It's time for Medicare for all

By Jonathan Michels
Winston-Salem (N.C.) Journal, Feb. 20, 2018

For more than 100 years, Americans have searched for a cure for health care inequality. Instead, we've been prescribed placebos: watered-down poverty programs and party politics.

Despite attempts to ease the pain with reforms like Medicaid and the Affordable Care Act (ACA), we continue to rely on a market-driven health care system. After stitching together the remnants of various poverty programs we are left with a system so dysfunctional and freakish it would make Dr. Frankenstein recoil.

After signing the Health Reinsurance Act — the result of a contentious battle for a national health program that was ultimately foiled by the American Medical Association — Republican President Dwight Eisenhower handed the pen to Esther Lape, a social scientist and longtime universal health care advocate. Disappointed that the bill fell far short of her expectations, Lape reportedly waved the souvenir in the air and declared, “This represents a puny little bone in the vertebrae of what I had in mind!”

What Lape envisioned would be transformative: quality health care for everyone.

The ACA reforms initiated by Democrats provided some patient protections and increased health access for 20 million Americans since it was implemented in 2010. Its primary mission, however, was to ensure that Americans would have to rely on the for-profit insurance market.

Merely protecting the ACA would leave the most marginalized populations behind. Despite the ACA’s improvements, 28 million Americans remain uninsured, without access to primary care that could prevent costly and life-threatening diseases. Those fortunate enough to have insurance are assaulted by prohibitively expensive co-pays, premiums and deductibles that limit access to care.

This past year we saw an upsurge in popular resistance against Republican attacks on important—if imperfect—social welfare initiatives, especially health care for the most vulnerable. Activists pushed back attempts to repeal and replace the ACA with bills that would lead to the loss of health coverage for at least 22 million Americans.

As a premedical student and a health care worker, I bear witness to a broad spectrum of suffering; the kind that we are all likely to face at some point during our lives. But what haunts me at the end of each shift is the pain that could have have been prevented if patients who are uninsured or under-insured had been able to access care sooner.

Take for instance the young woman who checked into the emergency room because she was uninsured and couldn't afford the anti-inflammatory drugs that her doctor prescribed for her Crohn's disease. Her symptoms worsened and when I x-rayed her, she was likely headed for invasive surgery.

Based on my personal experiences working in health care, I believe that the prescription for our collective heartache is improved Medicare for all: An insurance system that is government-financed but privately delivered and could save the U.S. nearly $600 billion annually while providing all Americans with access to quality health care.

Our health care system is once again at a crossroads.

Here in North Carolina, the General Assembly refused to expand Medicaid under the ACA, denying thousands access to basic care.

State Rep. Donny Lambeth, a Republican, recently proposed House Bill 662, also known as Carolina Cares, that would finally expand Medicaid. However, as the Winston-Salem Journal reported earlier this month, some members of the General Assembly say that even if work requirements like those in Kentucky and Indiana are put into place, they won’t support providing health care to the state’s neediest citizens. Meanwhile, the majority of Americans are increasingly realizing what 100 years of struggle has taught Medicare-for-all supporters already know: any measure other than national health insurance will fail.

Support for single payer is growing. According to the Pew Research Center, 60 percent of Americans believe that the federal government has a responsibility to provide health coverage to everyone. H.R. 676, the single-payer bill in the House, now has a record 120 co-sponsors; Sen. Bernie Sanders’ Medicare for All Act has 16 co-sponsors, including potential candidates for the presidential nomination.

It's true that in our time, just as in Lape's era, embracing single payer demands not only a radical revision of how health care is financed but the courage to move beyond half-measures.

As the popular saying goes, “You can’t cross a chasm in two small jumps.” Imagine a health care program that provides affordable, quality care to every person—ourselves, our families and our neighbors—regardless of age, income or employment; a model proven to work in every other developed nation. Isn’t that reason enough to take a leap?