In our inaugural mailbag episode, Rose Roach – Executive Director of the Minnesota Nurses – joins us to answer your questions about how Medicare for All would save money and impact rural hospitals, how to answer to pushback on cost, talking to conservatives about Medicare for All, the political landscape, petitions as a base-building tool, and more!
Ben and Stephanie are joined by Rose Roach, the Executive Director of the Minnesota Nurses Association (MNA), and answer questions from listeners.
First, we celebrate that Congresswoman Betty McCollum (D, MN-4), Rose’s own representative, signed on as a co-sponsor of HR 1976 after a conversation with MNA nurses during Nurses Week (and years of advocacy by healthcare activists in her district).
On to the mailbag questions!
Q: Jordan asked: How does insurance work for the Indian Health Service?
A: The Indian Health Service (IHS) is independent but not well funded. Earlier versions of Medicare for All absorbed IHS into the system, which concerned advocates for tribal sovereignty. Under HR 1976, though, IHS will stay independent of the Medicare for All system, but will be treated as a provider, so will receive financing like any other provider.
Q: Laurie asked: Why is it taking so long for Medicare for All?
A: For one, our political system and elected officials are influenced by money. The for-profit health insurance industry has deep pockets and is willing to spend big to maintain the status quo. Until we have campaign finance reform, we will have to fight this fight against monied special interests. Another issue is that we haven’t quite achieved the working class solidarity that it will take to create the grassroots demand that will force elected officials to pass Medicare for All.
Q: Heather asked: How would Medicare for All affect hospitals? How will they stay up and running, especially rural hospitals?
A: Medicare for All would actually be transformative for hospitals, despite the misperception generated by the industry that it would hurt them. Medicare for All would fund hospitals equitably and fairly, based on their value to the community rather than their profitability. In a market-based system, hospitals that don’t generate profits, like small rural and safety net hospitals, can go under, regardless of the benefit they provide for the community. Under the Medicare for All system, hospitals will be funded based on the care needed by people in the community. Medicare for All is actually what could save rural healthcare from closures and consolidation.
Q: Steve asked: How do we educate conservative rural communities at risk of losing their hospitals about the benefits of Medicare for All?
A: We have to meet people where they are. Ask them how the system works for them now? Do you have to travel far for your routine care? For some it’s an ideological difference and we’ll never convince them, but there are conservatives who can be engaged about the care they and their community need.
Q: Many asked: How would we pay for Medicare for All?
A: The two Medicare for All bills don’t have financing language yet. The plan is to build the financing through the committee process. Several studies over the years have shown ways to pay for the program and generate savings, including the Political Economy Research Institute (PERI) Economic Analysis of Medicare for All.
The PERI study found the whole system would cost about $3 trillion, which is less than we’re currently paying. We already pay for about two thirds of the healthcare in the US through tax dollars. The other third is currently coming out of people’s pockets in the form of employer and employee premiums, deductibles, and co-payments that generate insurance company profits. Under Medicare for all, those dollars would go to a public system that would guarantee your healthcare. Some proposals also include taxes on the extremely wealthy. Most individuals and employers would pay less under Medicare for All, and would have their healthcare guaranteed.
Q: Phillip asked: Would Medicare for All be modeled after traditional Medicare? Or Medicare Advantage?
A: Traditional Medicare! Medicare Advantage is the private option of our current Medicare system, part of the problem. Medicare Advantage covers healthier seniors who cost less to insure, skimming healthcare dollars out of the system for profit, leaving sicker seniors needing more care for the publicly-funded traditional Medicare system to cover. M4A would be modeled after traditional Medicare, but improved, with better coverage and more services (dental, vision, hearing, etc.)
Q: Carol asked: Is extending Medicare benefits to include all necessary care and eliminating out of pocket costs doable under the Biden administration?
A: It wouldn’t get us the cost savings of putting everyone in the program and eliminating the profit grabbing, but improving Medicare and making private insurers redundant is an important step toward the bigger goal of achieving M4A. Unfortunately this probably isn’t doable under the current Congress without a lot more organizing. However, a group of senators and representatives – including many who have never signed on to M4A – recently signed a letter to President Biden proposing expanded and improved Medicare, which gives us a new group of elected officials to start educating and lobbying!
Q: Paul asks: Are you going to conduct a grassroots petition drive?
A: Basebuilding is a constant process; we need more people to get involved in our movement in order to pressure elected officials. Petitions themselves have very little impact on legislators, but are a good way to build the base and engage with people who can become active in the movement. National Nurses United is currently doing on-the-ground organizing. Forums and town halls are going on all the time, often sponsored by elected officials and local single payer groups.
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