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House Democrats Schedule Hearing on HR1384 (#MedicareForAll) for This Tuesday, April 30

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By Lambert Strether of Corrente

Kudos to the Democrat-controlled House Rules Committee for scheduling a hearing on HR1384, the “Medicare for All Act of 2019.” (Here is the announcement; here are the witnesses). However, readers who suspect my rapture will be modified will not be disappointed. In this post, I won’t go into health care industry funding of Democrats, and anti-Medicare for All think tanks and thought leaders; readers who check out those links will be unsurprised. Rather, I’ll look at the mechanics of the process: First, the members of the committee; second, the witnesses before the committee; and finally, the next hearing coming up. But first, a word about the House Rules Committee itself, from its own About page:

The Committee is commonly known as “The Speaker’s Committee” because it is the mechanism that the Speaker uses to maintain control of the House Floor…. The Rules Committee has two broad categories of jurisdiction: special orders for the consideration of legislation (known as “special rules” or “rules”) and original jurisdiction matters. A special rule provides the terms and conditions of debate on a measure or matter, consideration of which constitutes the bulk of the work of the Rules Committee. The Committee also considers original jurisdiction measures, which commonly represent changes to the standing rules of the House, or measures that contain special rules, such as the expedited procedures in trade legislation.

The Committee has the authority to do virtually anything during the course of consideration of a measure, including deeming it passed. The Committee can also include a self- executed amendment which could rewrite just parts of a bill, or the entire measure. In essence, so long as a majority of the House is willing to vote for a special rule, there is little that the Rules Committee cannot do.

(As the Rules Committee page shows, this is an “original jurisdiction” hearing.) Just spitballing here, but I would imagine that whatever fate Pelosi has pre-ordained for HR1384 will be expressed by the rules for debate and amendment under which it comes to the House floor, if indeed it ever does. If the canonical example of originial jurisdiction is trade legislation, the House leadership must have something complicated in mind. From WikiPedia (sorry):

Amendments might only be allowed to specific sections of the bill, or no amendments might be allowed at all. Besides control over amendments, the rule issued by the Rules Committee also determines the amount of speaking time assigned on each bill or resolution. If the leadership wants a bill pushed forward quietly, for instance, there might be no debate time scheduled; if they want attention, they might allow time for lengthy speeches in support of the bill.

Between control over amendments, debate, and when measures will be considered, the Rules Committee exerts vast power in the House.

Now, to the members of the House Rules Committee, Democrats because the Rules Committee operated in party line fashion. Here they are:

Representative HR 1384 Co-Sponsor
Rep. Mark DeSaulnier (D-CA) X
Rep. Alcee L. Hastings (D-FL) X
Jim McGovern (D-MA) (Chair) X
Rep. Joe Morelle (D-NY)
Rep. Ed Perlmutter (D-CO) X
Rep. Jamie Raskin (D-MD) X
Rep. Mary Gay Scanlon (D-PA)
Rep. Donna Shalala (D-FL)
Rep. Norma J. Torres (D-CA)

As you can see, 5 of the 9 members are co-sponsors of HR1384. So we have, in this hearing, a good way to evaluate whether these co-sponsoring Representatives are committed to #MedicareForAll, or just paying lip service. (And if you, readers, are represented by any of these Democrats, it might be worth a call to their office to politely express their views.)

Next, let’s look at the witnesses for the hearings. Again from the Rules Committee:

I’ll dispose of the minority witnesses quickly. Starting with Grace-Marie Turner of the Galen Institute. From the Institute’s mission statement:

The Galen Institute has many plans to counter the march toward government-controlled medicine and shift the debate toward ideas that offer greater freedom and more affordable health care choices.

(Fascinatingly, Turner has grifting since Hillarycare; here is an extensive, though dated, post.) And their funding, from SourceWatch:

So, the usual suspects. And Charles Blahous, in case you have forgotten, is the loon world-renowned, Koch-funded expert who managed to prove that although #MedicareForAll would cost a lot, it would net out positive for the country. Now to the Democrats. Where Republicans, as one might expect, present a unified wall of opposition, the Democrats, as one might also expect, are mushier. Let’s look at each of them in turn (and as we shall see, the presences are less interesting than the absences. Witness Ady Barkan was added later; see the UPDATE at the end of the post).

First, Dean Baker. Baker, a well-respected analyst, is not an expert in Medicare for All; indeed, he has written nothing on that topic on his own site, the Center for Economic and Policy Research (CEPR):

(A search on H.R. 1384 yields a similar result.) Further, Baker supports for Medicare for All in principle, sorta, but not this bill. From Counterpunch:

Medicare for All is Doable and Most Americans Want It

Which is a good headline, but:

While a well-designed pathway can get us to Medicare for all, even we can’t do it all at once.

For beginners, we can look to lower the age of Medicare eligibility from the current 65 to 60 or even 55 in an initial round. We can also allow people of all ages to have the option to buy into a public Medicare-type system.

We can also look to start getting our costs down. This means lowering drug prices, both by negotiating in the same way as other countries, and directly funding research so that newly developed drugs can be sold as cheap generics.

We should do the same with medical equipment. And we can subject our doctors and dentists to the same sort of foreign and domestic competition that workers in other professions face.

These steps can get us on a path to Medicare for all, on which we will quickly be extending coverage to millions of people, while substantially reducing the cost of care for everyone.

We are smart [there’s that word!] enough to be able make the same sort of guarantees on providing health care as every other wealthy country.

Needless to say, HR1384 does not offer a phased approach, and so Baker opposes it. He does support a so-called public option, but that’s a different bill. In short, Baker — like, say, Beto O’Rourke — is a “path to” Medicare for All guy, not really a supporter at all.

On to Dr. Sara Collins, Vice President for Health Care Coverage and Access, The Commonwealth Fund. Collins is the creator of “The ‘Medicare for All’ Continuum: A New Comparison Tool for Congressional Health Bills Illustrates the Range of Reform Ideas” (here is the tool). Collins writes:

The Medicare for All Continuum

To address these problems, some Democrats running for president in 2020 are supporting Medicare for All. Meanwhile, in Congress, Democrats have introduced a handful of bills that might be characterized as falling along a continuum, with Medicare for All at one end.

The continuum of approaches suggests both the possibility of building toward a Medicare for All system over time, or adopting aspects of Medicare for All without the disruption that a major shift in coverage source might create for Americans.

As our new Commonwealth Fund interactive tool illustrates, the bills range from adding somewhat more public sector involvement into the system, to adding substantially more public sector involvement.

(The so-called tool is functionally a table, with the disadvantage, or advantage, that columns in the table cannot be readily compared.) Collins, then, shares Baker’s “path to” ideology; she, too, is not a supporter of the bill. She is contributing this #MedicareForAll cycle’s version of the familiar liberal Democrat tactic of brand confusion: Labelling a “continuum” by one of its endpoints is clever; it’s as if we were presented with the “cooked” continuum, which surprisingly includes frozen food, raw food, partially cooked food, underdone food…. “But frozen food is on the pathway to being cooked!”

Now we come to Dr. Doris Browne, Immediate Past-President, National Medical Association. Now, the National Medical Associated is listed at PNHP as an HR676 supporter, which is good (although a search of their site for “single payer” yields nothing; likewise “Medicare for All,” and “1384”). PNHP aggregates an enormous amount of material, but a search on “Doris Browne” turns up nothing. Google searches on “‘Doris Browne’ ‘Medicare for All'”, “‘Doris Brown’ ‘HR 676′”, and “‘Doris Brown’ universal” also turn up nothing. Given how crapified Google search is, I’m reluctant to make a judgement either way, but if she does support either #MedicareForAll in general, or HR1384 in particular, her support has not been made visible in venues were I would expect to find it.

Finally, we have Dr. Farzon Nahvi, Emergency Room Physician. Navhi did in fact write the following in the New York Times in 2017: “Don’t Leave Health Care to a Free Market“:

Republicans need to be honest with themselves and the public: If they want medicine to be truly free-market, then they have to be willing to let the next man or woman they find lying unconscious in the street remain there and die. In a truly free market, we cannot treat someone — and charge someone — without their consent and against their will. If we believe, however, that those lying there in their most vulnerable moments deserve a shot, then we need to push forward with the idea that health care, at its core, must be designed around a caring system that serves all people fairly

And the Rules Committee itself puts Nahvi forward as a Medicare for All supporter:

(Although they slip in “high quality universal coverage,” whatever that means.) The Now This video, like Nahvi’s editorial, appears to be from 2017 (as does this article, from the Guardian, which also does not mention single payer or Medicare for All). Since it’s from 2017, and this is 2019, Nahvi cannot be said to support HR1384.)

We can sum up the views of the witnesses in the form of a table:

Witness Supports Medicare for All Supports HR1384
Dean Baker
Dr. Sara Collins
Dr. Doris Browne ? ?
Dr. Farzon Nahvi X ?
Ms. Grace-Marie Turner
Dr. Charles Blahous
Ady Barkan* X X

* Barkan was added a day after the initial list of witnesses; see the UPDATE at the end of the post.

At this point, it’s worth noting the witnesses from the last time liberal Democrats tackled health care, in 2009. NEJM editor-in-chief Dr. Marcia Angell:

PNHP board advisor Dr. Walter Tsou:

Yet, this go-round, there are no single payer subject matter experts whatever, and no supporters [with Barkan, I think, one; see UPDATE below –lambert] of the bill which is supposedly the subject of the hearing. What could have led to such a seemingly paradoxical result? The Rules Committee is “The Speaker’s Commmittee,” and that’s what the Speaker wants. HuffPo explains:

It’s unclear who decided which experts would testify before the Rules Committee. Staffers on the Rules Committee say no one in leadership directly told them this person or that person couldn’t testify, but sources involved with the planning of the hearing say three criteria were applied to potential witnesses: (1) Is this person a leader of a single-payer group? If so, that person could not testify ― meaning Gaffney was out. (2) Is this person an activist? If so, they couldn’t testify. That meant people like Dr. Sanjeev Sriram, who has repeatedly advocated for Medicare for All, were ruled out. And (3) Has this person said anything negative about the Affordable Care Act?

That last requirement, implemented by House Speaker Nancy Pelosi’s top health care staffer, Wendell Primus, according to sources, is particularly an issue for some single-payer advocates, because they believe the hearing could turn into an exercise in which witnesses seem to endorse all sorts of different approaches to health care ― the ACA, a Medicare buy-in situation, and perhaps, maybe, Medicare for All.

Wowsers. If they won’t let anybody who said anything negative about ObamaCare testify, witnesses will be thin on the ground indeed!

Finally, the next hearing, which is the last scheduled one:

How much you want to bet Pelosi uses PayGo to choke off #MedicareForAll in the Budget Committee — perhaps under whatever rule the “the Speaker’s Committee” devises for HR1384’s speedy dispatch? As I have often said, I believe that preventing #MedicareForAll is the #1 goal of the liberal Democrat leadership. We’ll have to see how that proves out. But as of now, it looks to me like they’re right on track!

UPDATE

The HuffPo article (“farce”) triggered outrage in the #MedicareForAll community (see here, here, here, although most of it, sadly, simply echoes the HuffPo piece; the Baucus debacle in 2010 are only mentioned by an activist on Facebook, which speaks to the weakness of left reporting on this issue; failure of institutional memory is one reason liberal Democrats get away with what they do.) As a result, activist Ady Barkan was added to the witness list. HuffPo once more:

A day after HuffPost reported on the controversy over the lack of pro-single-payer voices at the upcoming hearing on “Medicare for All,” the House Rules Committee announced Friday that a hero among single-payer advocates would now also testify: Ady Barkan.

Barkan, who has ALS and is an undisputed champion of Medicare for All, will be a strong voice for a single-payer health care system and will put to bed the concerns of many activists that there wasn’t a forceful enough proponent of Medicare for All on the witness panel.

But Barkan is also exactly the sort of champion that Medicare for All proponents wanted to see speaking on the panel.

Apparently, Barkan reached out to Pelosi, and Pelosi gracefully requested McGovern to put Barkan on the panel:

Pelosi also, it would seem, threw out or weakened the criteria originally used — the source of the criteria is hazy — by staff to select witnesses:

Sources told HuffPost that Pelosi’s staff and the Rules Committee had applied a certain criteria to any witness: If the person led a single-payer group, was an activist or had said anything negative about the Affordable Care Act, they couldn’t testify.

In many ways, Barkan violates all three of the criteria. He is the founder of the Be A Hero PAC, an outspoken activist for single-payer, and while an enthusiastic defender of the ACA, he has also been clear that the law alone is not enough.

To be fair, Barkan supports Medicare for All. From Barkan’s Medium announcement:

On Tuesday, for the first time ever, Medicare For All will get a hearing in the United States Congress. I congratulate and thank Rep. Jayapal, Rep. Dingell, former Rep. Conyers and Sen. Sanders for their decades of leadership on this historic day.

“I am grateful to Chairman McGovern and Speaker Pelosi for making this hearing possible and inviting me to testify. Tuesday will be just the latest example of why I worked so hard to help Democrats win back the House in November. The American people have heard the message loud and clear: Republicans are bad for your health. On Tuesday, for the first time ever, Medicare For All will get a hearing in the United States Congress. I congratulate and thank Rep. Jayapal, Rep. Dingell, former Rep. Conyers and Sen. Sanders for their decades of leadership on this historic day.

“I am grateful to Chairman McGovern and Speaker Pelosi for making this hearing possible and inviting me to testify. Tuesday will be just the latest example of why I worked so hard to help Democrats win back the House in November. The American people have heard the message loud and clear: Republicans are bad for your health. Progressives have a plan to fix the American healthcare system once and for all. to fix the American healthcare system once and for all.

(I interpret “Progressives have a plan to fix the American healthcare system once and for all” to mean that Barkan supports HR1384 as well as #MedicareForAll.) Barkan is indeed a hero; it’s no small thing to testify before Congress with ALS. That said, for me, Barkan is not “exactly the sort of champion” I want to see. Barkan, despite his activism, is not a subject matter expert. The Rules Committee — and Pelosi, now that she has shown her hand — has refused to hear any #MedicareForAll activists who can testify authoritatively on how #MedicareForAll will impact the Federal budget (and net out positive for the American people). Not Marcia Angell (former editor of the New England Journal of Medicine). Nor Stephanie Woolhandler (from Harvard Medical School) was not invited to testify on that topic. Nor Gerald Freidman (Professor of Economics at the University of Massachusetts). For a party that fetishizes credentials above all, these omissions are quite remarkable, especially considering that a creature from that citadel of reaction, the Mercatus Center, who published an instantly discredited paper on budget impact, was invited. One can only wonder what the Democrat leadership’s motivation could have been, especially considering that liberal Democrat donors and operatives are working together to publish vicious and reprehensible campaign materials like this:

The Congressional forum for “straight answers” is controlled by liberal Democrats, and they’re refusing to allow the straight answers to be made, by subject matter experts known to all! It would certainly have been a welcome demonstration of fair play and commitment to the democratic process for liberal Democrats to enable #MedicareForAll advocates to get responses to PAHCF’s nonsense on the record, especially in an election year, but n-o-o-o-o-o-o!!!!!

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

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23 comments

    1. Lambert Strether Post author

      I think she is becoming more powerful within the caucus but less powerful outside it. At some point, that contradiction will be resolved.

      Adding, if anyone in your social circle goes triumphalist about Barkan or the hearings, feel free to show them this :-)

      1. JohnnyGL

        I think you’ve nailed it with that description.

        It’s clear where Pelosi (and Stahl, it seems) thinks power lies….https://www.youtube.com/watch?v=4IBPrUNU0As

        In the clip above, it’s pointed out that 43 districts were flipped with centrist blue-dog-ish types. That’s the basis for the confident, condescending brush off “it’s like 5 people” (as seen here: https://www.youtube.com/watch?v=pDvEv7RokDQ)

        Stahl pretty openly questions whether Pelosi can ‘control’ her left flank and occupy the center. It seems they are both clear that this is the priority.

        Pelosi gives the appearance of someone who’s confident that she’s got a grip on things. There’s other dismissive remarks about social media followers.

        I also agree that the ground is shifting under her feet and she may be underestimating the shifting of the tectonic plates.

    2. Big Tap

      I also have contempt for all the ‘Progressive’ members who said they wouldn’t support Pelosi for speaker but did anyway. She’s speaker thanks to these liars.

  2. divadab

    First the Russia Russia Russia hysteria and now back to business as usual for the Dems – thwarting any new initiative that actually benefits citizens. What a filthy corrupt lot of bribe-taking liars.

    Of course the Republicans are mostly worse but cholera is worse than typhoid.

    1. Cal2

      Thank you Lambert for yet another great column in the edifice of truth.

      I believe this subject is too complicated for many voters to analyze in depth. As this gets going, we’re going to be drowned in details.

      Therefore, in addition to all the great ongoing Naked Capitalism reporting, I humbly suggest, some kind of simplified scoreboard of the candidates running for national office on the subject of Medicare For All.

      Say, a scale of one to 10, with Ten being the most supportive of it in VOTES, not words, multiplied by WHAT they are voting for.

      i.e. Medicare For America, the keep the money flowing to insurance companies, would count as zero if candidate voted for it, or even as a negative number.

      A candidate who voted for mediocrities, half hearted versions, stalled, changed their mind, would through their votes get a low or no score.

      A candidate who voted for the best version of Medicare For All, universal coverage of the public, would get the highest number of points.

      After all is said or done this legislative season, each candidate in office would have a number based on their votes and that could be quickly scanned by voters in addition to their other policy positions.

    2. polecat

      I don’t know divadab … as they BOTH* are capable of eliciting mortality amongst the weak !

      *the parties AND the diseases ..

  3. Samuel Conner

    I’m waiting for Appropriations Committee hearings on MMT and its implications for the budget.

  4. allan

    That Joe Morelle, a freshman, is on the powerful Rules Committee is not a good sign.
    He’s a Dem apparatchik, steeped in the ways of Albany.
    He was Majority Leader in the NYS Assembly before running for Louise Slaughter’s seat after she died.
    You can listen to his health care talking points starting at about 41:20 in this interview.

    The fix is in.

    1. JohnnyGL

      Donna Shalala (longtime clinton-ite hack)
      Jamie Raskin (big russia-gater)

      Dem party hacks are well represented.

  5. Enquiring Mind

    From Blahous to Our House.

    That is a way to have the House stipulate to a statement about the overall cost to Americans of the proposed system versus the present system, along the lines of X percent of GDP compared to X+Y percent. Get attention on that Y, and keep asking why we should pay extra for that delta.

    They keep trying to hide the ball, or choose your own descriptor, say, like lie.

  6. The Rev Kev

    I suppose that there are no real surprises here. The Democrats will fight to the death the whole idea of single-payer in the United States. It seems to be part of their cultural DNA to try to kill off this idea and if they ever folded, their last boast would be that at least they stopped single-payer ever happening. This committee reminds me of the one on women’s health a few short years ago and all the people on the committee were very old men so not exactly their area of expertise. The Democrats will always choose a crappy version like Obamacare and make it a matter of urgency. Clinton said not long ago “People who have health emergencies can’t wait for us to have a theoretical debate about some better idea that will never, ever come to pass.” By that she meant single-payer health.
    You want to know what is so disappointing about the Democrats? And I come out here and say the Republicans are just the same but more open about it. It is the fact that they are such cheap dates. In that Michael Moore film “Sicko” a bunch of politicians came onstage and it listed how much they were receiving from the health sector and it was pocket change. Even George Bush got only a few tens of thousands of dollars. I would bet that the lobbyists are paid more than what the politicians actually get. So US healthcare involves about $3.5 trillion a year and these politicians are selling out hundreds of millions of people for pocket change. As I said, cheap dates.

  8. orlbucfan

    Lambert: define “liberal” for me. These Third Way/DLCraporate Democrats aren’t liberal. Not according to Webster’s Dictionary. They’re the YUPPIE Reagan GOP branch. Big reason why the Democrats recently lost over 1,000 seats in the short space of a few years.

    1. Yves Smith

      Since when is a dictionary an authoritative source on contemporary politics? Thomas Frank devoted an entire book to the topic. I suggest you read “Listen, Liberal.” Frank disagrees with you vehemently.

      And Democrats didn’t lose seats for being too centrist. Help me. I’m not going to treat your barmy assertion seriously since we have literally hundreds of posts on this issue.

  9. allan

    Looks like Dr. Blahous has come down with a severe case of Kochitis,
    the primary symptom being inflammation of the budget:

    Jeff Stein @JStein_WaPo

    Days before testifying on the Hill, Mercutus’ Charles Blahous changes his estimated cost of Medicare for All — now it’ll cost $55-$60 trillion, he says. Some noted Blahous’ first study found M4A would actually save $ by reducing overall health spending

    1. Synoia

      Ah I understand. The Noble and self-effacing medical insurance companies are containing the Public’s medical costs.

      That’s very, very public spirited of them. Very gratifying.

  10. Cal2

    From the

    Partnership for America’s Health Care Future Profits Stream

    “Medicare for all would “produce significant job losses” while delivering “a significant negative shock to the U.S. economy.”

    A. Same bunch of people were not worried about “significant job losses” when Bush I and Bill Clinton, pushed NAFTA though congress, or more recently, when they off shored medical billing, call centers, supplies and even remote surgeons.

    Maybe all those insurance billers, collection agents, Death Panel deniers of coverage, repossession men and staff of 100 million dollar bonus CEO types, could be retrained in computers or some updated version of that?

    Significant shock? Aren’t you all for “Disruption”?

    B.How are you going to pay for it?

    Same way we pay for the Pentagon and losing wars in the Middle East.
    Do you have a problem with that means of financing, and if so, why haven’t you done anything about it?

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