By Paul Y. Song, MD, writing for The Huffington Post.
As the nation and especially California breathes a collective sigh of relief that yet another Draconian GOP repeal of the Affordable Care Act (ACA) failed, it further illustrates just how vulnerable the Golden State remains to the legislative whims of Congress. Graham-Cassidy would have crippled California far more than any other repeal attempt by reducing California’s federal health funds by a staggering $139 Billion over a seven-year period.
Thankfully, due to a sustained unwavering opposition by countless Americans and healthcare activists, Mitch McConnell opted not to bring up a vote.
While only 20% of Americans supported the latest GOP bill, a majority of Americans now support Single Payer, commonly known as Medicare-for-all. In California, a poll conducted last May showed 70% support for SB562 (California’s Single Payer legislation) and that 81% believe California should ensure every resident has healthcare.
As many GOP Senators could not ignore the immense public opposition, opponents of single payer in Sacramento and Medicare-for-all in our nation’s capitol should not mistake a GOP defeat as any indication of satisfaction with the current status quo. Instead, they would be wise to recognize the underlying harm, frustrations, and dissatisfaction brought on by our current dysfunctional healthcare system and the rapidly increasing power and demands of an awakened angry electorate.
Like the rapid evolution on marriage equality, there is an equally rapid sea change occurring with regard to Medicare-for-all.
Prior to Senator Bernie Sanders’ presidential run that elevated the concept of Medicare-for-all into the public consciousness, many activists can recall decades of activism during which time they were often marginalized, ridiculed, and/or summarily dismissed as delusional socialists.
The late Dr. Quentin Young, who cared for Reverend Martin Luther King, Jr. and President Barack Obama, inspired so many of us through his uncompromising life fighting for healthcare justice. In 2001, at the age of 77, he took part in a 167-mile, 15 day walk across Illinois to promote universal healthcare and sadly very few paid attention. Today, we have Medicare-for-all marches and rallies throughout our country and thousands of people routinely show up.
Many activists can also remember being consistently ignored by elected officials from both major parties. In May 2009 in the run-up to the Affordable Care Act, eight brave Medicare-for-all activists led by Dr. Margaret Flowers and Dr. Carol Paris were removed and arrested by then Democratic Senator Max Baucus, during a Senate Finance Committee hearing which he chaired. Ironically, it was the same Baucus who earlier this month publicly affirmed the need to now consider single payer.
For years, physicians who were outspoken proponents of single payer risked losing referrals and being ostracized by some of their medical colleagues. And whereas a 2008 survey of physicians found 58% opposition towards Medicare-for-all, a new Merritt Hawkins poll revealed that 56% are now in favor of it.
At the same time, the business community has generally viewed government run healthcare as an unwelcome intrusion and even sued the government to prevent implementation of much of the ACA. Despite calling the ACA a “job killer,” job growth has steadily increased since its inception. In reality, what has been crippling for business more than anything has been uncontrollable healthcare costs which continually consume a larger share of their annual budgets, so much so that Berkshire Hathaway’s Republican vice chair, Charlie Munger recently called medical costs the “tapeworm of American economic competitiveness” and lamented our “cockamamie system” saying that “it gives our companies a big disadvantage in competing with other manufacturers. They’ve got single-payer medicine and we’re paying it out of the company.” He reluctantly concluded that single payer is the best system and many business leaders have since followed.
Further reflecting these profound changes in attitude is a recent Pew poll where 60% now believe that it is the responsibility of the federal government to provide healthcare for all Americans.
Representative John Conyers has been introducing his Medicare-for-all legislation since 2003, and for the first time has 119 co-sponsors. In 2013 Senator Sanders could not find one co-sponsor for his Medicare-for-all bill. Today he has sixteen co-sponsors for his 2017 Medicare-for-all Act (S.1804).
So what has moved so many in Washington to not only declare their support for Medicare-for-all, but to actually co-sponsor legislation that was once considered socialist and politically untouchable?
The answer is…….We the People.
In much the same way that so many of us called to defeat Graham-Cassidy, it was through a similar pressure and presence that a record number of Democrats felt compelled to co-sponsor HR676 and S.1804.
It is through an unprecedented rise of individuals from different communities of color, religions, socio-economic backgrounds, and ages that have all come together to say enough and to demand far better. This new wave of healthcare activists has brought much needed diversity, energy, and passion coupled with a relentless attitude which has reinvigorated what had become a very stagnant ineffective movement.
For decades, politicians could simply dismiss Medicare-for-all and have no fear of retribution for siding with insurance companies and the pharmaceutical industry. But, today’s movement is no longer willing to forgive and forget such pro-corporate actions or the constant harm that so many endure at the hands of our current ruthless system. As the number of Americans who struggle with their health security continues to grow, so does the fight for healthcare equality which gains strength and allies each day.
Together this movement is lending a much needed voice to: The 29 million Americans who remain uninsured. Many of whom are from communities of color and/or undocumented; The tens of thousands of people who die each year because they lack coverage; The hundreds of thousands of people who go bankrupt annually due to medical illness; The 30+ million insured Americans who have such high out-of-pocket costs and deductibles relative to their income that they are considered underinsured; The millions with insurance who delay seeking care because they cannot afford their co-pays or deductibles; The 45 million Americans who did not fill their prescriptions last year because they cost too much; And the millions who continue to struggle to pay their monthly premiums.
But, it is not just families and businesses that are struggling to meet their healthcare costs. California, with one-third of its residents already on Medicaid, remains hostage to a Congress hell bent on finding ways to significantly decrease its funding. Coupled with a $77 Billion unfunded state healthcare retiree liability, and an estimated $24 Billion healthcare retiree liability for California schools, the continued inaction by Governor Jerry Brown and the legislature is at best denial and at worst negligence reflecting an overall lack of political will.
Critics of SB562 and Medicare-for-all who feign outrage at its high costs and the lack of any specific funding mechanism, fail to acknowledge the outrageous costs that remain with inaction, while displaying no evidence of any fiscal vigilance as they approve blank checks for military and bullet train spending.
To be clear, with or without any federal or state legislation, the federal government will spend $49 Trillion over the next 10 years while still leaving 29 million uninsured, and California will continue to spend $368 Billion annually while leaving 15 million lacking access to care.
The Urban Institute study found that Senator Sanders’ plan would cost $32 Trillion over the next 10 years while a U. Mass/Pollin study found SB562 would cost $331 Billion a year. Both solutions would save substantial money while insuring everyone. Sadly, neither Sacramento nor Washington have come up with any serious alternative solutions other than kicking this ticking time bomb down the road.
“Human progress is neither automatic or inevitable… Every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.”
Reverend Martin Luther King, Jr.
This healthcare justice movement is filled with an ever expanding group of dedicated individuals, who along with an increasing number of healthcare professionals fed-up with practicing in a callous out-of-control for-profit system, and business leaders who remain helpless to dwindling profits consumed by runaway employee premiums, have rapidly coalesced and found tremendous power in a new collective voice. Emerging from years of systematic abuse at the hands of a broken and immoral healthcare system, healthcare justice has quickly reemerged as the next big civil rights issue and Sacramento and Washington would be wise to recognize this sooner than later.