Single Payer Health Care: Part II
Another busy week in the world of health care policy. Last Sunday, I was in South Gate, CA with my son Marching for Medicare for all. We marched to Assembly Speaker Rendon’s office in South Gate and talked about the importance of health care as part of the US economy, but more importantly as essential to help people stay alive. Assembly Speaker Rendon has stalled single-payer health care in California. I came home to the San Francisco Bay Area and the US Senate started to discuss the “Repeal and Replace.” A week later, I went to a protest in Walnut Creek, CA with my son. In the US Senate, first Senator John McCain returned from surgery to vote for the Senate to allow for a vote and discussion to repeal the Affordable Care Act (ACA). He then joined his Republican colleagues, Susan Collins of Maine, and Lisa Murkowski from Alaska in voting to defeat those repeals.
Americans have come to depend on the ACA for their basic health care. It is difficult to take a benefit away from people. When people don’t want something to change, it becomes more difficult than Congress can imagine to change that policy. Congress and the White House, generally choose to move on while leaving the issue that they were addressing at the moment unchanged. For some reason, Congress and the President seem unwilling to move on from the Affordable Care Act. It becomes abundantly clear that no matter what they choose to do at this point is going to result in 22 million or more Americans losing their insurance. That has not made many of Congress’ constituents very happy. The Affordable Care Act is not a perfect solution. Constituents who do not feel the need for insurance or who believe that insurance is too expensive for them simply pay the fine when they file their taxes. Some employers might like to grow their business but don’t hire a 50th employee because they would be required to provide health insurance. Low-income workers often work two or three jobs because employers do not want to provide health care for a full-time worker. The only thing Congress has succeeded in is helping their constituents to see that single-payer health care is a better solution than the Affordable Care Act. So the question becomes: Do we fix the ACA? Do we move to a Single-Payer system?
I think the interesting messaging piece here comes when we start talking to our family and friends about what they want this to look like. I run into few people who believe, as some of our Republican members of congress seem to think, that health care should go back to what we had before the ACA. Most people had health care through their work. Some received health care through government programs, Medicare and Medicaid. Other people bought insurance on individual markets. About 50 million Americans went without medical insurance at all. Insurance could deny coverage for pre-existing conditions. Some policies were limited to lifetime limits, such as $1 million. Once the insured spent that much on medical care, their insurance would not ever cover anymore for them ever. Some people had these problems trying to get affordable coverage on the individual market. Other people got this coverage at work. Very few of the people we run into at Thanksgiving and Christmas dinner are going to be advocating for returning to this system. We are not going to have that conversation. Most people who want to return to a freer market system, are not going to be convinced by anything you and I have to say. The conversation we are going to be having is where do we go from here. I have five sisters and a brother. As you can imagine, we fall all over the map regarding opinions on many issues, including health care. I asked my newly retired sister what she thought we should do about health care. She surprised me by coming up with what many people see as a practical solution to the problems. She does not want to see the issue addressed through the government. She already believes that we pay too much in taxes. She gets her health care through Kaiser Permanente. It is provided as a benefit from work, even in retirement. She finds the treatment helpful, with a wellness focus. She believes that the care she is receiving is benefiting her and her family. She would like to see that treatment available to everyone. She is not clear as to how we should pay for it. She does not trust the government to do it, but she does see a social responsibility to make sure everyone is taken care of. I think that health care is one area where people who believe that the government should stay out of our lives, need to take action in regards to making sure everyone has health care. Even someone like my sister may come around when she sees that taxes are how we act as a community. The first step is to support steps in the direction of the nurturing parent. Health care is a good place to start.
While the Affordable Care Act taken as a whole faced opposition among the American people, when polls asked about specifics of the bill (allowing young people to stay on their parents’ insurance, covering pre-existing conditions, covering certain basic services, expansion of Medicaid, supplements for the individual market) those specifics were all very popular. People do not like things like the mandate to carry insurance, but the only way to make an insurance based system work is to require everyone to participate. Even though people did not like being required to participate in the insurance market if they did not want to, the only way to have all of the other things people did want in the bill was to include everyone. Wednesday, the Senate voted on whether or not to repeal the ACA without a replacement. That effort went down in flames. On Friday, they voted again on a repeal light. Again, down in flames. The problem for the GOP in the Senate is that there is only one system better than ACA. That system is single payer. If the GOP wants to replace the ACA with a better one, they have to cover more people and take less money out of people’s pockets. Everything they have proposed so far has included covering fewer people and taking less money out of the pockets of big donors. If all of this is true if the only system that would provide better medical care for less money over all. if people are starting to express a desire for the improved system, what is it that Congress is up to? Whatever the Senate, the House or the President have proposed, it is not about health care. It is about a tax cut. Now we need to get our family and friends talking about health care. Do only people who can afford it get treatment? What do they think we should do to make sure everyone is covered? If they don’t think taxes should be used, how do you keep the prices down? What do you do about drug companies raising prices for drugs developed with taxpayer funds? Should insurance company executives be paid $20 million a year salaries? Is their contribution that valuable to the health care?
Share your conversations or any other thoughts you have in the comments section. Share on your social media. Next time we are going to talk about listening. Also, let me know if you have topics you would like me to address. Sign up for the newsletter. That will be starting in the next couple of weeks.