By Any Other Name

Over the years, I've hosted a handful of Town Hall events spotlighting Medicare for All to various communities across the state, from unions to universities. One of my favorite speakers to get when I could was Dr. Abdul El-Sayed. He was knowledgeable and was absolutely electric talking about the issue. He always fired up the crowd.

I was similarly fired up when I saw he was entering a primary race to be Michigan's next senator. For years, I have birddogged his opponent, Haley Stevens, to sign onto the House M4A bill (she never has), and while Mallory McMorrow is a political talent, El-Sayed was clearly stepping into the progressive lane; declaring support for Medicare for All, calling out genocide in Gaza, and demanding we abolish ICE.

This is all to say I'm an El-Sayed supporter and likely voter, but after the last few days, he needs to clarify his position on Medicare for All.

McMorrow recently posted a snippet of an interview El-Sayed gave in which he made the claim that "if you like your employer insurance or your union insurance, those will still be there for you". She pointed out that this was more akin to a public option, which is what she has consistently supported over Medicare for All and been criticized by El-Sayed for.

I was willing to give El-Sayed the benefit of the doubt. It was very possible that he was saying coverage was going to be there regardless of losing your job, but not necessarily the specific private plan.

But then he further muddied the waters when he replied to McMorrow's tweet. He posted a snippet from his book with the last line highlighting to suggest that under Medicare for All, private insurance could exist and duplicate coverage with Medicare.

This is not a good response. The House and Senate M4A bills explicitly do not allow for duplicate coverage. They are single-payer policies, meaning the only possible private insurance would be supplemental, covering things expanded Medicare would not cover (IVF, for example). By definition, if private insurance exists and is providing duplicative coverage to the public insurer, it is not a single-payer system.

This isn't a post about the virtues of M4A, but rather to say Abdul seemed dangerously close to bailing on the policy, the way we watched almost every Democratic primary contender in the 2020 race abandon the idea, exactly because it would eliminate people's private insurance.

He was then asked to clarify his remarks, and unfortunately, not only was he more unclear, he seemed to be implying that McMorrow was just inexperienced or unintelligent on the matter. The tone itself invited a lot of dunking, but I'm concerned about his quote on the policy in which he says, "I don’t have a problem with private insurance offering some of the same services to folks, or covering some of the same services." And then adds the incoherent "It’s public guaranteed, private option." (???)

Some pundits are saying this is basically Pete Buttigieg's Medicare for All Who Want It. This is wrong. Mayor Pete's plan would have put up a new plan on the ACA exchanges for people to buy into that was like a publicly owned insurance option (this was a stupid policy). But El-Sayed defenders like Ryan Grim are also wrong in that this ALSO isn't Medicare for All. What El-Sayed seems to be alluding to and, honestly, McMorrow is supporting, is what the Center for American Progress calls Medicare for America. This is a true public option that exists to be the insurance of default for people who fall off of or simply don't/can't have employer-provided insurance. It's frankly not that bad of a policy; it's just not as good as Medicare for All.

Not to get in the weeds, but here is just a quick note on why Medicare for All is a superior policy. Even the liberal policy critics can really only serve up the political difficulty of passing it as the major problem with it (because it eliminates private, employer insurance). It solves problems in healthcare that a public option doesn't: it stops insurance churn, it ends the administrative burden of switching coverage, and reduces the cost of care with single risk pools and monopsony power over drugs. 

To be fair, Abdul also says he supports the current iteration of Sanders' M4A bill, but then he tries to imply he's middling because "we don't have the votes for that right now".

This is getting dumb. No one, even supporters like me, expects or thinks El-Sayed is going to go to Washington and make Medicare for All happen any more than McMorrow supporters think she will be able to make a public option happen. When you say you support Medicare for All, you are signaling your values. You are open to radically changing the status quo, disrupting a model that isn't working at a fundamental level. When you support the public option over M4A, you are signaling that you are compromising with the status quo. El-Sayed could simply say he would vote for the Bernie bill and his opponent won't; that is the key distinction. I would rather he lose the primary than prove even our chosen progressive champions are too chicken-shit to support it.

If this seems unfair, it's because I expect better of El-Sayed. I want to see him make the case like I have so many times at town halls, in stirring debates, and on national television. Tell people, Yes: your private insurance plan will go away and be replaced with an objectively superior plan that cannot go away by virtue of losing your job or the divine writ of your employer. This is unequivocally good and better than a public option. That is the bold El-Sayed I want as our next senator.