On the other side, there’s “Medicare for America,” originally a proposal from the Center for American Progress, now embodied in legislation. While none of the announced Democratic candidates has endorsed this proposal yet, it’s a good guess that most of them will come around to something similar.
The big difference from a Sanders-type plan is that people would be allowed to keep private coverage if they chose — but they or their employers would also have the option of buying into an enhanced version of Medicare, with substantial subsidies for lower- and middle-income families.
The most important thing you need to know about these rival plans is that both of them would do the job.
Many
people realize, I think, that we’re the only advanced country that
doesn’t guarantee essential health care to its legal residents. My guess
is that fewer realize that nations achieve that goal in a variety of
ways — and they all work.
Every two years the Commonwealth Fund provides an invaluable survey
of major nations’ health care systems. America always comes in last; in
the latest edition, the three leaders are Britain, Australia and the
Netherlands.
What’s remarkable about those top three is that they have radically
different systems. Britain has true socialized medicine — direct
government provision of health care. Australia has single-payer — it’s
basically Bernie down under. But the Dutch rely on private insurance companies
— heavily regulated, with lots of subsidies, but looking more like a
better-funded version of Obamacare than like Medicare for All. And the
Netherlands actually tops the Commonwealth Fund rankings.
So which system should Democrats advocate? The answer, I’d argue, is the
system we’re most likely actually to create — the one that will play
best in the general election, and is then most likely to pass Congress
if the Democrat wins.
--- Paul Krugman, 3/21/19
--- Paul Krugman, 3/21/19
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