We’re heading for the wrong debate on reform

New Coalition Will Push Back on Repeal of Obama Health Law

By The Associated Press
The New York Times, December 9, 2016

Supporters of the 2010 health care law will launch a political coalition Friday to block its repeal.

The initial goal is to stop Congress from repealing the law without simultaneously passing a replacement for some 20 million people covered through subsidized private health insurance and expanded Medicaid.

Called "Protect Our Care," the group brings together organizations that helped pass the Affordable Care Act, also known as "Obamacare."

On the list are the NAACP, liberal advocacy groups like Families USA and the Center on Budget and Policy Priorities, the Service Employees International Union, which represents many health care workers, and the Center for American Progress, a think tank closely aligned with the Obama White House.



By Don McCanne, M.D.

The conservatives want to repeal much of the Affordable Care Act (ACA) and replace it with something similar. The centrists want to preserve ACA pretty much as it is. Although the specifics are important since many people could lose their coverage and the effectiveness of health plans could diminish further, in the global perspective we’ll still be left with a highly dysfunctional health care financing system that will not cover everyone while perpetuating inadequate coverage for many of those who are insured.

The national dialogue leading up to ACA early on was a debate between making modest adjustments in the financing system we had or replacing it with a much more effective and equitable system that would truly cover everyone while making health care affordable for all.

But very soon the Democratic Party leadership along with representatives of a multitude of supposedly liberal organizations (many through HCAN) coalesced around reform that would greatly benefit insurers, the pharmaceutical industry, and other vested interests. Those supporting comprehensive reform through a single payer national health program were quickly booted out of the process, and the media became silent on single payer. That ended the debate, and we moved on to providing some beneficial tweaks to the existing dysfunctional system, when instead we should have had an honest dialogue over the weak, inadequate policies of what became ACA and the profound, sweeping benefits that characterize the single payer model.

Here we go again. Our health care financing system is still in shambles with tens of millions remaining uninsured and the insured having increasing difficulties in obtaining care in the narrow provider networks while facing financial hardship because of the insurers shifting ever more risk onto the patients. And the “Protect Our Care“ coalition of centrists wants to make this a debate between protecting the shambles versus making them even worse through “replace” policies that would further weaken health care coverage.

No!! The debate needs to be between accepting or tweaking a system in shambles or moving on to a well-designed single payer system - an improved Medicare for all - affordable, accessible health care for everyone.

The same people who took control last time and led us down the wrong path are now regrouping as the “Protect Our Care” coalition with a mission to protect a program in shambles. We cannot let them get away with it this time. We need to form a large coalition of healer activists to lead us to the high-performance system we desperately need. And, yes, we need to be sure that members of the media understand the difference.