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What does the Becerra HHS nomination do for Medicare for All?

December 7, 2020

Topics: Quote of the Day

By Sheryl Gay Stolberg and Michael D. Shear
The New York Times, December 6, 2020

President-elect Joseph R. Biden Jr. has selected Xavier Becerra, the Democratic attorney general of California, as his nominee for secretary of health and human services, tapping a former congressman who would be the first Latino to run the department as it battles the surging coronavirus pandemic.

An outspoken advocate of improved health care access, Mr. Becerra said in 2017 that he would “absolutely” support Medicare for all, a proposal for government-run health care that Mr. Biden has explicitly rejected. A source familiar with the selection said Mr. Becerra would support the president-elect’s call for strengthening and preserving the A.C.A. and would not be pushing Medicare for all while in office.



By Don McCanne, M.D.

Supporters of single payer Medicare for All should be pleased that President-elect Biden has selected Xavier Becerra as his nominee for HHS Secretary since Becerra has been a long time supporter of single payer, having repeatedly been a co-sponsor of John Conyers’ H.R. 676 Medicare for All Act.

At the same time, we should understand why Becerra is willing to agree to honor Biden’s campaign promise to reject Medicare for All. Becerra had a choice to do all he can to support health care justice short of single payer reform, or to reject the offer, leaving the opportunity for someone else who would likely be more friendly with the medical-industrial complex, including the private insurers. There is no way that Becerra, or anyone else, could have convinced Biden to permit single payer advocacy by his administration’s HHS Secretary.

Becerra’s most urgent task will be, with other members of the Biden team, to quash the COVID-19 pandemic. At the same time, he will have to supervise the reversal of the harmful policies implemented by Trumps’ team that wreaked so much havoc at HHS, significantly impairing the government’s role in ensuring health care justice in America. He will be buried in essential work that must be done immediately, so it is not the time to spin his wheels trying to make Biden change his mind on this one issue.

It is not clear that efforts will begin soon on enacting a public option, but it is unlikely considering that they have their hands full. Nevertheless, if and when the public option process begins, the private insurance industry will be working behind the scenes to be certain that the government will not produce a product that can successfully compete with the private insurance industry as long as we perpetuate our fragmented, dysfunctional financing infrastructure. There is absolutely no chance that a public option would be created that has all of the features of the PNHP single payer model and still would cost less than the private plans. Yet the risk is that a mediocre plan could be used to convince the public that the government role has been fulfilled and that Medicare for All should be dismissed permanently from consideration, especially when they find out how mediocre a government plan can be, while remaining oblivious to the sabotage.

At this point, it is not Becerra who has to be convinced that single payer Medicare for All is a much better approach for the intermediate and long term. It is Joe Biden that needs convincing.

So that brings it back to us.

We need to step up the education of our colleagues and the public at large since they still do not understand the vast superiority of the single payer model and still believe that everyone should be offered the option of private insurance.

We need to work with others in the social justice movement, bringing us together in coalition activities that will be effective in delivering the message.

We need to build a grassroots movement that will reach the very high political threshold of “make me do it.” Joe Biden is not asking us to make him do it; we need to change the politics so that he will.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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