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An Open Letter to Rep. Pramila Jayapal Regarding Medicare for All

An Open Letter to Rep. Pramila Jayapal Regarding Medicare for All

Isabel Ostrer, Chris Cai, and Ana Malinow
Dear Congresswoman Jayapal,

Thank you for your hard work and leadership as the new lead sponsor of the forthcoming Medicare for All Act of 2019. As health care providers and health justice advocates, we look forward to working with you to grow support for the bill and ensure its future passage.


Immigrants pay more into the system than they use in healthcare.

Do the math, druid, and start aiming higher.


This is just stupid thinking based more on Nationalistic jingoism than on any reflection about what is healthy for the entire community.

Disease is a problem that affects the entire community, not just citizens. If we have health care for citizen but not the rest, then the illnesses of those in the community who aren’t citizens will infect and impact in other ways the citizens.

It’s also economically stupid. It’s been proven that preventive care through a primary care physician costs less that emergency care through the ER. Doctors take an oath to provide health care to those they see. Private practice doesn’t see people who can’t afford them. ER doctors have to serve those who come in, even if they have no means to pay for it.

The result is that non-citizens will still get ER care and it will cost everyone a LOT more.


Right, like if you’re in France and need emergency care you should be turned away. Go die, non-citizen.

Fuck your divisive racism. ALL people are humans.



Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances, except in the case of those who aren’t citizens


The right of the people who are citizens to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized, unless they aren’t citizens.


No person who is a citizen shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger and the case when it is a non-citizen; nor shall any person who is a citizen be subject for the same offence to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.


In all criminal prosecutions, the accused if they are citizens and have the means to pay for it shall enjoy the right to a speedy and public trial, by an impartial jury of the State and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defence.



All persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law unless they are not a citizen; nor deny to any person within its jurisdiction the equal protection of the laws except in the case of non-citizens.

(Seeing how some people don’t get sarcasm and some people won’t realize it and take it the wrong way- this is sarcasm and the italicized parts above are NOT part of the Constitution.)

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Never trust Democrats.


That is obviously wrong. A permanent resident is supposed to go to their country of birth for health care? People with valid work visas? The final compromise will likely have some limitations for undocumented immigrants though as people have said here an outright denial of all services is not only unnecessarily cruel, it isn’t even cost or public health effective.

@dpearl pointed me to a nice document on the topic (Progressives Warn Against Democrats Pushing 'Diluted' Half-Measures as Alternative to Medicare for All) though I am only part way through it, it is clear that it is a topic that needs more than a knee jerk response.

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You really don’t get it. Healthcare is a human right, not a privilege. I’ve traveled extensively and once had a health incident in a remote nation. I got healthcare because I was present in the country and not based on whether I was a citizen. I paid a ridiculously small fee for it, even though I spent a night in the hospital. If they’d had your worldview, I’m might never have gotten home alive or would not have gotten any care. Open your eyes and your heart to the rest of humanity.


Good letter but they didn’t address the phase in problem in what we hear is in Jayapal’s proposal. HR676 was everybody in nobody out and that is the only way it will work. A phase leaves million out through the phase in period and it leaves the door open for privatization schemes to undermine the single payer system.

Gee, sounds like some kind of third world dictatorship.

I’m pretty sure I read a summary of HR676 a year or so ago and it did include a phase-out period of three years, which I think is pretty short for such a massive reorientation of such a large system. I don’t see how it could be done without a phase-out period without putting several hundred thousand people out of work overnight, even if the date was set in advance. No matter how the transition is done, it’s an awfully big battleship to try to turn instantaneously. My concern, from the rumors I’ve seen about what Jayapal is proposing, is that it would not dismantle the current for-profit system but would have it continuing as a parallel system.

There is a large and blatant contradiction between the sub-head to the article and what the article actually says.

The sub-head says, “. . . two serious questions about the future of private insurers and exactly who might be left out of an otherwise universal system. . . .”

But the article says, " . . . for-profit health facilities should be converted to nonprofit governance and their owners compensated for past investments.

Since the authors are a physician and two med students, my guess is that the headline writer made the very common mistake of failing to distinguish between health care facilities (hospitals, medical offices, and other facilities which actually provide health care to persons) and health care insurance companies (the health care financing system), which take a cut of whatever households, employers, government, or other parties pay for a person’s health care before the actual providers are paid.

To the best of my knowledge virtually no one has been talking about the latter system, not merely a universal single-payer system but a complete nationalization of the health care system. There are some advantages and some disadvantages of such a system, but what the authors are proposing would NOT be “Medicare For All” in any sense, and this would be a wise time to introduce such a consequential change of course.

FOR PROFIT health care can be murderous- That means when a disaster occurs, people come AFTER profits. When profit is the motive, I bet it’s a whole lot easier to murder a patient—for their own good, of course------ because, they are( choose your evil) too young, too old, too sick too female too male, too black, too hispanic or Asian or too diseased or too poor-------to matter when Profits are the goal. : (


Medicare has been successful for more than half a century because it started out as a very simple program 12 pages long. Its biggest shortcoming was Congress limiting coverage to those age 65 plus rather than LBJ’s vision that it cover all Americans.

The ACA flopped because it is a complex 2000 plus page corporate welfare program disguised as health care reform.

It is therefore hard to take Jaypal’s bill seriously seeing how it supersedes 676 that was more like the Medicare legislation.

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You are right that the sub headline is not accurate to the content of the letter and in general few people here think we can get an NHS or VA type solution anytime soon so the fight is over socialized health insurance.

However there is an important debate between those that want no profit on the delivery side and those that would allow it assuming the provider follows all the payer’s (government’s) rules. In neither of these cases are the providers owned by the government or the workers employed by the government (as is the case with NHS or VA).

On the separate point of possibly keeping a role for private insurance almost everybody who is a big single payer advocate is against it. I agree you can’t even call it single payer. For this reason I wish we hadn’t gone with the name Medicare for All since some slimy politicians will try to piggy back on the term while keeping a private insurance role (absolutely unacceptable in my opinion)

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How many people will die today because of crappy US healthcare? The US has one of the worst infant mortality rates among first world countries.

WE NEED FREE HEALTHCARE CENTERS IN EVERY NEIGHBORHOOD! And the focus should be on prevention-----and yes there should be paid staff but people in the community should volunteer to help----if people can afford it they should donate. There should be open space----community gardens----classrooms for people to be taught about childbirth----and outreach to families in crisis.-HEALTH- everyone wants t be healthy-----make it the center of the community.

Similar thing when my wife and her sister took a trip to Ireland. Sister-in-law tripped in the shower and messed up her ankle. All doctors bills and medication paid by the state.

Jill Stein and her supporters don’t really care about actually improving health care, they helped elect Trump knowing how bad he was on all progressive issues, maybe even getting Russian help to do this. She should apologize for such foolish political activity to folks who care about improving health care, protecting the environment, reproductive freedom etc