RACHEL MARTIN, HOST:
Various Democratic presidential hopefuls are getting behind an idea long thought to be on the outer edge of progressive politics - so-called "Medicare-for-all." Senator Kamala Harris endorsed the idea the other night in a CNN town hall. She also suggested getting rid of all private insurance.
Clearly health care is going to be a major issue in the Democratic primary and seems like a good moment to have NPR's health policy correspondent Alison Kodjak on to educate us. Good morning, Alison.
ALISON KODJAK, BYLINE: Good morning, Rachel.
MARTIN: We've heard this phrase for a long time, but it's worth explaining it again. Can you just describe what exactly is "Medicare-for-all"?
KODJAK: Yeah, so what Senator Harris says she is supporting is a bill that was proposed by Bernie Sanders, and that would create a national single-payer health plan that would replace the whole private insurance system. And here's how she described it.
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KAMALA 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.
KODJAK: So everyone would get a Medicare card just like the one that my elderly mother has, and doctors would have to sign an agreement to participate in the program.
MARTIN: And as you point out, this is the same thing as the single-payer system. So everyone may hear "Medicare-for-all" and think, oh, this is just for, you know, elderly people. But this is actually - what she's proposing is a much more substantive overhaul of the current health care system.
KODJAK: Yeah, it's huge. It would change everybody's health insurance.
MARTIN: How would it be paid for?
KODJAK: Well, that's the big unknown.
KODJAK: I mean, it would clearly have to be through some sort of tax increase. Harris didn't specify what she wanted to do in her town hall, and Sanders, in the proposal that he put on the table, did outline some options. Right now we spend about $3 1/2 trillion a year on health care, and Sanders says his - making "Medicare-for-all" will cost less. But the proposals to pay for it would be maybe a tax increase on employers to replace what they're now paying for health insurance premiums like a Social Security tax or maybe a tax increase on personal income tax. And then there are always proposals to increase tax rates on the wealthy high-earners and reduce their deductions.
MARTIN: So we know Kamala Harris is behind this idea. What about the other candidates who've thrown their hat into the ring thus far?
KODJAK: Yeah, well, we have Kirsten Gillibrand of New York and Elizabeth Warren who both also co-sponsored Senator Sanders' bill, so the - that Democratic crowd is pretty much all in. You have two so-called moderate billionaire businessmen who are testing the waters, those centrist candidates. Howard Schultz, the former CEO of Starbucks - he called this program not American because it would eliminate the health insurance industry. Mike Bloomberg - he says a "Medicare-for-all" plan would, quote, "bankrupt us." So those two potential candidates aren't quite as supportive as the three senators who have already co-sponsored Senator Sanders' bill.
MARTIN: I mean, we should just point out it wasn't that long ago that there was an overhaul of the American health care system that gave birth to the Affordable Care Act. So - and these Democrats are arguing that didn't go far enough. But this is a very politically difficult issue. I mean, how does it poll with the public? Do Americans want a single-payer system?
KODJAK: You know, conceptually they do. Fifty-six percent of people in a recent poll said they were supportive. But when you get into the nitty gritty - like, you're going to have to change your insurance, and if you like it, you won't get to keep it - people don't like that. People never like to hear that they're going to have to pay more taxes even if it replaces their insurance premiums. And of course the insurance industry is going to fight this like crazy...
KODJAK: ...If it gets to that point.
MARTIN: NPR's Alison Kodjak - thanks, Alison.
KODJAK: Thank you, Rachel.
MARTIN: One correction now - earlier we described the Kamala Harris campaign as backtracking from one aspect of "Medicare-for-all." Her campaign has said that in fact she remains supportive of the "Medicare-for-all" bill she co-sponsors with Bernie Sanders.
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