Friday, April 23, 2021

Looking at the reaction of Medicare Extra for All

 So, after finding the Medicare Extra for All proposal to be interesting and a decent middle ground between universal coverage and affordability, I decided to look more into the reactions to it. It seems surprising to me. Much of the neoliberal crowd seems to love it, and much of the Bernie crowd seems to hate it. 

Honestly, I have a different approach than most people. I am a believer in single payer medicare for all. I believe a full medicare for all plan is possible, but after running the numbers in tandem with a UBI proposal I decided that it may not be possible to fund both proposals while remaining under the laffer curve peak. I mean, maybe it's possible, but it would be pushing it. Given both are multi trillion dollar proposals, it is very clear that one of them has to give. Either I need to compromise my UBI plan, or I need to compromise on medicare for all. I would prefer to compromise on medicare for all if I can find an adequate replacement plan, and the plan I decided was best is the medicare extra proposal. If I were a pure Bernie oriented social democrat I would just support medicare for all, but given my indepentarian UBI roots, I felt a need to look into other options.

The proposal originates from the Center for American Progress, which is associated with the more centrist wing of the democratic party. It is the think tank Neera Tanden is from, you know, that lady who got rejected from a cabinet position in Biden's administration from talking crap about Bernie and others on twitter. Normally I would not give these people the time of day. I feel like centrists love circlejerking about pragmatism and incremental change, but they rarely deliver.

This medicare extra plan is precisely what I need given my own goals though. Here's the thing. Most public option plans SUCK. Like, most centrist democratic plans are complete garbage. I passed over so many plans in my analysis in the past article because I feel like a lot of moderates like to push stuff that goes through the motions and barely accomplishes anything. 

But this medicare extra plan, while it is a public option, it's a GOOD public option. The thing that sets it apart is it automatically enrolls people into it. It sets a minimum guaranteed bottom for all citizens, much like single payer, or a universal healthcare plan. It essentially accomplishes the coverage of single payer without actually implementing it fully. And over time, much like Yang's "I support the spirit of medicare for all without supporting it" mentality, this plan does actually intend to push people toward medicare for all over time. It actually aggressively enrolls people and makes it the de facto default option, not some theoretical alternative hiding in some dark corner of a government website where you need to fill out dozens of pages of information and probably pay a monthly fee just to get coverage. Over time, more people might choose this plan, and we get everyone having healthcare on it. Alternatively, employers might remain prevalent and people might get their coverage through that. Much like my UBI and anti work views, it gives people that choice. It essentially has the same philosophy in a sense. If you don't work, you get UBI. But if you work, you slowly pay it back the more you make. Universal coverage with a phase out for higher incomes. That's basically what this is. It is aligned with my indepentarian goals for ending wage slavery, and guaranteeing universal coverage, while also costing far less in the short term. The difference here is if you don't work, you get the base medicare extra plan. If you work, you pay into it or alternativrly buy your own insurance. Seems fair.

This is the sort of plan Yang should have supported in 2020. If he did, I might have seriously supported him more. And I think this plan is consistent with the Yang Gang's philosophy. The thing is, he always claimed, after backing off of medicare for all, to support a public option that would get us to medicare for all eventually. Not ideal being a M4A fan, but a decent compromise that would be consistent with that philosophy. Yang lost me in part because he couldn't even solve that. 

I get why the Bernie crowd is upset. It isnt medicare for all. Noted. I understand the appeal for medicare for all. If I were not supporting UBI and had a Sanders-esque social democratic ideology, I would say go for M4A. I believe Sanders' plan could work, and if youre not trying to fund a $3 trillion UBI, is a lot more affordable than people say it is. But as someone who is supporting a $3 trillion UBI plan, I would prefer to go with a more intermediate option on healthcare. We need a plan that isn't some dinky medicare buy in or other Biden-esque band aid, but also isn't a $1.75 trillion UBI killer. My recent thinking had me wondering if I could find an intermediate option, and this is it. Again, I get why the Bernie crowd would be disappointed with this. Well, in response, I 'm also disappointed Bernie isn't for UBI and would prefer a $1.6 trillion jobs program instead. So there. Different priorities. 

At least this public option has teeth and actually WOULD get us to medicare for all some day without costing an arm and a leg. That's why I support it. It isn't just a symbolic gesture. It isn't just a bunch of nothing. It actually does accomplish what the centrists keep saying they want to accomplish, and doesn't appear to be a smoke and mirrors trick. It doesn't solve all problems, but it fits the price tag and appropriate level of aggression in accomplishing universal healthcare that I'm looking for if I am going to compromise on medicare for all. 

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