Why Hillary Clinton and Obamacare Will Not Solve the Health Care Crisis

By Michael Corcoran   
Truthout, June 9, 2016

Bernie Sanders' campaign, which proposed replacing the Affordable Care Act (ACA), with a Medicare for All system, has sparked a much-needed debate over the need for a single-payer health system. But this bold proposal didn't win him the election. And now that Hillary Clinton has become the presumptive nominee against Donald Trump, the debate over health care reform is about to become extremely narrow.

With the media and candidates in full general election mode, Sanders' argument that we must do better than Obamacare will soon be replaced by Trump's insistence that we must do worse. Clinton will almost certainly respond by pushing the status quo, which remains broken. Critical dialogue, at least on the national stage, will likely be in short supply.

The Clinton campaign, prompted by Sanders' strong showing and her relationship with the drug and insurance industries, declared war against single-payer this year. Her allies -- establishment economists and so-called "left-leaning" (industry-supported) think tanks -- promptly followed her lead. These efforts, as Adam Gaffney explains in the New Republic, were attempts "to kill the dream of single-payer," a "cherished policy goal of the left."

Yet, for all the (often dubious) attacks that Clinton loyalists made against Sanders' proposal, they have placed the existing law under virtually no scrutiny. In fact, Clinton and her supporters have issued bold claims that the ACA renders more reform -- and even critical discussion -- pointless. "We finally have a path to universal health care," Clinton said. "And I don't want us to start over with a contentious debate."

But does the ACA really achieve these lofty heights? Can it lead to universal health care? The unfortunate reality is that Clinton is wrong. Obamacare, while responsible for many positive developments, is not a solution to our health care crises. The law is hampered by at least three major structural flaws: It does not lead to universal health care; it fails to slow costs enough to make it sustainable; and millions of Americans who do have health insurance are nevertheless left underinsured and exposed to financial ruin.

These limitations are very real, regardless of one's view on single-payer. The ACA needs to be analyzed on its own merit. Such an analysis shows that the law cannot credibly be sold as a long-term solution or as a path to universal health care. It is important the public has an honest discussion about these realities, even though we cannot expect this discussion to take place within the spectacle that is the 2016 presidential election.

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PNHP note: Physicians for a National Health Program is a nonpartisan educational organization. It neither supports nor opposes any candidate for public office.