Give Berniecare an ear

At least, let “Medicare for All” reboot the healthcare debate

Jeffrey Denny

When Vermont U.S. Senator Bernie Sanders announced his “Medicare for All” proposal for a single-payer healthcare system, it met the usual shopworn attacks. It’s “socialism” at its worst. We don’t want lazy, stupid federal bureaucrats running our healthcare system with rationed care, death panels, red tape and wasted taxpayer dollars. Canadians fly to Texas to get better care. Nationalized healthcare would destroy American innovation that advances care and saves lives. Besides, Medicare stinks. And how are we going to pay for Berniecare and hold down costs?

Having served in government, I have my own doubts about single-payer. But whether or not Sanders’ proposal is right, I hope he’s touched off a national discussion we desperately need: What healthcare system do we want? How do we get there? Who pays? How do we ensure the best healthcare bang for the buck, just as we expect from every other market? Is single-payer really so bad? And if so, what’s better?

We need to rise above the easy, snarky attacks on Obamacare, and acknowledge that the old free-for-all private market system wasn’t working and actually hurt those who need care the most. Healthcare policy shouldn’t devolve to a childish, name-calling brawl between clueless libtards and ignorant MAGAs, when we all want the same thing: The best care at the best price. Ideology tends to end when we or our loved ones are sick.

I suggest a new consideration of the single-payer system, based on some reasoned thoughts by a client who heads a Fortune 500 global healthcare company. He is not doing the guilt-driven sackcloth/ashes thing of the rich, seeking absolution, but is looking at the U.S. healthcare system as a pragmatic businessman.

Our system, he thinks, is too complicated, with too many players fighting over pennies of profit margin. He likens it to children squabbling over a birthday cake, grabbing chunks but letting pieces fall on the floor.

In our healthcare system, instead of free-market competition improving care and lowering costs, those chunks of fallen cake represent care we’re not getting, or are paying more than we should for. By “we,” I mean anyone paying for our healthcare or insurance — an employer, the government (taxpayers), or an Obamacare exchange member — which in the end really is all of us.

Plus, some healthcare system middlemen take chunks of cake and nobody knows exactly what they deliver in return. Drug makers like convicted “pharma-bro” Martin Shkreli are easy villains for price-gouging sick people. But even when makers offer rebates, patients often don’t see the savings because the middlemen absorbed them for no discernable value provided.

This CEO has much experience dealing with the European system. He knows that a single government payer can lead to bureaucratic inefficiencies and squelch innovation driven by profit motive. But he also sees, on balance, that the single-payer systems overall deliver the best care for the most people at the best cost, simply because they’re simpler with fewer cake-grabbers.

I’m not advocating Bernie’s Medicare for All. I don’t have the experience or expertise to advocate for one system or another, and I’m skeptical about what I don’t know. And I always doubt my strongest opinions. Maybe I’m weird that way.

I just want people to stop, open their minds, and see Sanders’ proposal as a fresh, clean start for a national discussion — perhaps even a constructive debate — about fixing our healthcare system.

Let’s stop simply quoting Fox or MSNBC blabbers who parrot their paymasters, and instead read Bernie’s bill and see whether it makes sense. Research further, even sources you disdain. Sneer at Bernie if it feels good. But at least, consider — if not this, then what better?

We might come out hating Berniecare. Or thinking about whether or why we love or hate Obamacare, or want to tweak or repeal and replace Obamacare, or return to the wholly private market free-for-all. Or even see that single-payer is not such a bad idea after all, if imperfect. Maybe perfect is not the goal but rather just the least imperfect solution.

Even if we reject Berniecare, at least we’ll have the benefit of knowing why. We’ll learn more about the healthcare system and the tradeoffs involved in every approach. And perhaps along the way, someday, we’ll choose a better way that at least most can agree on.

I’m no Bernie fan living in a fantasy world. I believe the old saw, “If wishes were horses, beggars would ride; if horse flop were donuts, they’d eat ’til they died.” In fact, I’m a “pragmatic progressive,” favoring advancements as long as they work. But fixing our fragmented and wasteful healthcare system must start somewhere — even with a reach that might well exceed our grasp.

Jeffrey Denny is a Washington writer