At least this won’t get a Lie of the Year award, although the rest of Kamala Harris’ argument might not be as immune. The Democratic contender held a townhall forum on CNN last night, where moderator Jake Tapper asked about Harris’ support and sponsorship for a Medicare for All bill. Some people like their private insurance plan, Tapper noted. What about them?
We’re going to “eliminate all of that,” Harris promised:
TAPPER: Just to follow up on that, correct me if I’m wrong. To reiterate: You support the Medicare for All bill, I think initially co-sponsored by Bernie Sanders, you’re also a co-sponsor.
TAPPER: I believe it will totally eliminate private insurance. So for people out there who like their insurance — they don’t get to keep it?
HARRIS: Well, listen, the idea is that everyone gets access to medical care. And you don’t have to go through the process of going through an insurance company, having them give you approval, going through the paperwork, all of the delay that may require. Who of us has not had that situation where you’ve got to wait for approval, and the doctor says, “Well, I don’t know if your insurance company is going to cover this”? Let’s eliminate all of that. Let’s move on.
Spoken like someone who never had to deal with Medicare, which — contrary to Harris’ claims here — requires every single step she claims to detest. The biggest fib here is that switching to Medicare eliminates the approval process. It most certainly does not, a fact easily found with about two seconds’ worth of research on the website for the Centers for Medicare & Medicaid Services (CMS):
Medicare coverage is limited to items and services that are reasonable and necessary for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). National coverage determinations (NCDs) are made through an evidence-based process, with opportunities for public participation. In some cases, CMS’ own research is supplemented by an outside technology assessment and/or consultation with the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). In the absence of a national coverage policy, an item or service may be covered at the discretion of the Medicare contractors based on a local coverage determination (LCD).
That’s no different than dealing with private insurers, whose coverage is similarly limited by “reasonable and necessary” clauses. Furthermore, Medicare requires plenty of its own paperwork and red tape, with response times that routinely exceed those of private insurers, at least those outside the HMO model. Private insurers also manage care, but at least consumers have some choice for insurers and options for potentially better service and more tailored coverage.
Furthermore, we already know how government-run single-payer systems in the US operate, because we have two of them besides CMS: The Veterans Administration and Indian Health Services. The latter is a disgrace which Congress keeps ignoring, while the former is often a disgrace that Congress can’t quite ignore. Every ill Harris assigns to private insurers is amplified in both systems — delays, red tape, lack of accountability, and arbitrary services. For the past six years after the horrendous wait-time corruption scandal, Congress and the executive branch have promised to fix the VA system and insist it can be accomplished without allowing veterans to access private-sector providers. For six years we’ve seen nothing but a few firings and the same bureaucracy assuring us all is well.
Harris and her allies can’t or won’t focus on fixing what’s already broken within the government’s own house. Perhaps they should start there rather than breaking what’s in our houses — again.