Don’t Fall for It

With every week that passes, it seems there’s both another attack on health care from the right, and another half baked market-based response.

While the GOP-led Congress has so far succumbed to intense public pressure and failed to fully repeal the Affordable Care Act, the Trump administration continues its stealth attack through various means. The latest attempt to dismantle key provisions of the ACA is a proposal for so called “freedom plans” which are, in fact, free from the kinds of rules and regulations that, under the ACA, curbed some of the insurance companies’ most egregious abuses. These plans would, for example, drop maternity and mental health benefits and deny coverage for preexisting conditions, allowing insurers to get away with providing even less in terms of service while protecting their virtually unlimited right to profit.

On the other hand, we have groups like United States of Care (with its mostly undisclosed funders and potential conflicts of interest) seeking to ensure “access to affordable care” through bipartisan solutions. Unfortunately, the terms access and affordable seem to mean very different things depending on whether you are creating health care policy or trying to choose between taking your kid to the doctor or buying groceries.

This week The Center for American Progress unveiled its health care plan called Medicare Extra for All, which appears to needlessly complicate a functioning and successful program. Rather than simply extending it to everyone equally, it creates a Medicare that is more complex and more expensive while continuing to ensure that private insurance corporations maintain their stranglehold over American health care. Forgive me if I’m not impressed.

I am a middle aged woman with a chronic autoimmune disease. I juggle a number of part time teaching jobs. None of my employers provide health benefits for part timers, nor do they allow more than a small fraction of teachers to work enough hours to qualify for coverage. A few months ago, one of my programs was cut and my income dropped by half. I thought my drop in income might lead to a little more in terms of a subsidy, but what actually happened was my insurance company raised my premium another $105/month and and added another $1000 to my deductible.

Current care guidelines for my autoimmune disease recommend regular lab work and monitoring, but the fact is I hadn’t been able to see a doctor since I enrolled in the Affordable Care Act even as my insurance company had been receiving thousands of dollars from me for literally nothing. Seeing no other option while barely employed, I canceled my ACA coverage because, quite frankly, paying hundreds of dollars every month for nothing while my health needs were going unmet was a luxury I could no longer afford. At the moment, I’m enrolled in a Patient-Physician Cooperative for my primary care needs and, like millions of Americans, crossing my fingers in the hopes that nothing goes seriously wrong.

Given the precariousness of my situation, one might think I’d be cheering for these recent proposals aimed at health care reform. On the one hand, I am thrilled, because they mean that liberal policymakers are getting the message: Americans increasingly want a universal, single payer Medicare for All system, and we want it now. I’m glad they are paying attention. Half measures like these may look like “a step in the right direction” just as the Affordable Care Act before them, but they fail to address the fundamental cause of our unaffordable, inequitable, and inefficient health care system: a capitalist health care model prioritizing profits over people.

Our current insurance-based system fails Americans in so very many ways. We all know that we spend more on health care than any other developed country, but we’re getting very little for that high price. Our maternal mortality rate is rising. Our infant mortality rate is a disgrace. Life expectancy in the United States is declining. And for so many of us, the care we do get can leave us saddled with lifelong debt or bankruptcy. Additionally, Americans delay care and are unable to fill prescriptions for financial reasons, compounding our health issues. Moreover, many of us struggle to find local providers in our networks.

We’re not just wasting money, but time as well. We’ve all spent precious hours of our lives arguing with insurance companies over billing and trying to sort out errors. Anyone enrolled in income based health coverage has to continuously reapply and submit documentation. Not so bad if it’s only once a year, but if you are part of the ever-expanding group of Americans whose income and employment vary widely from month to month, the numbers of hours wasted on the application process increases exponentially. At the same time, providers report wasting billions of dollars each year on insurance billing, money that directly impacts the cost of care.

Every one of these problems is an inherent part of a health care system that exists to maximize profit by restricting coverage and service. By continuing to allow corporations to control our health care system, none of these flaws are addressed in any meaningful way. While the policymakers continue to debate the complexities of health care reform, we know that the solution already exists. The ideal improved and expanded publicly funded non-profit Medicare for All plan would include automatic coverage for all Americans regardless of income or employment status with no fee at the point of service. We deserve nothing less.

The good news is that this movement is gaining strength. Seventeen states are now working on state-level single payer legislation. A majority of House Democrats and a growing number of Democratic senators (including a number considered potential 2020 presidential candidates) have declared their support for single payer health care. The Democratic Socialists of America are now actively campaigning nationwide for Medicare for All. It’s happening. This energy and momentum must remain laser-focused on eliminating the profit motive from health care so we can concentrate on what’s truly important: building healthy communities. This is not the time to placated by cosmetic tweaks to a fundamentally flawed system. We need to educate, mobilize, agitate, and vote in only those candidates who both support and will fight for the real deal: universal, single payer Medicare for All. Anything less is just a distraction.