Tuesday, March 26, 2019

Bernie takes it to the road

It doesn’t matter if he personally wins or not, so long as his platform – and particularly Medicare for All – is victorious.

Photo Credit: Wikipedia

Those of us who worked so hard for Bernie in 2016 feel grateful, now that he has announced for President in 2020.  It doesn’t matter if he personally wins or not, so long as his platform – and particularly Medicare for All – is victorious. For those of us who have retired outside the United States, though, there is one glaring glitch in his program. And my personal hope is that he hears us and will make the change.

In his announcement of his candidacy, Bernie made his position clear. “I’m running for president because, now more than ever, we need leadership that brings us together – not divides us up,” he wrote in an email that went out to supporters. “Women and men, black, white, Latino, Native American, Asian American, gay and straight, young and old, native born and immigrant. Now is the time for us to stand together.” As you’ll see, the importance of “native born” in his speech (to balance “immigrants’) isn’t carried through in the text of his bill for 2017 Medicare for All. Neither is the promise that it is to be “for all.: And this is indeed sad.

SEC. 102. UNIVERSAL ENTITLEMENT.

(a) In General. – Every individual who is a resident of the United States is entitled to benefits for health care services under this Act. The Secretary shall promulgate a rule that provides criteria for determining residency for eligibility purposes under this Act.

(b) Treatment Of Other Individuals. – The Secretary may make eligible for benefits for health care services under this Act other individuals not described in subsection (a), and regulate the nature of eligibility of such individuals, while inhibiting travel and immigration to the United States for the sole purpose of obtaining health care services.

SEC. 105. ENROLLMENT.

(a) In General. – The Secretary shall provide a mechanism for the enrollment of individuals eligible for benefits under this Act. The mechanism shall –

(1) include a process for the automatic enrollment of individuals at the time of birth in the United States and at the time of immigration into the United States or other acquisition of qualified resident status in the United States;

Bernie said: “I’m running for president because the time is long overdue for the United States to join every other major country on Earth and guarantee health care to all people as a right, not a privilege, through a Medicare-for-all program.”

The emphasis is on Medicare being “for all.” It is supposed to be for all Americans, and yet it is not. In fact, his bill gives Medicare to immigrants, so long as they remain residents of the United States, but does not give Medicare to the native if they have retired overseas.

You may recall that one must be “native born” to be President of the United States. It is indeed shocking that people who are native born Americans can be deprived of their right to healthcare. This is all the more so if they have worked all their lives in the United States and have fully contributed to the Social Security and Medicare system. What can Bernie been thinking of?

It’s perfectly true that doctors and hospitals outside the United States are not generally registered under the Medicare system. But that element alone should not deprive Americans the right to healthcare they have paid for. If an American pays for healthcare outside the U.S., he or she should be allowed to submit a copy of proof of payment to the Medicare system and get recompense. If for some reason the foreign doctor charges more than would a U.S. doctor, the recovery should be limited, but at a minimum the American should get as much as he or she would have gotten inside the U.S. And the Medicare system should be free to gather as much information as may prove necessary to insure that the amount in the applicant’s bill is truthful and the amount paid was really required for good health. Beyond that, entitlement should be absolute.

Why did Bernie require that Medicare only go to U.S. residents? I earlier speculated as follows: “What’s the point of this exclusionary rule? While it is not expressed specifically, the reason for the rule is plain: the government wants retired persons with their disposable income to remain within the American economy. And, of course, the American medical establishment wants older patients to remain within their economic grasp.” Yet it is hard to believe that Bernie Sanders would be so unfair. There’s certainly no political or economic reason for it.

My hope is that Bernie is going to rethink the blatant unfairness of this rule.  In a sense, I think that Trump is going to force his hand. If Trump states: “Sanders is against native born Americans and refuses to allow them to use the Medicare benefits they have worked so hard for,” what can Bernie do? Change his mind – as he should.

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