Medicare For All is Back on the Table
Senator Bernie Sanders has sponsored a Medicare for All Act in the Senate, with co-sponsorship from sixteen other senators. His bill resembles Representative John Conyers’ H.R. 676, the Expanded and Improved Medicare for All Act in the House, which has gone from 62 co-sponsors in the last session of Congress to 117 and counting this session. Oregon Senator Jeff Merkley is a co-sponsor of Sanders’ Medicare for All Act. Oregon Representatives Earl Blumenauer, Suzanne Bonamici and Peter DeFazio are co-sponsors of H.R. 676.
Previously, many members of Congress and reform advocates refused to support Improved Medicare for All because it was “not politically realistic.” That calculus has shifted. Sanders’ co-sponsors include all of the senators touted in the media as possible Democratic presidential candidates in 2020. The reason for that is clear. Improved Medicare for All is wildly popular among the Democratic base, with support of 80% in poll after poll of registered Democrats. Equally important, polls put support among independent non-party voters at 60% or above. Even a substantial minority of Republicans back the public single payer approach. In Democratic presidential politics, opposing Improved Medicare for All has now become politically unrealistic.
Why is there so much popular support for the idea? After all, Americans are supposed to dislike anything that can be labeled big government. The basic reason boils down to this: The American health care system has been a crisis for decades. The Affordable Care Act, while bringing crucial improvements, has not solved the fundamental problems. The Republican plan is to ignore the underlying systemic problems while fighting to take care away from tens of millions of people to pay for tax cuts for the rich.
In ordinary people’s lives the crisis means paying ever-rising premiums for less and less coverage. Tens of millions of families must choose between timely health care and other basic family needs, due to lack of insurance or high deductibles and cost sharing. They must hassle with insurance companies if they do seek care. Most personal bankruptcies in the U.S. involve medical bills, and most of those people have health insurance. Even families with strong insurance live in fear of losing their coverage due to job loss–including job loss due to health crises. And individuals and families facing serious illness or injury cannot focus on healing, because they have to worry about how they will pay the bills.
Meanwhile doctors and hospitals must employ armies of people to handle billing and claims to thousands of plans, while private insurers hire their own armies to deny claims and reduce payments. Administration of all aspects of the private insurance based system wastefully takes 25% of private health care dollars, compared to 3%-7% in Medicare. Employers also face insurance prices rising faster than inflation. More and more of them require their employees to pay a bigger share of premiums, reduce benefits, or stop offering health benefits entirely.
And it turns out the competition does not bring down insurance prices. Instead, insurers compete to have healthier and less risky risk pools, and to push out riskier and sicker people, using narrow networks and other tactics.
Is it any wonder then that people are turning to a system that offers simple, secure, predictable access to health care, when it’s needed, with full choice of providers, and no worries about how it will be paid for? A system that cuts out wasteful private insurance bureaucracy? That supports more effective prevention, and primary care approaches?
The path to passing Improved Medicare for All in Congress is not short, simple, or easy. We need a people’s movement to demand such a system. The movement must be powerful enough to force elected officials and politicians to respond to the people, rather than to insurance companies, pharmaceutical companies, and for-profit health systems.
In Oregon, Health Care for All-Oregon, a statewide coalition organizing from LaGrande to Medford, Portland to Roseburg, Astoria to Bend, with over 120 member organizations and growing, along with its political partner, HCAO Action, is the form that movement takes. We invite you to join us.