Breaking News
November 22, 2018 - Response to daily stressors plays important role in cognitive health of older adults
November 22, 2018 - Efficient method for producing induced pluripotent stem cells
November 22, 2018 - Report outlines inequalities in access to healthcare
November 22, 2018 - New research center will pave way to better diagnosis and treatment of skin diseases
November 22, 2018 - Mylan Initiates Voluntary Nationwide Recall of 15 Lots of Valsartan Tablets, USP, Amlodipine and Valsartan Tablets, USP, and Valsartan and Hydrochlorothiazide Tablets, USP, Due to the Detection of Trace Amounts of NDEA (N-Nitrosodiethylamine) Impurity Found in the Active Pharmaceutical Ingredient
November 22, 2018 - Lung Cancer Tumor Markers: MedlinePlus Lab Test Information
November 22, 2018 - Patchy distribution of joint inflammation resolved
November 22, 2018 - Researchers find crucial inhibitory role for signal peptide in GluK1 trafficking
November 22, 2018 - nutritional supplement, could slow some cancers
November 22, 2018 - Researchers awarded $7 million funding in Pancreatic Cancer Collective’s ‘New Therapies Challenge’
November 22, 2018 - UMN researchers focus on improving dermatologic care for sexual and gender minority patients
November 22, 2018 - Researchers harness visible light to develop safer building block for drug discovery
November 22, 2018 - Scientists identify key protein involved in Hantavirus Pulmonary Syndrome
November 22, 2018 - ACAAI: Oral Immunotherapy Is Protective in Peanut Allergy
November 22, 2018 - Arthritis and depression often occur together in older adults
November 22, 2018 - Scientists uncover unexpected ‘foreign’ genes in tiny itch-inducing chigger mite
November 22, 2018 - Negative social cues on tobacco packaging could help reduce smoking intentions
November 22, 2018 - Study finds no differences in quit rates for ‘dual users’ of both traditional and electronic cigarettes
November 22, 2018 - Immunity connects gut microbiota and age-related pathologies
November 22, 2018 - New diagnostics based on nanopore analytics and AI can identify single influenza virions
November 22, 2018 - Blocking activity of plasma protein can be possible way to protect against radiation-induced injury
November 22, 2018 - Secondhand Pot Smoke Found in Kids’ Lungs
November 22, 2018 - Air pollution may be linked to heightened dementia risk
November 22, 2018 - Brain implant lets people with limb paralysis compose and send emails, select videos and even play music, just by thinking
November 22, 2018 - Should health-care workers press charges against violent patients?
November 22, 2018 - Obesity linked to COPD in never-smokers
November 22, 2018 - Improving dementia treatment and staff training in care homes saves thousands of pounds per year
November 22, 2018 - Researchers identify genetic changes that could increase risk for death by suicide
November 22, 2018 - John Snow Labs launches new Data Market to help healthcare and life science innovators
November 22, 2018 - New inhibitor could hold key to treating Acute Respiratory Distress Syndrome
November 22, 2018 - Misconceptions about opioid use undermine pain control among Asian cancer patients
November 22, 2018 - Owlstone Medical named Medtech Company of the Year
November 22, 2018 - Anabolic steroids may increase risk of early death in men
November 22, 2018 - Researchers develop model that predicts transmissibility of viral zoonoses
November 22, 2018 - Evidence mounts that an eye scan may detect early Alzheimer’s disease
November 22, 2018 - Sensors could provide dexterity to robots, with potential surgical applications
November 22, 2018 - Why Are We Still So Fat?
November 22, 2018 - MRI scans may help predict dementia risk
November 22, 2018 - Groundbreaking research projects show how AI can be used to predict under diagnosed chronic diseases
November 21, 2018 - Stand Up to Cancer supports potential approach to more efficiently target pancreatic cancer
November 21, 2018 - Using smartphone confocal microscopes to stop cancer
November 21, 2018 - Self-care program for COPD patients reduces emergency room visits and burdensome symptoms
November 21, 2018 - Blueprint Medicines Announces Updated NAVIGATOR Trial Results in Patients with Advanced Gastrointestinal Stromal Tumors Supporting Development of Avapritinib Across All Lines of Therapy
November 21, 2018 - Cocaine adulterant may cause brain damage
November 21, 2018 - Amid the devastation, a Stanford doctor stitches up George, a search dog
November 21, 2018 - America’s Health-Care System Is Making the Opioid Crisis Worse
November 21, 2018 - Colorectal cancer screening reduces need for intense treatments among male patients
November 21, 2018 - Scientists find evidence of prions in the eyes of CJD patients
November 21, 2018 - Study explores individual and organizational risk factors for one-year mortality in ICU survivors
November 21, 2018 - Pulmonologists want more information on inhalation devices for COPD
November 21, 2018 - Cessation fatigue predicts relapse rate after attempts to quit smoking
November 21, 2018 - Special care should be taken with drugs that inhibit epigenetic factors, study suggests
November 21, 2018 - More than one in ten heavy cannabis users experience withdrawal after quitting cannabis
November 21, 2018 - Reflections on the California fires
November 21, 2018 - Donna Lynne Appointed to Key Leadership Role at CUIMC
November 21, 2018 - Smoke-free laws associated with reduced systolic blood pressure
November 21, 2018 - Achieving new guideline blood pressure goals may prevent 3 million cardiovascular events
November 21, 2018 - LDR brachytherapy for treating early-stage prostate cancer lacks conclusive data
November 21, 2018 - Older adults with CVD more likely to experience rapid functional decline
November 21, 2018 - Purified omega-3 and aspirin reduce pre-cancerous bowel polyps, shows study
November 21, 2018 - Study warns that potential epigenetic therapy may boost lung cancer stem cells
November 21, 2018 - Noise pollution in hospital impact quality and safety of healthcare
November 21, 2018 - Interventions to improve sleep may reduce risk of falls
November 21, 2018 - Outdoor air pollution linked to intellectual disabilities in children
November 21, 2018 - Study highlights need for better screening tools to detect maternal sepsis
November 21, 2018 - Higher Risk for Amputation, DKA With SGLT2 Inhibitors for T2DM
November 21, 2018 - Researchers stop ‘sneaky’ cancer cells in their tracks
November 21, 2018 - People who are afraid to draw their blood over-estimate the risk of fainting
November 21, 2018 - Personalized physical exercise reverses functional, cognitive deterioration in the elderly
November 21, 2018 - COPD linked to obesity in older women who have never smoked
November 21, 2018 - AHA: Cold-Weather Drinks Are Here, But Watch Out for the Calories
November 21, 2018 - Crowds line up at 1st East Coast pot shops
November 21, 2018 - Merck declares 2018 Life Science Award winners
November 21, 2018 - Many people underestimate the impact of sprains, say foot scientists
November 21, 2018 - Lower levels of protein make squamous carcinoma cells more invasive
November 21, 2018 - Study highlights a new predictor of type 2 diabetes
November 21, 2018 - NTU and TTSH join forces to improve doctor-patient communication
November 21, 2018 - New low-cost injectable hydrogel could help wounds heal faster
November 21, 2018 - Merck Announces Winners of 2018 Life Science Awards
November 21, 2018 - Check your medical records for dangerous errors
What’s the difference between Medicare-for-all and single-payer?

What’s the difference between Medicare-for-all and single-payer?

image_pdfDownload PDFimage_print

Betsy Foster and Doug Dillon are devotees of Josh Harder. The Democratic upstart is attempting to topple Republican incumbent Jeff Denham in this conflicted, semi-rural district that is home to conservative agricultural interests, a growing Latino population and liberal San Francisco Bay Area refugees.

To Foster’s and Dillon’s delight, Harder supports a “Medicare-for-all” health care system that would cover all Americans.

Foster, a 54-year-old campaign volunteer from Berkeley, believes Medicare-for-all is similar to what’s offered in Canada, where the government provides health insurance to everybody.

Dillon, a 57-year-old almond farmer from Modesto, says Foster’s description sounds like a single-payer system.

“It all means many different things to many different people,” Foster said from behind a volunteer table inside the warehouse Harder uses as his campaign headquarters. “It’s all so complicated.”

Across the country, catchphrases such as “Medicare-for-all,” “single-payer,” “public option” and “universal health care” are sweeping state and federal political races as Democrats tap into voter anger about GOP efforts to kill the Affordable Care Act and erode protections for people with preexisting conditions.

Republicans, including President Donald Trump, describe such proposals as “socialist” schemes that will cost taxpayers too much. They say their party is committed to providing affordable and accessible health insurance, which includes coverage for preexisting conditions, but with less government involvement.

Voters have become casualties as candidates toss around these catchphrases — sometimes vaguely and inaccurately. The sound bites often come across as “quick answers without a lot of detail,” said Gerard Anderson, a professor of public health at the Johns Hopkins University Bloomberg School Public Health.

“It’s quite understandable people don’t understand the terms,” Anderson added.

For example, U.S. Sen. Bernie Sanders (I-Vt.) advocates a single-payer national health care program that he calls Medicare-for-all, an idea that caught fire during his 2016 presidential bid.

But Sanders’ labels are misleading, health experts agree, because Medicare isn’t actually a single-payer system. Medicare allows private insurance companies to manage care in the program, which means the government is not the only payer of claims.

What Sanders wants is a federally run program charged with providing health coverage to everyone. Private insurance companies wouldn’t participate.

In other words: single-payer, with the federal government at the helm.

Absent federal action, Democratic gubernatorial candidates Gavin Newsom in California, Jay Gonzales in Massachusetts and Andrew Gillum in Florida are pushing for state-run single-payer.

To complicate matters, some Democrats are simply calling for universal coverage, a vague philosophical idea subject to interpretation. Universal health care could mean a single-payer system, Medicare-for-all or building upon what exists today — a combination of public and private programs in which everyone has access to health care.

Others call for a “public option,” a government plan open to everyone, including Democratic House candidates Antonio Delgado in New York and Cindy Axne in Iowa. Delgado wants the public option to be Medicare, but Axne proposes Medicare or Medicaid.

Are you confused yet?

Sacramento-area voter Sarah Grace, who describes herself as politically independent, said the dialogue is over her head.

“I was a health care professional for so long, and I don’t even know,” said Grace, 42, who worked as a paramedic for 16 years and now owns a holistic healing business. “That’s telling.”

In fact, most voters approached for this article declined to be interviewed, saying they didn’t understand the issue. “I just don’t know enough,” Paul Her of Sacramento said candidly.

“You get all this conflicting information,” said Her, 32, a medical instrument technician who was touring the state Capitol with two uncles visiting from Thailand. “Half the time, I’m just confused.”

Paul Her, 32, a medical instrument technician from Sacramento, says he’s “just confused” by the conflicting health care pitches he hears from politicians. (Samantha Young/KHN)

The confusion is all the more striking in a state where the expansion of coverage has dominated the political debate on and off for more than a decade. Although the issue clearly resonates with voters, the details of what might be done about it remain fuzzy.

A late-October poll by the Public Policy Institute of California shows the majority of Californians, nearly 60 percent, believe it is the responsibility of the federal government to make sure all Americans have health coverage. Other state and national surveys reveal that health care is one of the top concerns on voters’ minds this midterm election.

Democrats have seized on the issue, pounding GOP incumbents for voting last year to repeal the Affordable Care Act and attempting to water down protections for people with preexisting medical conditions in the process. A Texas lawsuit brought by 18 Republican state attorneys general and two GOP governors could decimate protections for preexisting conditions under the ACA — or kill the law itself.

Republicans say the current health care system is broken, and they have criticized the rising premiums that have hit many Americans under the ACA.

Whether the Democratic focus on health care translates into votes remains to be seen in the party’s drive to flip 23 seats to gain control of the House.

The Denham-Harder race is one of the most watched in the country, rated too close to call by most political analysts. Harder has aired blistering ads against Denham for his vote last year against the ACA, and he sought to distinguish himself from the incumbent by calling for Medicare-for-all — an issue he hopes will play well in a district where an estimated 146,000 people would lose coverage if the 2010 health law is overturned.

Yet Harder is not clinging to the Medicare-for-all label and said Democrats may need to talk more broadly about getting everyone health care coverage.

“I think there’s a spectrum of options that we can talk about,” Harder said. “I think the reality is we’ve got to keep all options open as we’re thinking towards what the next 50 years of American health care should look like.”

To some voters, what politicians call their plans is irrelevant. They just want reasonably priced coverage for everyone.

John Byron, a 73-year-old retired grandfather from Modesto, wants a government-run health care system that doesn’t include private insurance companies. What politicians call the program is irrelevant to him, he says. (Samantha Young/KHN)

Sitting with his newspaper on the porch of a local coffee shop in Modesto, John Byron said he wants private health insurance companies out of the picture.

The 73-year-old retired grandfather said he has seen too many families struggle with their medical bills and believes a government-run system is the only way.

“I think it’s the most effective and affordable,” he said.

Linda Wahler of Santa Cruz, who drove to this Central Valley city to knock on doors for the Harder campaign, also thinks the government should play a larger role in providing coverage.

But unlike Byron, Wahler, 68, wants politicians to minimize confusion by better defining their health care pitches.

“I think we could use some more education in what it all means,” she said.

This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.


Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles