Amidst the changing landscape of health policy and reform, even politically savvy Americans can become confused by the language candidates use to describe public health insurance proposals. Policies that share the same name – “Medicare for All” – often do not have consistent definitions. The question of what “Medicare for All” actually means is indicative of a larger debate about the role of the government in United States health care.
In the Milbank Quarterly, Dr. Jonathan Oberlander tackles the context behind this discourse in “Navigating the Shifting Terrain of US Health Care Reform—Medicare for All, Single Payer, and the Public Option.” Oberlander is a professor of health policy and management at the University of North Carolina Gillings School of Global Public Health.
In the article, Oberlander tracks the rhetoric of health care reform in the U.S. back a full century, starting from the use of terms like “social” and “compulsory” insurance in the early 1900s. That evolution has continued, ultimately arriving at the “Medicare for All” plans seen today.
In the run up to the 2020 presidential election, many Democratic candidates have used Medicare in the branding of their health care proposals. Dr. Oberlander suggests this is intentional, because it connects Americans to an already existing and successful health care program in the U.S.
However, as popular as Medicare may be, there is no consensus over how to expand it or even what “Medicare for All” means. In his article, Dr. Oberlander identifies three varying models of Medicare expansion, each of which reflects differing assessments by reformers of how to to balance “pragmatism with principle.”
“This is an historic moment in American health politics,” he says. “The question is what will happen after 2020.”Friday Letter Submission, Publish on October 18