Bernie v. Biden – Medicare for All Sooner or Later

(This post was originally posted 5/18/20)


(Author’s note: As we enter the last few weeks of the presidential campaign, there are several campaign issues which have been previously addressed in this blog. These include Medicare for All, single-payer healthcare, socialism, school choice and others. In the next few weeks I will be re-posting many of my previous posts on these issues as a review for voters. For this limited time I will be posting five days a week instead of the usual twice a week. These earlier posts will be intermingled with new posts on current topics.)


The Democratic Party race for the nomination for president is down to two men – Senator Bernie Sanders and former Vice-President Joe Biden. All the other hopefuls have now dropped out of the race.

Biden is the front-runner and considered the moderate in this race while Sanders is the progressive “far-left” candidate preferred by those enamored with socialism. This post is not intended to analyze the differences in their platforms except to compare their positions on healthcare. How much do they really differ?

Sanders is well-known for his healthcare proposal known as Medicare for All – his form of socialized medicine that would take effect immediately and eliminate all private healthcare insurance. In the first Democratic presidential debate, nearly every candidate including Kamala Harris, Elizabeth Warren, Kirsten Gillibrand, Corey Booker and Pete Buttigieg agree with Sanders. The only leading candidates that disagreed were Joe Biden and Amy Klobuchar.

Now that all those other Medicare for All supporters have dropped out, we’re down to just Sanders and Biden. Biden was Vice-President under President Obama, who engineered the passage of the Affordable Care Act (better known as ObamaCare) so he defends that legislation. He says he wants to “protect ObamaCare” and improve it by adding a Public Option.

What is the Public Option?

ObamaCare is a government-supported health insurance system that uses private healthcare insurers to provide coverage. Even though some lower income individuals receive government subsidies for their insurance, they purchase that coverage from private health insurers. These private insurers compete with other private insurers for quality and price in the marketplace. Those who charge too little or provide too little go bankrupt because they weren’t competitive. The government doesn’t bail them out when they fail.

The Public Option is different. It would allow the government to compete directly with these private healthcare insurers on price and quality. If the government fails, it doesn’t go bankrupt – the government simply raises taxes on the taxpayers to provide the shortfall. The government Public Option will have this huge advantage over private insurers so it will definitely win in the long run, driving out the private insurance competition.

Therefore, when Biden says he won’t take away your private healthcare insurance, he is being disingenuous. He may not take it away immediately, but he will surely take it away eventually. Jonathan Gruber, the MIT economist credited with designing ObamaCare, showed in 2007 that when government insurance expands, six people go off private insurance for every 10 people who go on public insurance.

For example, in Hawaii, only seven months after offering Keiki Care in 2008, the country’s only statewide universal child health insurance, the state ended its optional program. Some 85% of those who signed up already had private insurance. Those costs were suddenly shifted to the taxpayers.

The Public Option would cause premiums for private insurance to skyrocket because of underpayment by government insurance compared with costs for services. According to the American Hospital Association, annual underpayment by Medicare and Medicaid surged to nearly $76.8 billion in 2017, nearly doubling once ObamaCare’s regulations came into play. That resulted in an increase in private insurance premiums of more than $1500 per family.

A Public Option is a slow, but steady, path to single-payer healthcare – socialized medicine. It will guarantee the government will eventually control all healthcare. The Wall Street Journal editorial board puts it this way: “Joe Biden’s new healthcare plan is supposed to show his moderation, not that this is a virtue to progressives. Hence the back and forth this week between Mr. Biden and Bernie Sanders about single payer. But cut through the spin, and the only debate Democrats are having is whether to eliminate private health insurance in one blow or on the installment plan.”

If you go back to the days before ObamaCare, it was clear that Democratic leaders including Obama, Biden, Nancy Pelosi, and Harry Reid were all in favor of single-payer systems. The only reason they didn’t push for it then was they didn’t have the votes even in their own party. They knew the country wasn’t ready for it.

Therefore, they pushed through ObamaCare and hoped it would fail, thus setting the stage for a single-payer solution to the crisis. That time has come. Secretly they are ecstatic to see Biden pitted against Sanders since Biden can appear to be the moderate compared to the extreme position of Sanders. But reality is that both candidates want to take the nation to the same healthcare system – government-controlled healthcare. It’s just a matter of time – sooner or later.