By Margaret Flowers, M.D. Photo from WMUR.

Beware. In Washington, DC, words can lose their meaning. Representative Carol Shea-Porter, from the First District in New Hampshire, introduced legislation last month that she claims is “universal health care” when in reality it would delay and prevent actual universal health care. Her bill is called the “Medicare You Can Opt Into Act of 2017.”

Far from being universal, Shea-Porter’s legislation  has serious deficiencies, especially when compared to Medicare for All as embodied in HR 676 “The Expanded and Improved Medicare for All Act.” Shea-Porter says that she supports a Medicare for All healthcare system, but she has never put her name on HR 676. Her website justifies this by saying “it would also essentially eliminate private health care providers [see Section 103].”

Perhaps she didn’t read HR 676 carefully. It states at the very beginning of section 103: “Private physicians, private clinics, and private health care providers shall continue to operate as private entities, but are prohibited from being investor owned.”

The only change to providers is that they can no longer profiteer off of our health. They can’t be investor-owned because these types of facilities have a long history of costing more and having poorer quality. That’s common sense – when profit is the bottom line, the incentive is to charge as much as possible and skimp as much as possible. Private clinics and health professionals will thrive under a Medicare for All healthcare system because they can focus on providing care to their patients instead of filling out endless paperwork and fighting with insurance companies for authorizations and payment.

Here are some of the problems with Shea-Porter’s bill Medicare Opt-in:

  • Opt-in systems are not effective because they cannot achieve universality. The ideal system is opt-out because it begins by being universal.
  • Shea-Porter claims that her Medicare Opt-In system will compete with private health insurers to control the costs of premiums. This contradicts decades of experience with public insurances in the United States. What happens instead is that private health insurers continue to cherry-pick the healthy and those who have health conditions wind up in the public system which eventually collapses under the responsibility of paying for care.
  • Shea-Porter’s bill is discriminatory. It requires that premiums be based on age. Those who are older will pay more.
  • And her bill offers current Medicare benefits, which are designed for the elderly instead of for youth and families. Medicare currently leaves out dental, hearing and vision benefits.
  • Finally, Shea-Porter’s bill simply creates one more choice in an already overly-complex healthcare system. This will add more cost to the system.

Perhaps the best thing about Shea-Porter’s bill is that it isn’t going anywhere. It has zero co-sponsors while HR 676 has a record number of supporters, 110 members of Congress.

Constituents of Shea-Porter need to contact her and tell her that she needs to stop misleading the public. We need National Improved Medicare for All, not substandard Medicare for Some.

Urge her to join the majority support for HR 676 by adding her name as a co-sponsor. You can reach her office by telephone here: 202 225 5456, or by email here:


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