Medicare for All Kids

I’m for Medicare for All, but not all at once.  We should expand Medicare to cover all Americans.  But we should do it in steps.  Step one: cover the kids.

What is Medicare for All?  When I talk about it, I mean the current Medicare system, expanded to cover everyone.  People understand the current Medicare, and it was created by our last great President, a Texan.  Senator Bernie Sanders (I voted for him and may again.) and some Democrats define Medicare for All to mean a fully comprehensive system that covers all necessary medical costs.  That would be great, some day.

Back in 2010, when the so-called “tea party” Republicans were demonstrating against the Affordable Care Act, I went to my Congressman’s town hall meeting carrying a sign that I made.  It said:

Universal Medicare

From my little home-made sign, the idea of expanding Medicare caught fire.  (Well, okay, maybe that wasn’t the spark.  But the idea did catch fire.)

Universal Medicare should be phased in for three reasons.  First, there is not enough support, even in the Democratic Party, to get the expansion done in one time.  Second, such a sweeping expansion would be a tremendous shock to the economy.  Third, we don’t want another disastrous rollout like we had with Obamacare.  The best way to expand Medicare substantially while establishing that it is going to be for everyone eventually, is to extend it to all children under 25.

Start with the kids

We should start with kids for several reasons.  First, children are the most vulnerable population.  Medicare, like Social Security, was established for the elderly because they are a vulnerable population.  Children are also a vulnerable population.  Second, covering children will take a lot of financial pressure off families.  Third, we are already spending some of the money to cover children, so it’s not as big a budget stretch to bring them under Medicare.

We spend money covering kids now with a program called CHIP.  It’s a very limited, means-tested program, so it’s inefficient and unfair.  Let’s discontinue CHIP and bring the kids into a solid program.

Forget about expanding Obamacare (Pelosicare, anyone?).  It’s a house built on sand.  Let’s build our house on rock—Medicare.

Life span

The beauty is that, once we have covered both ends of the life span, we will have created a donut hole in the middle that obviously will be closed in time.  Just as the donut hole in prescription drug coverage created by the Republicans was inevitably filled…  What?  The prescription drug donut hole hasn’t been filled?  What’s the holdup?

Do you want to lock in the remaining expansion?  Sure.  Take it in two more steps.  Cover 45 to 65 in the thirties.  Then cover 25 to 45 in the forties.  That’s soon enough to feel definite, but far enough out to feel non-threatening.

Maybe this is our only shot to expand Medicare in this generation.  Let’s don’t blow it.  Social Security was created in the thirties.  Medicare was created in the sixties.  If we get this expansion done in the twenties, we may be waiting another generation or two.  Let’s make it the most important one. 


Democrats compromise

This is what democrats do. They argue for what they believe in. Then they listen to the opponent’s argument.  Then they agree on middle ground.  That’s what makes democracy work.

A special kind of compromiseis badly needed.  I mean that Democrats should compromise among themselves.  The Democratic representatives in the U.S. House must forge a compromise among themselves that they can then represent to the whole country.

I’m a social democrat, meaning I’m in the left wing of the party.  I believe in Medicare for All.  I believe in the Green New Deal.  I believe that it is urgent that we impeach the loathsome sociopath impersonating a president.  But I believe in something else more.

I’m a majoritarian, meaning I want the Democratic Party to build a stable majority in this country that can govern for a generation.  You don’t do that by holding purity votes and holding out for exactly what you want.  You do that by forging compromises and achieving significant legislation that moves the country forward.

This is not the time to be trying to scrape off those moderate Democrats who won in Republican districts.  This is the time to listen to them.  They are important messengers from persuadable voters.  They are also messengers from the Democrats to those persuadable voters.

What good is it going to do to elect a Democratic president for one or two terms, if the Democrats are going to be driven out of office by a Republican wrecking crew that then devotes itself to undoing all the progress that was made?

Focus on the settlement zone.  Democrats should be focusing on the settlement zone, not the end zone.  The settlement zone is that area between two ends where compromise is possible.  It can usually lie in the middle 40 percent between the two ends.  If I say $100 billion, and you say zero, then the settlement zone is somewhere between $30 billion and $70 billion.  I’m going to make my argument for $100 billion, yes.  But I’m going to accept something in the settlement zone.

I hope Speaker Nancy Pelosi will not give up on passing a budget in the House.  This is a critical test of leadership, and it is a critical test of Democrats.  If Pelosi can’t get her own party to agree on a budget, then how is she a leader?  Does she know about the settlement zone?  If the Democrats can’t get a plan among themselves, how are they going to govern the country?

House Democrats must remember that they are America’s team now.  This is their chance to prove themselves.  They can win the confidence of the country if they rise to the challenge.  They can give our next president an effective force for change, if they rise to the challenge.