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In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. Friedrich Nietzsche

Politics

What Bernie’s Medicare for all would do, and Why Bernie Care Now?

U.S. Senator Bernie Sanders (I-Vermont) “Medicare for All” proposal has gone from a fringe issue to a Democratic mainstay. Support for Bernie Care went from one Senator (Sanders) in 2013 to 15 co-sponsors in 2017.

Those co-sponsors include four potential Democratic presidential candidates; Kamala Harris (D-California), Liz Warren (D-Massachusetts), Jeff Merkley (D-Oregon), and Cory Booker (D-New Jersey), National Public Radio reported. Supporters also include some prominent Obamacare fans; such as Saturday Night Live clown turned U.S. Senator Al Franken (D-Minnesota). That means we should take a close look at Bernie Care and what it might do.

More tellingly some of those cosponsors including Harris and Franken are well-known centrists. News stories indicate that Harris’s positions on criminal justice issues like asset forfeiture are close to those of U.S. Attorney General Jeff Sessions (R-Alabama). Franken has been one of the most outspoken admirers and defenders of Obamacare in the recent past.

What’s in Bernie Care?

Here are the highlights of the Medicare for All Bill:

  • Offer Medicare coverage to all Americans regardless of age or income. Currently, Medicare is restricted to those over 65 and the disabled.

 

  • Expand Medicare coverage to include a wide variety of goods and services not currently covered. A few of these items include; dentistry, eyeglasses, hearing aids, emergency-room visits, ambulance services, and eye tests.

 

  • News stories indicate that Bernie Care would ban private health insurance policies that duplicate its’ services. Note: I’m opposed to this because I think it is unnecessary.

 

  • Some very important aspects of Bernie Care including how insurance will be administered are unclear. Bernie does not say if Medicare Part D prescription drug coverage would be administered to all Americans. Nor does say who would administer the plan, the Centers for Medicare and Medicaid or the states? Another point left unclear is whether people will be able to opt out or not.

 

  • The role of private health insurance companies in the plan is unspecified. Sanders did not say if they would be eliminated, or offer policies through Medicare similar to Part D. Part D policies are administered by private insurers but paid for by Medicare. Although he seems to want to ban some private health-insurance policies.

 

  • The cost of Bernie Care is unknown. Figures of $3 trillion to $16 trillion are mentioned.

 

  • Bernie Care would be phased in over a five-year period. In the first year, the added services would be covered; and coverage expanded to those between 55 and 65 and everybody under 18.

 

  • Bernie Care would effectively abolish most of Medicaid and CHIP (health coverage for poor children). People in those programs would presumably be moved into Medicare. Although Medicaid payments for nursing-home care would remain.

 

  • Bernie Care would not cover assisted living facilities, (nursing homes) or long-term at home care, Health over Profit pointed out. Presumably, those services would be covered by Medicaid and private insurance as they are now.

 

  • Bernie does not mention the cost of premiums or if there would be premiums.

 

  • Copays and copay costs are not mentioned.

 

  • It is not clear if employers would be able to buy Medicare policies for their employees.

 

  • Payment procedures for healthcare providers are not mentioned. This is vital. How are doctors supposed to get paid?

 

  • Veterans would not be affected by Bernie Care, the plan specifically exempts coverage provided by the Veterans Administration (VA).

 

  • Bernie is not sure how to pay for it. He mentions a number of options but seems to favor a 7.5% payroll tax. Several tax proposals are outlined here.

 

Okay, so What Would Bernie Care Do?

The effects of Bernie Care would not be as great as opponents would have us believe. Over a third of all Americans, (about 129.726 million) already get their health insurance through the government via Medicaid, Medicare, or CHIP.

There were 68.61 million people on Medicaid, 5.816 million children on CHIP in June 2017, according to Medicaid.gov. There were also 55.3 million seniors and disabled people on Medicare according to the National Committee to Preserve Social Security & Medicare. Note: this number is an undercount because it does include those using the Veterans Administration and Indian Health Service.

This means the only practical change for most people will be the insurance card in their wallets. Many of those who get employer health insurance won’t notice that many changes either. They would get their healthcare at the same place but use a different card to pay for it with.

Surprise Big Retail would Profit from Bernie Care

A surprising effect of Bernie Care would be to help Big Retail make more money.

Retail giants such as Walmart (NYSE: WMT), Kroger (NYSE: KR), Walgreens (NASDAQ: WBA), CVS Health (NYSE: CVS), Costco Wholesale (NASDAQ: COST), and Safeway, would profit from Bernie Care. Average Americans would have more money to spend at their stores because they would no longer have health insurance premiums or medical bills to worry about. Operating costs for retailers would be lower because employee health-insurance costs would be lowered or eliminated.

Those companies own tens of thousands of pharmacies, and some of them also operate clinics in certain stores. Retailers that operate clinics include; Kroger, Walmart, Walgreens, Safeway, and CVS.

Kroger, Walgreens, CVS, and Walmart are likely to greatly expand their number of clinics they operate; and move into the dentistry business, if Bernie Care becomes law. Costco is likely to enter the clinic and dental business, and Amazon (NASDAQ: AMZN); which now owns Whole Foods, is likely to enter the pharmacy and clinic businesses if Bernie Care becomes reality.

One has to wonder if single-payer health insurance advocates might soon find an unexpected ally in lobbyists for Big Retail. How would Bernie and company react if the Walmart lobbyist suddenly sits down at their table?

Why Democrats Suddenly Love Bernie Care

The most interesting aspect of Bernie Care is Democrats’ new-found love for it. Some of the same Democratic U.S. Senators and U.S. Representatives that used to avoid “Medicare for All” like the plague – are now embracing it. The Expanded Medicare for All Act (House Resolution 676) now has 119 sponsors in the House of Representatives.

There are several good reasons why Democrats now love Bernie Care including:

  1. President Donald J. Trump (R-New York). Democrats used to be able to win over working-class whites and older voters by playing the entitlement card. That is screaming; “the big, bad, Republicans are coming to take your Social Security and Medicare away!” Trump killed that; and won the majority of those voters, by committing to preserving Social Security and Medicare. Trump showed Republicans they can win by defending Medicare and Social Security.

 

  1. A great way for Democrats to out-Trump Trump is to champion benefit expansion. This is vital because other Republicans have noticed Trump’s success and jumped on his bandwagon.

 

  1. Obamacare is a miserable failure and unpopular. Even though the media ignored the obvious fact, several prominent Democrats; including U.S. Senator and Obamacare supporter Mark Udall (D-Colorado), went down to defeat because of it. Udall’s opponent U.S. Senator Cory Gardner (R-Colorado) made opposition to Obamacare a central tenet of his campaign.

 

  1. Bernie and Medicare for All are extremely popular in red states where Democrats have been losing big. Berniecrats are doing better in races there than establishment Democrats. This is because Bernie gets lots of support among rural and working-class whites, African Americans, and union members.
Sen. Kamala Harris, D-Calif., reacts during a Senate Intelligence Committee hearing about the Foreign Intelligence Surveillance Act, on Capitol Hill, Wednesday, June 7, 2017, in Washington.  (AP Photo/Alex Brandon)
  1. There are polls that indicate the real reason for Hillary’s loss was protest votes for Trump from disgruntled Bernie fans. The Big Media has ignored that data – but Democratic politicians such as U.S. Senator Kamala Harris (D-California) a presidential hopeful and born-again single payer champion and Senator Al (I used to be Stuart Smalley) Franken (D-Minnesota); have noticed.

 

There are many unknowns here including the extent of support for single-payer and the amount of opposition to Bernie Care. Nobody knows how much support and opposition there really is.

To complicate matters, Republicans are just as divided on the issue as Democrats. President Trump is an outspoken single-payer fan, Libertarians like U.S. Senator Rand Paul (R-Kentucky) are opposed, while many cultural conservatives; including those at The American Conservative and some members of the Alt-Right, like the idea. Other GOP leaders such as Governor John R. Kasich (R-Ohio) and Mitt Romney (the real creator of Obamacare) seem to favor some sort of single-payer light or Obamacare.

It looks as if the Bernie Care battle has just begun, one has to wonder how far it will go and if Bernie will succeed. Investors need to pay attention because Bernie Care would change business and create enormous opportunities for profit.