Health Advice



Analysis: Elizabeth Warren throws down the gauntlet

Elisabeth Rosenthal, Kaiser Health News on

Published in Health & Fitness

WASHINGTON -- Laying the table for the next Democratic debate, Massachusetts Sen. Elizabeth Warren has issued a plan that explains how she would fund what she calls Medicare for All. She had studiously avoided saying whether it would raise taxes for the middle class, and in her proposal, she says (repeatedly) it will not.

It will instead be financed by a mix of wealth taxes, employer transfers of money they currently spend on healthcare and reductions of the many inefficiencies in our current byzantine system -- among other initiatives.

But now all the candidates need to tell us more of those details about their healthcare strategies. It's time for the candidates to stop talking slogans and start talking sense -- or dollars and cents -- so that voters can know what they mean and choose among them.

Medicare for All, Medicare for All Who Want It, a public option, improving the Affordable Care Act -- those are 30,000-foot concepts that, depending on the details, could work (or not) and be popular (or not).

The candidates (including Warren) also need to say more about what they'll do right now: In one poll, 40% of Americans said they had skipped a recommended test or treatment, and 32% said they had skipped a medicine, because of cost.

Supporters of Medicare for All want to tie their future to the popularity of the Medicare program. But Warren (and Sen. Bernie Sanders) are offering up Americans a supercharged version of the current government insurance for those over 65.


It promises to eliminate copayments for prescription drugs. (Under current Medicare, many patients contribute thousands of dollars annually.) It includes dental and long-term care -- a huge expense that is conspicuously missing from current Medicare.

That ambition would make a health care plan vastly more expensive. The national health systems of Britain and Canada, both single payer systems like the Medicare for All proposal, do not offer comprehensive long-term care coverage. Canada's system, where benefits vary somewhat by province, doesn't generally include prescription drug coverage out of the hospital for adults under 65.

Is the financing Warren proposes going to be adequate to support the expanded goals? Economists disagree.

But in releasing her proposal, she has thrown down the gauntlet before the other candidates -- who support Medicare for All Who Want It or some other type of public option -- to be a whole lot clearer about what they mean.


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