While everybody was watching Michael Cohen alternate between answering questions and being called a filthy liar who lied (for Donald Trump) Wednesday, elsewhere on Capitol Hill Washington state Congresswoman Pramila Jayapal introduced the House's leading version of a Medicare for All Bill. It's pretty darned ambitious, and would switch the US healthcare system from a tangled mess of private and public health insurance plans to a single-payer system that genuinely covers everyone in the country. Jayapal's proposal (summary here) would actually cover even more healthcare needs than Bernie Sanders's Medicare for All proposal in the Senate. For that matter, it would provide even more wide-ranging coverage, with fewer direct costs to the consumer, than any of the existing single-payer systems in the world. Take that, Old Europe!

So what's in the proposal? Jayapal would build a single-payer system on to the existing structure of Medicare over two years. (This is important; the long lead time of Obama's ACA ensured nobody saw any benefits before deciding to throw all the bum Dems out.) At the end of the first year, every American under the age of 19 and over the age of 55 would be eligible, and all Americans would have the option to buy in to the system. Then everyone else would be covered at the end of the second year of the phase-in. (The Sanders bill would come into effect over four years.) Once Jayapal's Medicare for All is up and running, it would replace all private insurance with government-paid coverage; Medicaid and the existing Medicare senior insurance program would also end, since everyone would now be covered. The only two existing health services not to be taken over would be the Veterans Administration system and the Indian Health Services. Jayapal said Tuesday she knows exactly what a huge change this all would be:

We mean a complete transformation of our health care system and we mean a system where there are no private insurance companies that provide these core benefits [...] We mean universal care, everybody in, nobody out.

The plan would provide truly comprehensive healthcare benefits for all Americans. The whole shootin' match:

It would cover hospital visits, primary care, medical devices, lab services, maternity care, and prescription drugs, as well as vision and dental benefits.

DENTAL! An oral infection that can KILL YOU would actually BE COVERED. What is this world even coming to???

In a move certain to win the adoration of Republicans, the plan would also cover abortions, and possibly make them mandatory for enemies of the state (defined as anyone who's said the words "Bible-believing Christian" in earnest). We are joking about that last part. Probably. But it would cover abortions, which are actually healthcare OMG.

And in a step well beyond the Sanders version, Jayapal's plan would also cover long-term care, which yes, would be pricey, but certainly beats our existing system of driving people into bankruptcy and poverty so they'll qualify for Medicaid.

Here's part of Jayapal's speech announcing the bill and pointing out that as things stand now, America pays a hell of a lot more for healthcare than the rest of the world, but we still have lower life expectancy and cover fewer people. As Jayapal notes, it's obscene that anyone should have to rely on GoFundMe for healthcare:

As Vox notes, the proposal would be even more generous than in other countries' versions of single-payer:

The Canadian health care system, for example, does not cover vision or dental care, prescription drugs, rehabilitative services, or home health services. Instead, two-thirds of Canadians take out private insurance policies to cover these benefits. The Netherlands has a similar set of benefits (it also excludes dental and vision care), as does Australia.

What's more, the Jayapal plan does not require consumers pay any out-of-pocket spending on health aside from prescription drugs. This means there would be no charge when you go to the doctor, no copayments when you visit the emergency room. All those services would be covered fully by the universal Medicare plan.

None of which means it's undoable -- remember, even that Koch-brothers-funded analysis found that, compared with our current system, Medicare for All would actually save two TRILLION dollars over 10 years, which would pay for a lot of healthcare. And, for that matter, for a lot of aid to people in the health insurance industry who'd lose their jobs and need retraining. The bill would provide at least five years of aid to help with that transition, through job training, early retirement, and "wage replacement" as we reshape the healthcare system.

The bill would also empower the government to negotiate drug prices directly with pharmaceutical companies, whose lobbyists will also be first up against the wall when the revolution comes. Or not. Get ready for a lot of the Usual Suspects to insist we simply can't afford to do universal coverage, and to point out that the bill doesn't include a mechanism for funding Medicare for All. Jayapal says for now, the goal is to lay out an ambitious set of goals (yes, for Democrats to run on in 2020) and that the funding part will come when there's a mandate to actually do this.

Jayapal says that this is an issue that will get dealt with in the future. "Most bills don't have that when they're introduced, that comes later in the process," she said of a financing plan. "I actually think the question is not about how we pay for it, the question is where is the will to make sure every American has the health care they deserve and have a right."

Again, it's not that this is undoable, but that there are a lot of people making a lot of money who would be inconvenienced if the government started sharply limiting how rich you can get making insulin, for instance. Also, keep in mind that what we REALLY can't afford is continuing to pay twice as much per capita on healthcare while still not covering everyone. Frankly, we're excited to see a bold proposal -- since any effort to remake the healthcare system will be called socialist anyway, how about we actually propose a genuine remaking of the whole awful mess as the first step, for a change?

[Vox / Politico / Common Dreams]

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