The Medicare-for-All Moment


There is only one solution to the twin problems of escalating health care costs and the epidemic of the uninsured: a Medicare-for-All, single payer system.

Unfortunately, the healthcare debate on Capitol Hill has evolved without serious consideration of the Medicare-for-All single payer health proposal. There are many reasons for this, but one is that many who actually support Medicare-for-All have claimed that the proposal is "not feasible."

With the House leadership having settled on a single proposal, now is the time to set aside worries about feasibility. The House process is resolved. Members of Congress should have the opportunity to vote on the merits, up-or-down, on a Medicare-for-All single payer health proposal.

Whether they will have this chance is in the hands of Speaker Nancy Pelosi, and likely to be decided today. Contact her right away to urge that the House be permitted to vote on a Medicare-for-All single payer health proposal. Call (202) 225-0100 or (as a second best alternative, submit comments on the Speaker’s web page: http://speaker.house.gov/contact.

Representative Anthony Weiner, D-New York, has proposed to introduce such a Medicare-for-All measure on the House floor in the form of an amendment to the leadership’s healthcare package. If a vote is permitted, it will mark the first time either house of Congress has voted on Medicare-for-All, and will be a landmark in the inevitable march to a national Medicare-for-All system.

Meanwhile, Representative Dennis Kucinich, D-Ohio, is seeking to enable states to implement their own Medicare-for-All single payer health initiatives. Representative Kucinich introduced an amendment in the House Education and Labor Committee to facilitate such action, by providing for waivers of ERISA (employee benefit) requirements for states adopting single payer plans. This amendment passed the committee with bipartisan support. If Speaker Pelosi decides to incorporate it into the leadership bill, it stands a good chance of becoming law.

Although there are reasons to be skeptical, one can hope that the health reform package that ultimately becomes law will significantly expand coverage and curb insurance industry abuses.

But it is certain that the health reform package will not solve the overwhelming problems of coverage, cost and quality of care facing the country. Solving those problems requires going to the source: the health insurance corporations.

With its private health insurance industry-dominated system, the United States spends far more than other wealthy nations on health care (at least 50 percent more than every country except Luxembourg) but sports middling health indicators.

The private health insurance industry-dominated system in the United States permits 45 million people to live without health insurance, denying them access to preventative and routine care, resulting in the death of at least 35,000 people a year.

The private health insurance industry-dominated system tolerates private health insurance companies making life-and-death rationing decisions for millions of people with only minimal accountability.

The private health insurance industry-dominated system lets private health insurers refuse to take sick people as customers and engage in endless manipulations to discard its customers if they do become sick.

The private health insurance industry-dominated system features a system in which medical bills and illness contribute to almost two of every three personal bankruptcies — even though three-quarters of these bankrupt people had insurance when they became sick.

Not least, the private health insurance industry-dominated health care system translates into a private health insurance industry-dominated political system. As a result, too many politicians refuse to consider real solutions.

There is a cure all for these ills. It is a Medicare-for-All, single-payer system, in which the government pays medical bills (thus operating as the "single payer").

In a Medicare-for-All system, health care is available as a matter of right. No one is denied treatment because they can’t pay. No one is mandated to buy coverage. No one is denied coverage because of pre-existing conditions. No one goes bankrupt paying medical bills.

A Medicare-for-All system would save $350 billion-$400 billion a year in costs (up to $4 trillion over the 10-year period routinely analyzed by the Congressional Budget Office) — enough to cover all of the uninsured. No scandalous CEO pay packages. No money siphoned out of the system by rent-seeking middlemen. No needless paperwork and bureaucracy.

A Medicare-for-All system succeeds by doing away with the private health insurance industry.

The powerful insurers, understandably, don’t like this idea. Yet despite waves of deceptive and misleading propaganda about the purported horrors of government-run insurance, the people do like the idea of Medicare-for-All — polls show it is supported by a majority of the public.  But insurance industry dollars have spoken louder than the people’s voices. And so Medicare-for-All hasn’t been given a serious hearing in Congress. Speaker Pelosi should at least enable a clean up-or-down vote. Call (202) 225-0100 and urge her to do so.

Robert Weissman is president of Public Citizen: www.citizen.org

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