Krystal Ramirez/Las Vegas Sun via AP
Bernie Sanders during a town hall meeting at the Culinary Workers Union Local 226 in December
Yesterday, I posted a piece on the Culinary Workers’ dust-up with Bernie Sanders in the context of the upcoming Nevada precinct caucuses. The Culinary, part of UNITE HERE, wants an exception for their superb health plan. Sanders’s version of Medicare for All doesn’t allow it. So unlike much of organized labor in the Casino State, Culinary is not endorsing him.
A few interesting complications: Yesterday, Sanders asked his supporters to stop trolling and trashing the Culinary Union. Amen.
I received a complaint from a reader for failing to credit Kaiser Permanente, which is nominally quite similar to the Culinary Union plan—a not-for-profit plan with salaried doctors and low co-pays. Fair point, sort of.
Kaiser Permanente delivers excellent care, but it is partly for-profit, partly nonprofit; and as a giant that competes in a market dominated by commercial profit-maximizing plans, it is not quite the same animal as the Culinary plan, which is not looking to defend or expand market share, much less turn a profit. Some of the worst commercial abuses are by hospitals, such as those owned by the Partners group in Boston, which are nominally nonprofit.
The practical challenge, if we are to grant exemptions from Medicare for All to the Culinary plan, is where to draw the line. Actually, that one is easy. Plans would be allowed to exist outside Medicare for All only if they did not use private insurers and prohibited all profiteering. That describes the Culinary plan and very few others.
This whole debate has something of an angels-on-the-head-of-a-pin quality, since Medicare for All done right would require large Democratic and progressive majorities in both houses of Congress that are improbable. Too many corporate Democrats are in bed with the industry. And Medicare for All done wrong—keeping insurance industry–run Medicare Advantage for instance—would be worse than nothing.
In the meantime, back in the real world where the best is the enemy of the good, the last thing we need is progressives attacking each other, much less attacking unions.
