LAS VEGAS — Democratic voters appear to be reassessing their approach to health care, a pragmatic shift on their party’s top 2020 issue.
“Medicare for All” remains hugely popular, but majorities say they’d prefer building on “Obamacare” to expand coverage instead of a new government program that replaces America’s mix of private and public insurance.
Highlighted by a recent national poll, shifting views are echoed in interviews with voters and the evolving positions of Democratic presidential candidates on a proposal that months ago seemed to have growing momentum within their party. Several have endorsed an incremental approach — rather than a government-run plan backed by Sens. Bernie Sanders and Elizabeth Warren.
It could mean trouble for Sanders and his supporters, signaling a limit to how far Democratic voters are willing to move to the left and an underlying skepticism that Americans will back such a dramatic change to their health care.
“We hear Medicare for All, but I’m not absolutely certain what that means and what that would then mean for me,” said Democrat Terrie Dietrich, who lives near Las Vegas. “Does it mean that private insurance is gone forever?”
Dietrich, 74, has Medicare and supplements that with private insurance, an arrangement she said she’s pretty comfortable with.
She thinks it’s important that everyone has health care, not just those who can afford it. She said she would support Medicare for All if it was the only way to achieve that.
But “I don’t think we can ever get it passed,” Dietrich added.
Erin Cross, her 54-year-old daughter and also a Democrat, said she’s not comfortable with switching to a system where a government plan is the only choice. She said Democrats won’t be able to appeal to Republicans unless they strike a middle ground and allow people to keep their private insurance.
“We’ve got to get some of these other people, these Republican voters, to come on over just to get rid of Trump,” she said.
Democratic presidential candidates also have expressed skepticism.
California Sen. Kamala Harris’ new plan would preserve a role for private insurance. New Jersey Sen. Cory Booker is open to step-by-step approaches. Meanwhile, health care moderates including former Vice President Joe Biden have been blunt in criticizing the government-run system envisioned by Sanders.
In Nevada, the early voting swing state that tests presidential candidates’ appeal to labor and a diverse population, moderate Democrats have won statewide by focusing on health care affordability and preserving protections from President Barack Obama’s law.
Nationwide, 55% of Democrats and independents who lean Democratic said in a poll last month they’d prefer building on Obama’s Affordable Care Act instead of replacing it with Medicare for All. The survey by the nonpartisan Kaiser Family Foundation found 39% would prefer Medicare for All. Majorities of liberals and moderates concurred.
On a separate question, Democratic support for Medicare for All was a robust 72% in July, but that was down from 80% in April, a drop Kaiser says is statistically significant but not necessarily a definitive downward trend.
That said, Kaiser pollster Liz Hamel said it wouldn’t be surprising if it turned into one. On big health care ideas, she said, “as the public starts seeing arguments for and against, we often see movement.”
The Kaiser survey also found broad backing for the public-option alternative that moderates are touting, a government plan that would compete with but not replace private insurance.
Eight-five percent of Democrats supported that idea, along with 68% of independents. Republicans were opposed, 62% to 36%.
Large increases in federal spending and a significant expansion of government power are often cited as arguments against Medicare for All. However, the main criticism Democrats are hearing from some of their own candidates is that the Sanders plan would force people to give up their private health insurance. Under the Vermont senator’s legislation, it would be unlawful for insurers or employers to offer coverage for benefits provided by the new government plan.
Ohio Rep. Tim Ryan argued during the last round of Democratic debates that that’s problematic for union members with hard-fought health care plans secured by sacrificing wage increases. However, Sanders has long asserted his plan will allow unions to obtain bigger wage increases by taking health care out of the equation.
In interviews with The Associated Press, union workers in Nevada said they worried about how Medicare for All would affect their coverage.
Chad Neanover, prep cook at the Margaritaville casino-restaurant on the Las Vegas Strip, said he would be reluctant to give up the comprehensive insurance that his union has fought to keep. He has asthma, and his wife is dealing with diabetes. The union’s plan has no monthly premium cost and no deductible.
“I don’t want to give up my health insurance. I’ve personally been involved in the fight to keep it,” said Neanover, 44. “A lot of people have fought to have what we have today.”
Savannah Palmira, a 34-year-old union construction worker in Las Vegas, said she’s open to supporting Medicare for All, but wants to know specifically what it would look like, how the country would transition and how it would affect her plan.
“That’s one of the biggest things that I love about being in the union, is our quality health care,” Palmira said.
Medicare for All backers say their plan has been unfairly portrayed.
“The shift in polling on Medicare for All is a direct result of mischaracterizations by opponents,” said Rep. Ro Khanna, D-Calif., a Sanders campaign co-chair. People are most interested in keeping their own doctors, Khanna added, and Medicare for All would not interfere with that.
Longtime watchers of America’s health care debate see new energy among Democrats, along with a familiar pattern.
“The long-standing history of health reform is that people want to hang on to what they have,” said Georgetown University public policy professor Judith Feder, who was a health policy adviser in the Clinton administration.
Nonetheless, she noted a common interest among Democrats: “People want affordable, reliable, stable coverage.”
Alonso-Zaldivar reported from Washington.
MYRTLE CREEK — Bill Michalek’s morning hello comes with an offer of a cup of coffee.
“We have delicious Folger’s instant because that’s what I drink, and the guy who drinks real coffee is not here this morning,” Michalek says.
He’s wearing a blue polo with a silver dollar-sized NASA insignia on it. Michalek is the director of Umpqua Research Company in Myrtle Creek.
Behind the company’s inconspicuous offices across from Millsite Park, researchers are building machines that might be on board the first manned trip to Mars.
The company has been working with NASA and other aerospace firms since the early 1970s. It developed a water purification device that was on the first NASA space shuttle missions, a microbial check valve that fits in one hand.
“There’s probably one out in Texas somewhere from that shuttle that blew up,” Michalek said.
In 2007, URC was inducted into the Space Technology Hall of Fame.
Michalek and his team are developing technologies that help astronauts do something people don’t often think about on Earth — breathe.
During long trips into space — potentially several years to and from Mars — giving crews a constant supply of oxygen isn’t easy, Michalek said. Spacecrafts can’t carry tanks with all the oxygen crew members need throughout an entire mission because weight in space is expensive.
“We pretty much focus on the nuts and bolts of things, and we gotta recycle oxygen,” Michalek said.
When people exhale, they breathe out carbon dioxide. The key to providing astronauts with a steady stream of oxygen for long periods of time in space is recycling oxygen contained in the carbon dioxide that people exhale.
Michalek said a promising technology called a Bosch reactor, which URC is currently developing for NASA, could be the most efficient way to recycle oxygen ever developed.
“The reaction has been known for a long time, we can do it,” said laboratory director Tom Williams, the guy who drinks real coffee, according to Michalek.
Williams wasn’t in the lab early that day because a machine that automatically analyzes samples wasn’t working the night before. He was there until midnight analyzing samples manually.
The Bosch reactor uses hydrogen to decompose carbon dioxide that people exhale when onboard a spacecraft. The reaction produces water, which can be separated into oxygen for astronauts to breathe, and hydrogen, which can be recycled to decompose more exhaled carbon dioxide.
But the reaction also produces solid carbon. And figuring out a way to safely contain the solid carbon byproduct is the hard part in developing a Bosch reactor.
“The innovation here is developing an effective way for this reaction to take place and to capture that carbon,” Williams said.
From the outside, the Bosch reactor in the lab of Umpqua Research Company looks like a 10-foot metal cylinder with tubes leading in and out. But inside the reactor, carbon dioxide is being decomposed to produce oxygen at temperatures up to 600 degrees Celsius.
Michalek pointed at black dust on the floor around the reactor and said, “You get this really fine carbon powder, which at zero (gravity) goes everywhere. It gets on everything.”
The company is near the end of the second phase of NASA funding for the project. The goal is to make the Bosch reactor flight-ready. In the first phase, NASA awarded contracts to four research teams, including URC, who proposed methods of recycling oxygen. Two of the teams were from NASA’s Glenn Research Center in Cleveland and the other was from the University of Texas at Arlington.
Michalek and Williams both grew up in Douglas County. Michalek is from Roseburg and Williams is from Sutherlin. After spending years away from the area studying advanced chemical engineering and chemistry, the scientists said they’re privileged to be back working on projects that help advance space research.
“It’s great because we get to live in rural Oregon,” Williams said.
One downside of being a business that needs highly skilled workers in a rural area is that it’s difficult to find skilled workers who are willing to move to the area, he said.
Michalek said sometimes it’s hard to keep people aware of the work URC does, especially the people who influence NASA’s budget.
“Our representatives in Congress don’t even know we’re here,” Michalek said with a smile. “We have to remind them every once in a while when the NASA budget comes up and say, ‘Hey! People in your district rely on the NASA budget, so pass it.’”
While students enjoyed summer vacation, crews have been hard at work freshening up school campuses throughout the county.
In addition to seismic upgrades at some schools, pavement projects across the Roseburg school district and a Yoncalla gym update entering its third phase. Repairs and renovations are nearly complete at the Douglas High School cafeteria.
The Douglas High roof and beams were damaged in February’s snowstorm. Along with the repairs, new insulation is being added to improve energy efficiency. Properly installed drainage sumps, which will allow for effective water removal, are also being added.
Construction will still be going when school starts next week.
“They are going to still be wrapping up, like putting on the ceiling tiles and hooking up the kitchen again,” Winston-Dillard Superintendent Kevin Miller said.
Miller said potentially unsafe areas will be taped or fenced off. Repairs should be completed by the second week of September.
At the Roseburg school district, Physical Plant Manager Tracy Grauf said minor work included pavement projects on playgrounds at Green, Eastwood, Hucrest and Winchester elementary schools, updates to the Jo Lane Middle School bus lane and the entryway to Sunnyslope Elementary.
“We are basically cleaning up some rough playgrounds, some driveways that were failing and walkways that were failing and stuff like that,” Grauf said.
Some of the projects are still under construction, though Grauf said most should be wrapped up before the beginning of school. However, Hucrest playground improvements will not finish until later in September.
Fences have been added or replaced at Winchester Elementary, Roseburg High School, Jo Lane Middle School and the district office. Several new automatic doors will be added to the high school in order to meet ADA compliance.
Schools undergoing seismic upgrades include Fullerton IV, Hucrest and Melrose elementary schools. These upgrades should conclude before the beginning of school on Tuesday, Sept. 3.
Yoncalla High School has been under construction since February when its seismic retrofit project began.
“We are currently nearing the end of our Phase 2 seismic retrofit which involved work on our gym, stage and music room,” Yoncalla School District Superintendent and YHS principal Brian Berry said. “This work is scheduled for completion in September of this school year.”
The school is also in the middle of the third phase of construction to update the gym. So far, the building has received roof and gutter repairs, new windows, a new coat of paint to the interior and exterior and a new HVAC system. Major changes include the removal of the building’s chimney, work on the gym trusses and removal of the lowered ceiling.
“We are adding a new weight room, gym floor, bleachers and putting in a sprinkler system on the football field,” Berry said. “Phase 3 will not be completed until the end of this coming school year. The bleachers and gym floor are scheduled for October. So, yes, we will have basketball!”