Dunn County, Wisconsin - Citizens of Dunn County, Wisconsin, have a plan to place national, publicly-funded health care for everyone on their November 8th county ballot. In June and July at meetings of the County Board of Supervisors, many spoke of a broken health care system and their proposal to fix it. After the third meeting, the Board voted unanimously to put the following question on the ballot: “Shall Congress and the President of the United States enact into law the creation of a publicly financed, non-profit, national health insurance program that would fully cover medical care costs for all Americans?” Located in central west Wisconsin and blessed with lakes and farmland, Dunn County is far from bustling cities.
Single payer health care
There is a need for a national group of grassroots activists advocating, mobilizing, and organizing exclusively for national single payer. In the early days of 2021, when it became clear no member of Congress would champion the cause of Medicare for All, a group of long-time health care activists, unionists, grassroots organizers, and progressives met to discuss the need for a national organization to unite activists across the country and rally the movement for national single payer health care free from corporate profits. The activists were frustrated. After all, the Democrats held power in the House, in the Senate, and in the Executive Branch, and yet, there was no enthusiasm for improved and expanded Medicare for All.
In an article in The Nation magazine last week, doctors David U. Himmelstein, Steffie Woolhandler, Adam Gaffney, Don McCanne and John Geyman called for a National Health System in the United States. “We have long advocated for single-payer national health insurance,” the doctors wrote. “By eliminating private insurers and simplifying how providers are paid, single-payer would free up hundreds of billions of dollars now squandered annually on insurance-related bureaucracy. The savings would make it feasible to cover the uninsured and to eliminate the cost barriers that keep even insured patients from getting the care they need. And it would free patients and doctors from the narrow provider networks and other bureaucratic constraints imposed by insurance middlemen. We still urgently need this reform.”
Last week, USAToday ran a feature by reporter Jill Castellano that spotlighted issues around the VA MISSION Act, which is supposed to assure that veterans have easier access to care – outside the VA when clinically necessary. The project was blatantly biased and had Koch fingerprints all over it. We hate to give it any extra attention but must correct the record. The piece falsely accuses the VA of systematically denying veterans access to private sector care when it’s warranted. In truth, veterans are being referred to the private sector at acceleratingly high levels, as the aforementioned Hill op-edmakes clear. Much of the story centers on the MISSION Act’s criteria of providing eligibility for private sector care for veterans “if it is in their best medical interest.”
At a Bernie Sanders healthcare town hall last year, Rep. Pramila Jayapal glibly stated that the problem to enacting Medicare for All was not more education of the public, but a question of “political will” necessary to actually push it forward. Yet, despite a pandemic, which has laid bare the inequalities and deficiencies of our healthcare system coupled with Democrat majorities in three branches of government, Medicare for All seems off the table. Where is the political will?
To say that there’s a political disconnect in the fight for a national single payer health care delivery system is to state the obvious. The struggle for M4ALL has grown due to decades of grassroots organizing alongside the gradual worsening of Americans’ health insurance coverage, with support now reaching 70% in the general public as reported by FOX News after the November elections. Yet now in the middle of a pandemic, where the USA accounts for a quarter of the world’s infections, and a third of the deaths, the USA’s for-profit healthcare system has no national plan or coordinated response. Instead, since so few Americans are going to the doctor this year, there is resounding joy in the industry as profits mount simultaneously with the despair of millions.
The inefficiencies and problems caused by the U.S. system of tying access to health insurance to specific jobs are well known. The downsides of employer-based health insurance access have been made spectacularly visible by the COVID-19 shock—a shock that has cost millions of Americans their jobs and their access to health care in the midst of a public health catastrophe. Delinking access to health insurance from specific jobs should be a top policy priority for the long term. The most ambitious and transformational way to sever this link is to make the federal government the payer of first resort for all health care expenses—a “single-payer” plan. The federal government already is the primary insurer for all Americans over the age of 65 and for households with incomes low enough to qualify for Medicaid. The advantages of a single-payer system are large, both in ensuring consistent access to medical providers that households prefer and in restraining the often-rapid growth of health care costs. The lowest-hanging fruit in the current crisis is to have the federal government pay all expenses for COVID-19-related testing and treatment. Given the historically rapid increase in uninsurance in the first months of the COVID-19 shock, policymakers should also allow all those without insurance to enroll in Medicaid, regardless of income, for the duration of the crisis.
There’s a yawning gap between the number of U.S. nurses the viral pandemic has killed so far in the U.S. and the number of Canadian nurses killed. The count as of May 11: U.S. 91, Canada, 0. That prompted National Nurses United President Zunei Cortez, RN, of California and her Canadian counterpart, Linda Silas, RN, to meet each other via Zoom on May 11, with hundreds of nurses from both nations listening in, to discuss why. And it all comes down to the fact, both agreed, that Canada’s nationalized health system, despite a large hole involving nursing homes, puts people – patients and practitioners – before profits, while the U.S. is the other way around.
Plenty has been written about the critical condition of the healthcare system. The response to the pandemic has been faulty at best, and the resources mobilized are falling dramatically short of what is needed. Personal protective equipment (PPE) is so scarce that nurses and other healthcare workers are protesting across the country, because working without appropriate PPE is resulting in high rates of infections and deaths. The media has been reporting on a national dearth of ventilators since the outbreak began. The New York state government has been scrambling to acquire the 30,000 ventilators that are going to be needed at the peak, according to estimates. Despite Donald Trump’s boasting about invoking the Defense Production Act, we are now at the peak of the pandemic, and the companies that were supposed to be retooled to churn out thousands of ventilators, like GM and Tesla, have produced a total of zero devices.
A couple of weeks ago, as countries scrambled to protect their citizens from the COVID-19 pandemic by closing borders and quarantining travelers, the Norwegian University of Science and Technology, upon the “recommendation of the Ministry of Foreign Affairs,” took the unprecedented step of urging all students who are studying abroad to return home. In the announcement, they emphasized the need to return home if students are living in a country with “poorly developed health services and infrastructure … for example the USA.” The word spread quickly on social media that the United States had been singled out as an example of a country with poor health care infrastructure, with many people in the U.S. agreeing that we lack the capacity to handle the pandemic.
Tens of thousands of people, disproportionately Black and brown, are marked for death by coronavirus in the coming weeks and months because the United States political system allows only corporate parties to govern. By ensuring that the Dictatorship of Capital is immune to effective electoral challenge, the duopoly system has made the people of the United States less healthy than the rest of the developed world, and far more vulnerable to epidemics of all types. As dutiful servants of Capital, the Democratic and Republican parties have for more than 40 years facilitated a Race to the Bottom (austerity) that has steadily lowered working people’s living standards and slashed social service supports, including the number of hospital beds, which have declined by more than half a million since 1975 despite a population increase of 114 million.
Insurers and healthcare providers in the United States spent a staggering $812 billion on paperwork and other administrative burdens in 2017 alone, bureaucratic costs that could be dramatically reduced by switching to a single-payer system like Medicare for All. That's according to a study published Monday in the journal Annals of Internal Medicine, which found that administrative costs amounted to 34.2 percent of total U.S. national health expenditures in 2017—twice the amount Canada spent on healthcare administration that same year. The study's authors noted that U.S. healthcare providers impose "a hidden surcharge" on patients "to cover their costly administrative burden." U.S. insurers and providers spent $2,497 per person on healthcare administration in 2017 while Canada spent just $551 per capita, the study found.
If you want to know why the single payer movement is having trouble breaking through in the United States, look no further than Leo Gerard. From 2001 to earlier this year, Gerard was the president of the United Steelworkers of America. Then earlier this month, just a few months after retiring as head of the union, Gerard joined the board of Highmark Health. How can it be that a major American union leader who says he supports Medicare for All single payer, who says he grew up under a single payer system in Canada and “knows the benefits,” who wrote earlier this year that “with a single-payer system like Medicare for All...