allows her to hide the true cost of the plan. The Congressional Budget Office, which provides cost estimates for legislation, typically estimates the price of only the first 10 years of any given piece of legislation, meaning that the fully implemented program would not be part of the cost estimate.

Harris, tellingly, has not provided any cost estimate of her own, nor has she specified how it would pay providers, a critical issue for determining a price tag. Relying on Medicare rates would reduce the total price tag of the legislation, but would also subject hospitals and doctors to large pay cuts that would almost certainly result in service reductions.

Nor has Harris specified a way to pay for her plan. Instead, she continues to pretend she can finance it without new taxes or fees on the broad middle class, a position that not even Bernie Sanders holds. Indeed, Harris specifically rejects Sanders' proposal for a 4 percent "premium" on households making more than $29,000 annually, reserving that fee for families with incomes over $100,000, and further adjustments for high-cost areas. No country that provides health care benefits on the level that Harris envisions has done so without higher middle-class taxes. Harris is describing a system that does not exist.  

With the second series of Democratic presidential debates looming, it was clear that Harris had a health care problem. Even liberals were criticizing her incoherence on the issue. But rather than honestly reckon with the contradictions of her previous statements and the trade-offs inherent in any health policy proposal, Harris has merely attempted to paper over those contradictions with yet another poorly-thought-out, detail-light plan designed to allow her to make promises she cannot possibly keep. Her new plan is pitched as a way of answering tough questions, but it's just another way of dodging them. 

NEXT: When Is Violating the Constitution by Pulling Over Motorists With No Legal Justification 'Not a Bad Thing'?

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  1. Since we Koch / Reason libertarians support #ImmigrationAboveAll, we should seriously consider backing ambitious and expensive Democratic health care proposals. Just think — plenty of people want to immigrate to the US now, even with Orange Hitler in the White House and a terrible economy. Imagine how much more attractive this country would be for immigrants if they knew they’d get free health care as soon as they crossed the border!

    #LibertariansForHarris
    #LibertariansForMedicareForAll
    #(AsLongAsImmigrantsGetItToo)

  2. She has a law degree so she is an expert in all things.

    1. “expert”: from the Greek “X” for the unknown, and “spurt”, a little drip under pressure.

    2. She’s certainly an expert at jailing people for victimless crimes.

      Maybe her healthcare plan is to threaten sick people with prison sentences, just like she did to parents of truant kids.

      Too be fair, she would probably see quite a few people who would lie about sudden improvements in their symptoms in order to avoid jail time.

    3. Yeah really. I know a lot of lawyers who are total idiots. Some are named partners in their firms with over twenty years in practice. I doubt there are many prosecutors out there who know a gaoddmaned ting about running health insurance. And let’s be honest, Harris is nothing special.

      I’m fact, her claim to fame, and basis for her rise to power is that she was Willie Brown’s chew toy (rrrrrr……rrrrrr!). Not any kind of real meritorious basis for her being elected senator.

  3. >>With the second series of Democratic presidential debates looming, it was clear that Harris had a health care problem.

    Harris has an “I’m a terrible candidate” problem.

    1. We the People have a terrible candidate problem. Lots of them.

  4. She does her best work off her feet.

    1. My guess is that distinction goes to Cory Booker. His girlfriend is Rosario Dawson. She was completely nude in that movie about stolen artwork with the guy who plays Prof Xavier. Dawson is so hot, she’s probably singlehandedly responsible for a fair amount of global warming. Booker is probably off his feet all the time when he’s not running his mouth in Washington.

      1. She’s his beard. He’s quite the three dollar bill.

  5. If she doesn’t support the elimination of private health insurance, why did she cosponsor Sanders’ Medicare for All Act of 2019 which has as one of its key components exactly that? She can’t walk that one back – it’s forever on the record and it’s recent.

    Did she “misread” this bill just as she “misheard” the related question during the debate? Do we really want a President who can neither hear nor read and doesn’t take steps to compensate for their disabilities so they can perform their job?

    Or, did she just quickly change her mind as she did on federally mandated school busing to agree with Biden on the very thing she initiated a scripted, non sequitur attack on him about just days earlier? Do we really want another President who changes their mind every few days on critical issues?

    1. “Do we really want a President who can neither hear nor read and doesn’t take steps to compensate for their disabilities so they can perform their job?”
      We got through eight years of one.

  6. Harris once again errs: we are not as stupid as she thinks we are. And she also errs in assuming that we don’t know that she isn’t half as bright as she wants us to think she is. Then again, taking into account some of the people who manage to find their way into elected offices…. well…..

    Let’s modify some old lawyer jokes, eh?

    What is a Harris standing neck-deep in a lake? ……

    1. What?

      1. in need of a few more gallons of water?

  7. Just for the record, these fascists are proposing Medicaid for all, not Medicare for all.
    Medicare pays only 80% of the costs of medical care (100% for hospital only) and has NO annual limit on out of pocket costs.
    Medicare is for people who have paid premiums without coverage for the span of an entire working career, not for people who have never paid a dime in premiums.
    To be clear; they are advocating the nationalization of health care and the elimination of the entire health insurance industry.

    1. Maybe Sanders does mean Medicare for All.

    2. Oh no, the end of the health insurance industry? What a *huge* loss that would be….

  8. “The presidential candidate is still dodging tough questions.”

    She studied politics under Willie Brown.

    1. Or on top of Willie Brown.

      1. Or on all fours in front of Willie Brown.

  9. Harris seems to smile and laugh a lot for my taste.

    “…And then we roasted that hare after I handcuffed it…”

    Laughs maniacally.

  10. Obamacare care was an incoherent mess to. Thousands of pages of goblins, clowns and alchemy that had to be passed in order to know what was in it!

    Yet, Americans still gave Obama a second mandate and thus the ‘okay’ to go ahead and pass it. So how does this differ? Democrats know all they have to do is get elected and then do their thang.

    I think it may have been in one of your articles years ago Peter when I said you Americans were fucked the second Obamacare was passed despite all the talk of repealing it.

    Even after its mangling through exemptions, low inscriptions (whatever happened to that anyway?) and increasing premiums no one was going to save America from it.

    Be careful here. If they’re talking about it – even if it’s a dumb idea – it means there’s support and they’ll find a way to ram it through.

    And then the media will go all ‘happiness is a warm gun mama’.

  11. Will anyone ever come to the fore and just simply explain all this free stuff simply isn’t possible?

    1. Not at the D debate; it’s gonna be ‘I can give away more free shit than you!’, one after the other.

  12. At least she has a plan, just like other Dems. If the Republicans ever offered anything worth a crap, you wouldn’t have to worry. But they decided complaining was far more important than actually doing something about the problem.

    1. You’re right, the GOP has largely ignored the need for health insurance reform for decades. Employer provided coverage, which dominates our system (along with Medicare) – is the leading reason health care consumption has largely been shielded from the positives of free market forces, including the distortions caused by the tax code quirks for employer provided insurance. Republicans and Democrats in general have been afraid to fix the tax code quirks tied to employer provided insurance because those millions of workers that are generally satisfied with that insurance are also voters. “Medicare for All” may be popular with this batch of Democratic candidates – but I think they underestimate the challenge of taking away employer provided insurance from millions of people.

      1. One of the first things which should be done is to no longer exempt employer-provided health care from income taxes. It is a benefit with a very precise monetary value. When my wife worked for the County, we both used her insurance. This amounted to pretty close to $12,000 annually in un-taxed income. Of course, when I was self-employed, I paid taxes on all my income before purchasing health insurance. I do believe they now tax part of “cadillac” plans, but it needs to be gradually extended to all such health-care benefits. Of course, this is assuming we can’t get rid of the income tax entirely……

        1. How does taxing something fix anything?

          1. It doesn’t “fix” anything. But why should someone who is self-employed or who purchases their own health insurance be, basically, “penalized” by a tax for not working for someone else? Doesn’t seem exactly “fair.” Now, if we could get rid of income tax, altogether, that would be okay, too.

    2. wearingit
      July.30.2019 at 8:06 am
      “At least she has a plan, just like other Dems. If the Republicans ever offered anything worth a crap, you wouldn’t have to worry….”

      Yeah, she has a plan to bankrupt the country and you’re happy about it.
      Fucking lefty ignoramus…

  13. Healthcare?

    Facts:
    1)“Healthcare” is a governmentally-concocted term not synonymous with Medicine. Cutting your toenails is “healthcare”. Curing your cancer is medicine.

    2) Indemnity-based, medical insurance is extinct. In its stead are “healthcare plans” amounting to managed cost in the name of “managed care”. True insurance spreads risk; it does not manage risk.

    3) Comparing health across national populations is equivalent to comparing fruit salad (USA) to grapefruit (Finland),

    4) VA-delivered medicine is awful. Medicare/Medicaid are bankrupting the nation. ObamaCare began and remains a fraud.

    5) In pharmaceuticals, massive manipulation of price and quantity reign. Ask any pharmacist.

    6) “Clinics” in drugstores and supermarkets represent Soviet-style medicine, in which the customer sees “Doctor Nurse” not “Doctor Doctor”.

    7) “Medicare For All” is not an expansion of the current Medicare but a new quasi-Marxist gambit for politicians to gain complete control over medical delivery.

    In 1994, this physician published Healthcare Reform D.O.A. exposing the lies contained in ClintonCare. The book contained a scientifically-based, alternative plan actively ignored by politicians then and now. Unsolicited, the book received nominations for two, national awards by the insurance-industry while satisfying demands of Democrats and Republicans. The plan was updated in Inescapable Consequences (2009) then in Retribution Fever (2018).

    https://www.nationonfire.com/healthcare-reform/ .

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