Dear Progressives, We Don't Need Single-Payer

Why We Don't Need Single-Payer Healthcare

The public option is a better policy to achieve universal healthcare than "Medicare for All."


It was at a Japanese restaurant at a hotel in Mexico where I changed my stance on single-payer healthcare. Since the 2016 election, I had been a big fan of Bernie Sanders and accordingly a supporter of his campaign, "Medicare for All." I thought single-payer would be an improvement from the current state of affairs.

But at the aforementioned restaurant, I started talking to my dad about healthcare policy and he laid out several objections to single payer, mentioning the failure of the VA system and the lack of incentives for efficiency that would result from a lack of competition. My sister, who wants to be a doctor, also pointed out that in single-payer systems, governments ration care, so the U.S. government would be able to limit how often my sister could see a doctor for her asthma, for example.

I realized at that moment that I had failed to really consider the negative consequences that a single payer system would have. After much deliberation, I concluded that the costs of single payer would outweigh the benefits. In all honesty, a public healthcare system may be a better policy.

In terms of political ideology, I am a liberal and a progressive. As a liberal, I wholeheartedly support government programs to help the poor and needy, but the idea of the government controlling the healthcare system and making people's healthcare decisions for them makes me deeply uncomfortable.

"Medicare for All" would be a drastic restructuring of the entire healthcare system which would reduce personal liberty and choice. Under the "Medicare for All" bills proposed in the Senate and the House, private insurance would be completely eliminated and so would the employer-based system we currently have.

The 30 million Americans who are currently uninsured would have health insurance, and there would be universal coverage; this is great. However, the majority of Americans (about 70%) would be forced to give up their current insurance for Medicare. And most Americans are happy with their insurance plan.

So while helping the uninsured, "Medicare for All" would take the tens of millions of Americans who get health insurance through their employer or via Medicare Advantage, completely off the health insurance plans they prefer. This would consequently be forcing government health insurance down their throats.

This flagrantly violates personal liberty. And while a democratic socialist may be fine with sacrificing personal liberty for the sake of big government, I am not.

An alternative policy, the public option, would allow the uninsured to have access to government insurance without disturbing the millions of Americans who have health insurance and like the plan they have. The public option, supported by Obama and initially included in Obamacare but killed by Sen. Joe Lieberman, was a good idea in 2009 and it's still a good idea a decade later. A public option would address many of the problems with our current system, provide several of the benefits of Medicare for All without the tremendous costs, and avoid the issues that have plagued single-payer systems.

I love Bernie, but his "Medicare for All" plan is deeply flawed. It's not just ambitious or idealistic; it's unrealistic and risky. It would be incredibly expensive and require massive tax increases, not just for the wealthy, but also for the middle class. Bernie's own home state of Vermont had to give up single-payer because such a policy would have a required a doubling of tax revenue.

No Democratic presidential nominee in recent decades has campaigned on raising middle-class taxes, so advocacy for this policy could be politically toxic for Democrats. While polls show that a majority of the American people support "Medicare for All", about half of Americans also believe that under Medicare for All, they could keep their current health plan— which is just plain wrong. In reality, we couldn't even guarantee that they would be able to keep their physician.

A public option, through either Medicare buy-in or a new program, would be "Medicare for Most", giving Americans a public health insurance plan alternative to private insurance plans. It would be easier to implement that Medicare for All and would increase competition and lower prices while expanding access to health insurance for millions of Americans.

Conservatives object to government intervention in health care because they want a "free market", but the health care market isn't free- it's a monopoly. In 2009 in my home state of Arkansas, the insurance company Blue Cross Blue Shield controlled 75% of the market. And unfortunately, under Obamacare, market consolidation has gotten worse, limiting choices for patients and making health care more expensive. A public option would break this monopoly, injecting some healthy competition.

Those on the public health insurance plan would still have to pay premiums, depending on their income. But these premiums would undoubtedly be lower because of lower administrative costs, the government's ability to negotiate with pharmaceutical companies and hospitals and the fact that the government, unlike private insurance, wouldn't be trying to make a profit.

Additionally, because people would be paying for care through premiums, there wouldn't need to be significant tax increases to pay for a public option. Even a new health program would likely combine Obamacare and Medicaid, redirecting existing federal funds. So the public option would be far cheaper than Medicare for All.

Democratic socialists argue that those who support a public option are neoliberal shrills, in the pockets of the health insurance industry. And while it is disturbing how many politicians in the Democratic establishment have taken money from health insurance companies, the view that the public option elevates the interests of health insurance companies over consumers is mistaken-quite the opposite in fact.

My stance on healthcare isn't just my own view- it is also the official stance of the Democratic Party. The policy of adding a public option to Obamacare was included as part of the 2016 Democratic Party Platform as a compromise, to appease both the Clinton camp and the Bernie camp and indeed it is a good policy for a big tent center-left party like the Democratic Party, whose membership includes centrists, democratic socialists, and everyone in between.

There's rhetoric from groups like the Justice Democrats that suggests that if you don't support Medicare for All, you aren't a true progressive- which I take issue with. As progressives, we believe that health care is a right and accordingly the government has a responsibility to ensure that all Americans have access to health care. But we can have reasonable disagreements about which policies would be the best to advance our goal of universal health care- and we should have a rigorous debate about this.

When it comes to health care policy, we don't need radical change (unlike in climate policy, where a Green New Deal is absolutely necessary to avert climate catastrophe). In health care, we need reform, not revolution. The American health care system is broken- but that doesn't mean we should burn it all down and try to build something new from the ashes; instead we should use the tools at our disposal to fix some flaws and add some new elements to make progress towards our goal of all Americans having access to quality, affordable healthcare.

Medicare for Those Who Need And/Or Want It. I concede it's not quite as catchy as Medicare for All. But it is, I believe, the right policy.

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This Is How Your Same-Sex Marriage Affects Me As A Catholic Woman

I hear you over there, Bible Bob.

It won't.

Wait, what?

I promise you did read that right. Not what you were expecting me to say, right? Who another person decides to marry will never in any way affect my own marriage whatsoever. Unless they try to marry the person that I want to, then we might have a few problems.

As a kid, I was raised, baptized, and confirmed into an old school Irish Catholic church in the middle of a small, midwestern town.

Not exactly a place that most people would consider to be very liberal or open-minded. Despite this I was taught to love and accept others as a child, to not cast judgment because the only person fit to judge was God. I learned this from my Grandpa, a man whose love of others was only rivaled by his love of sweets and spoiling his grandkids.

While I learned this at an early age, not everyone else in my hometown — or even within my own church — seemed to get the memo. When same-sex marriage was finally legalized country-wide, I cried tears of joy for some of my closest friends who happen to be members of the LGBTQ community.

I was happy while others I knew were disgusted and even enraged.

"That's not what it says in the bible! Marriage is between a man and a woman!"

"God made Adam and Eve for a reason! Man shall not lie with another man as he would a woman!"

"Homosexuality is a sin! It's bad enough that they're all going to hell, now we're letting them marry?"

Alright, Bible Bob, we get it, you don't agree with same-sex relationships. Honestly, that's not the issue. One of our civil liberties as United States citizens is the freedom of religion. If you believe your religion doesn't support homosexuality that's OK.

What isn't OK is thinking that your religious beliefs should dictate others lives.

What isn't OK is using your religion or your beliefs to take away rights from those who chose to live their life differently than you.

Some members of my church are still convinced that their marriage now means less because people are free to marry whoever they want to. Honestly, I wish I was kidding. Tell me again, Brenda how exactly do Steve and Jason's marriage affect yours and Tom's?

It doesn't. Really, it doesn't affect you at all.

Unless Tom suddenly starts having an affair with Steve their marriage has zero effect on you. You never know Brenda, you and Jason might become best friends by the end of the divorce. (And in that case, Brenda and Tom both need to go to church considering the bible also teaches against adultery and divorce.)

I'll say it one more time for the people in the back: same-sex marriage does not affect you even if you or your religion does not support it. If you don't agree with same-sex marriage then do not marry someone of the same sex. Really, it's a simple concept.

It amazes me that I still actually have to discuss this with some people in 2017. And it amazes me that people use God as a reason to hinder the lives of others.

As a proud young Catholic woman, I wholeheartedly support the LGBTQ community with my entire being.

My God taught me to not hold hate so close to my heart. He told me not to judge and to accept others with open arms. My God taught me to love and I hope yours teaches you the same.

Disclaimer - This article in no way is meant to be an insult to the Bible or religion or the LGBTQ community.

Cover Image Credit: Sushiesque / Flickr

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Sociolinguistics Series: Part 50

Language is a powerful tool.


It's part 50--halfway to 100! I'm so glad to still be here writing! In this section, we will talk about Dr. Shikaki's findings on how Palestinians view the state of Israel.

25 years ago, 85% of Palestinians supported a two-state solution. 10 years ago, this number decreased to 70%. Dr. Shikaki believes this was due to an increase in the prominence of Islamism in Palestinian society during the second intifada; Islamists were opposed to the two-state solution. In the most recent survey, the December 2018 one, only 43% of Palestinians supported the two state solution.

In 2000, American President Bill Clinton met with Israeli Prime Minister Ehud Barak and PA Chairman Yasser Arafat at the Camp David Summit to come up with a solution to the conflict. It ended without an agreement, but in December of 2000, Clinton once again proposed a resolution: the Clinton Parameters.

The content of the Parameters basically allowed Israel to annex settlements while Palestine to take 94-96% of the West Bank, as well as Arab neighborhoods in East Jerusalem. There were other guidelines regarding territory, refugees, security, and the end of the conflict. Essentially, the West Bank would have been split up by Israeli roads and settlements--which is kind of the reality today.

Both the Israeli government and Arafat accepted the terms with reservations, and Arafat wrote to Clinton a letter asking for clarifications on the terms. Clinton and Dennis Ross, an envoy of the Parameters, publicized that Arafat had refused to accept the terms; they painted Palestinians in a negative light, saying that Israel wanted to accept the peace negotiations but Palestine did not.

American Lawyer Robert Malley was at the Camp David Summit and oversaw parts of the Clinton Parameters. In 2001, he said that three myths had come out of the failure of both negotiations, and that these three myths were dangerous to any future peace processes if people kept believing in them.

These myths are as follows: "Camp David was an ideal test of Mr. Arafat's intentions," "Israel's offer met most if not all of the Palestinians' legitimate aspirations," and "The Palestinians made no concession of their own."

He said that these three statements were not true but very heavily publicized by America and Israel after the negotiations failed; rather, there is more nuance to each of these issues, and America and Israel have just as much responsibility in the failure of the Summit and Parameters as Palestine did. Malley wrote, "If peace is to be achieved, the parties cannot afford to tolerate the growing acceptance of these myths as reality."

Anyway, what does this have to do with Dr. Shikaki? He polled Palestinians not only on the their attitudes to the two-state solution, but the Clinton Parameters as well. 25 years ago, there was 60% support for the Clinton Parameters by Palestinians, but the June 2018 poll showed that the number had gone down to 37%.

The last ten years shows a significant decrease in public support for both the two-state solution and the Clinton Parameters, and it could be a result of disagreeing with specific parts of the proposals (such as how the Temple Mount/Dome of the Rock or Jerusalem is delegated).

I did some further digging when I got home, and I found this data from the UN Division for Palestinian Rights website:

"A 25 December [2000] published poll found that 48% of the 501 Israelis questioned were opposed to the proposals; 57% would object to Palestinian control of the Al-Aqsa Mosque compound; 72% were against even a limited return of Palestinian refugees to Israel. A 29 December published poll found that 56% of the Israelis would oppose a peace agreement reached on the basis of the Parameters."

This shows that though public media--especially Western media--may have painted the Palestinian government as the villain (and Israel and America as the "victims"), the proposals accepted by either government had varied support among its people.

The Israeli civilian population did not want to accept the Clinton Parameters because of the way certain things would be resolved; their reservations lie with the Temple Mount/Al-Aqsa Mosque because the Temple Mount, which is the holiest site in the world for Jews, would have been given to Palestine, while Jews would have control of the Western Wall of the Temple Mount (which is the status quo).

In addition, there was a section in the Clinton Parameters that dealt with the right of return for Palestinians, where there would be a certain number of Palestinian refugees who settled in the West Bank and Gaza Strip, while other Palestinians either would become citizens of their host countries, move to a third-party country, or settle back into the land that is Israel Proper (with permission from the Israeli government, of course); many Israelis did not support this.

That was the public opinion years ago. Today, there is even less support for these proposals. Dr. Shikaki outlined three issues as reasons for a decrease in support of compromise, which we will cover in the next section. Stay tuned!

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