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A brief (?) thread on the future of health reform, inspired by the new KFF poll. This poll shows a lot of public support for Medicare for All -- but this is a great slogan that could mean different things 1/ kff.org/health-reform/…
To oversimplify a bit, M4A could mean either (a) replacing the existing system with mandatory govt insurance, obliging those with private insurance to switch, or (b) offering an option to buy into govt insurance, while providing subsidies that make all insurance affordable 2/
Everything we know suggests that (a) would be cheaper -- low administrative costs, more bargaining power over prices -- and more effective at covering everyone because people wouldn't have to choose a plan or pay premiums. But it would be a big change 3/
By contrast, (b) would retain the administrative complexity of the current system and surely cost more. BUT it would cause much less disruption. And the polling says it has much higher support even now 4/ 
And that's before the furious campaign against M4A that will surely take place. If the usual suspects could demonize Obamacare, think what they will do to a plan that actually forces the 156 million with employer coverage to switch 5/
The thing is, a Medicare option would probably bring in a lot of people, and snowball over time. The system could evolve into single-payer once people see it in action. 6/
I guess the political message is, don't make commitment to the total replacement version of M4A a litmus test. That's an unpopular plan even now, and would get even less popular in the heat of a campaign 7/
