Britain’s Health Care Debate Is Broken

December 4, 2019December 20, 2019

London, England at night, February 14, 2012 (Warren Chrismas)

When it was revealed last week that the British government had not ruled out giving American pharmaceutical companies more generous patent rights under a post-Brexit trade agreement with the United States, the opposition Labour Party was up in arms, accusing the ruling Conservatives of putting the National Health Service (NHS) “up for sale”.

The Conservatives rushed to deny it.

“The NHS is not on the table,” said Health Secretary Matt Hancock. “We are absolutely resolved that there will be no sale of the NHS, no privatization,” said Prime Minister Boris Johnson.

The episode was emblematic of the British health care debate: Labour mischaracterizes any proposed change as a step toward privatization while the Conservatives, rather than make the case for choice and competition, try to convince voters they care about the NHS even more. Read more “Britain’s Health Care Debate Is Broken”

The Best Argument Against Medicare-for-All Is Not Cost

November 20, 2019November 28, 2019

Democratic senator Elizabeth Warren of Massachusetts visits a high school in Des Moines, Iowa, October 21 (Phil Roeder)

It’s worth asking how expensive nationalizing health insurance in the United States would be. I’ve written before that cost estimates range from 13 to 21 percent of GDP, a difference of $1.7 trillion, or two-and-a-half times the Pentagon budget.

Senator Elizabeth Warren puts her plan at the low end of spectrum, about $2 trillion per year (which would still mean a 50-percent increase in federal spending). Even journalists broadly sympathetic to Medicare-for-all doubt that’s realistic.

I doubt it’s going to convince anyone. Medicare-for-all’s proponents are unlikely to change their minds even if they find out the cost isn’t manageable. Americans who oppose nationalizing health insurance are unlikely to come around even if it is.

The questions most Americans will be asking are:

Would I pay more or less under Medicare-for-all?
Would my health care get better or worse? Read more “The Best Argument Against Medicare-for-All Is Not Cost”

Who Pays for Medicare-for-All?

October 22, 2019November 3, 2019

Democratic senator Elizabeth Warren of Massachusetts speaks at a campaign event in Las Vegas, Nevada, April 27 (Gage Skidmore)

Replacing private health insurance with a single-payer, government-run system is hugely unpopular in the United States, but that hasn’t convinced two of the Democrats’ three top-polling presidential candidates — Bernie Sanders and Elizabeth Warren — to back away from it.

In the most recent televised debate, Warren, who is polling neck and neck with former vice president Joe Biden, couldn’t say how much “Medicare-for-all” would cost or who would pay for it. She has since promised to release a detailed plan.

Sanders, to his credit, admitted it would require tax increases. But by how much, and for whom, he didn’t say.

He can’t. Nationalizing health insurance for 327 million Americans is such a huge and complex undertaking that nobody knows how much it would cost.

Which calls into question the wisdom of doing it at all. Read more “Who Pays for Medicare-for-All?”

Democrats Back Away from Abolishing Private Health Insurance

August 21, 2019August 29, 2019

Democratic senator Kamala Harris of California listens to voters during a town hall meeting in Los Angeles, April 21, 2017 (Office of Senator Kamala Harris)

Good news: Democratic presidential candidates are coming to their senses on health care.

Senators Cory Booker, Kirstin Gillibrand and Kamala Harris have all backed away from abolishing private health insurance in favor of Medicare-for-all.

Even Senator Elizabeth Warren has given herself wiggle room, saying “there are a lot of different pathways” to achieving universal coverage.

The exception is Bernie Sanders, the author of Medicare-for-all and a self-declared democratic socialist. Read more “Democrats Back Away from Abolishing Private Health Insurance”

Democrats Are Not Talking to Swing Voters

August 1, 2019October 24, 2019

New York mayor Bill de Blasio, Ohio congressman Tim Ryan, former housing secretary Julián Castro, New Jersey senator Cory Booker and Massachusetts senator Elizabeth Warren participate in a Democratic presidential debate in Miami, Florida, June 26 (Getty Images/Joe Raedle)

Imagine you’re an American swing voter and you listened Tuesday and Wednesday night to the twenty Democrats vying for their party’s presidential nomination. What did you hear?

Three of the four highest-polling candidates want to abolish private health insurance and replace it with a single government program.
Virtually all candidates would decriminalize illegal entry into the United States and all of them praised immigration.
Many would give free health care to undocumented immigrants.
Some, like Bernie Sanders, would even give them a free college education.

This is not a winning program. Read more “Democrats Are Not Talking to Swing Voters”

Abolishing Private Health Insurance Is Bad Policy for Democrats

June 28, 2019July 13, 2019

Four of the Democrats running for their party’s presidential nomination committed to replacing private health insurance with a government-run system in debates this week: Senators Kamala Harris of California, Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts as well as Mayor Bill de Blasio of New York.

Harris later maintained she had misheard the question and supports Medicare-for-all with supplemental private insurance.

She, as well as Sanders and Warren, stand a real chance of becoming the nominee (de Blasio is a long shot), so it’s worth pointing out why abolishing private health insurance is such bad policy for Democrats. Read more “Abolishing Private Health Insurance Is Bad Policy for Democrats”

Trump’s Drug Policy Is Destroying Lives

August 29, 2018August 29, 2018

American president Donald Trump arrives in Salt Lake City, Utah, December 4, 2017 (ANG/Annie Edwards)

Politico reports that President Donald Trump’s crackdown on opioids is backfiring.

Hundreds of patients told the political news website they have been suddenly refused prescriptions for medications they relied on for years — sometimes just to get out of bed in the morning — and have been left to suffer untreated pain on top of withdrawal symptoms.

Many … described being tapered off narcotics too quickly or, worse, turned away by doctors and left to navigate on their own. Some said they coped by using medical marijuana or CBD oil, an extract from marijuana or hemp plants; others turned to illicit street drugs despite the fear of buying fentanyl-laced heroin linked to soaring overdose death numbers. A few … contemplated suicide.

Republicans Are Killing Market-Based Health Care in America

August 3, 2018December 31, 2019

Matthew Yglesias makes a convincing argument in Vox that, by resisting Obamacare at every turn, Republicans are making European-style universal health care more likely in the United States. Read more “Republicans Are Killing Market-Based Health Care in America”

Donald Trump’s Instincts on Drugs Are All Wrong

February 26, 2018December 22, 2019

Axios reports that President Donald Trump envies countries that execute drug dealers, tells confidants a softer approach to drug reform will never work and that America needs to teach its children they’ll die if they take drugs.

His administration is looking into triggering five-year mandatory minimum sentences for traffickers who deal as little as two grams of fentanyl. Currently, the threshold is forty grams.

Fentanyl is a synthetic opioid that can be lethal in extremely small doses. Overdose deaths from fentanyl and other synthetic opioids have increased sixfold since 2013, outstripping those from every other drug.

But a crackdown won’t help. Read more “Donald Trump’s Instincts on Drugs Are All Wrong”

Health Insurance Sticking Point in German Coalition Talks

January 17, 2018October 24, 2019

Windows of a hospital in Erlangen, Germany, July 17, 2014 (Reinhard Kuchenbäcker)

One of the sticking points in attempts to form another grand coalition government in Germany is the country’s mixed public-private health insurance system.

The Social Democrats campaigned on merging the two. Their argument is that the one in ten Germans with private insurance (mostly people with yearly incomes over €50,000) get better care: shorter waiting lists, more services. Read more “Health Insurance Sticking Point in German Coalition Talks”