Biden’s party is holding onto a very slim margin in Congress. If he does not play his cards right, Pelosi and Schumer will be replaced by McConnell and McCarthy in 2022. And the Grim Reaper would make sure that no Biden bill was ever passed in 2023 and 2024. So, after his current infrastructure effort is concluded, Biden should look closely at national opinion polls before moving forward and proposing other legislative initiatives. Let’s take healthcare, for example.
Certainly, there’s a need to expand coverage. In Florida alone, there are 833,000 medically uninsured. Only Texas has more residents without coverage. The only question is “how can we best get them covered?”
With dozens of single-payer op-eds in various papers and magazines across the nation, I’m one of the more prolific Medicare-for-all advocates. I strongly believe that long term we should completely do away with private insurance. It’s ineffective and private insurance companies have 12% in overhead costs versus 2% for Medicare.
Medicare-for-all is a very popular topic among progressives. But I’m also a pragmatist. Enough folks in the middle of the political spectrum are not yet sold on the premise that Medicare-for-all will reduce their costs while preserving high quality care. In my opinion, it definitely will do so. But the public must first be educated so that pressure can be placed on national legislators, including what little is left of the moderate wing of the GOP.
Politically, Medicare-for-all would be a poor short-term item to push versus a public option, which still preserves private insurance and will not alienate those on corporate plans. However, on the technical side, the public option has “cherry-picking” issues due to adverse selection that will cause overall Medicare costs to rise longer term.
So, a better (although much more limited) option for short-term coverage expansion might be for the Federal government to assume 100% of Medicaid costs. The Feds currently pick up 90% and that gives red states like Florida an easy out by saying that they can’t afford to expand. But DeSantis can’t say that if the Feds pick up the full cost.
Better yet from a solely political standpoint, aggressively address excessive drug costs, something that worries liberals, moderates and conservatives (especially seniors). Trump repeatedly said he would act on drug costs but never did. For a start, Biden should have Schumer introduce a bill giving Medicare the right to negotiate drug pricing. GOP Senators like Marco Rubio and Rick Scott would have major difficulty voting against a drug cost reduction bill of this sort. And if they did, it would come back to haunt them at election time.
Biden can move “big” and illustrate the difference between a showman who cares only about himself and a real national leader who cares about our citizens. But he must also move wisely and only tackle items that have wide public acceptance.