Under our current patchwork health care system, the United States spends many times more than other rich nations on health care administration, pharmaceuticals and doctors’ salaries. But we have the 29th best health care system, according to the Lancet.
In 2018, Canada spent approximately 11% of its gross domestic product (GDP) on health care and has the planet’s 14th highest quality health care system. All of its citizens are covered from cradle to grave with single-payer, government-provided health insurance (free at the point of service with no premiums). They are free to go to any doctor, hospital or clinic.
During that same year, the U.S. spent approximately 18% of its GDP on health care. But we have around 30 million people who are uninsured. More than half of Americans delay or don’t get health care because they can’t afford it.
Healthcare was the most important issue in the 2018 elections. Voters were upset by attempts to destroy the Affordable Care Act (ACA or Obamacare) and alarmed by rising premiums and drug prices. It continues to be the predominant issue in the 2020 Democratic primary.
Trump claims he is going to come up with the absolutely greatest health care plan. Meanwhile, he and his fellow Republicans are bludgeoning the ACA, Medicare, Medicaid and the VA with big budget cuts and privatization schemes.
This spring, Trump said that Sen. Rick Scott (R-Florida) would help create a “spectacular” plan for him. That’s not entirely reassuring.
In the 1990s, Scott was the CEO of Columbia/HCA, a company that owned more than 340 hospitals, 135 surgery centers and 550 home health locations.
He resigned in 1997, the same year the FBI announced an investigation of the company for massive Medicare and Medicaid fraud. Columbia/HCA would plead guilty to 14 corporate felonies and pay out some $1.7 billion in criminal fines and penalties in what the Justice Department called the “largest health care fraud case in U.S. history.”
While Trump’s health care bullshit and lies are being challenged, the movement for single-payer Medicare for All has grown enormously. This has provoked a response from powerful health care interests. In June, the consumer advocacy group Public Citizen released a report entitled “Fever Pitch: Surge in Opposition Lobbying and Advocacy Validates the Credibility of the Medicare for All Movement.”
The study disclosed that “between the first quarter of 2018 and the first quarter of 2019, the number of organizations hiring lobbyists whose lobbying disclosure forms indicated that they worked on Medicare for All increased by nearly seven times, and the overall number of lobbyists hired increased ninefold.”
Public Citizen program associate Craig Sandler, the report’s author, said that “the increase in lobbying against Medicare for All serves as validation from our opposition that this movement has arrived.”
The report noted that “the diverse and powerful array of trade groups, conservative activist organizations, GOP-linked establishment groups, and health care industry interests launching an all-out advertising blitz against Medicare for All further reinforces this reality.”
Arguments about Medicare for All have played a big role in the Democratic presidential debates. The more moderate candidates say that many Americans love their employer-provided private insurance and don’t want it taken away. I suspect many may like their doctor but how much deep abiding love is there for faceless behemoths such as Aetna and Cigna?
Joe Biden and Pete Buttigieg claim Medicare for All is “elitist” because it takes away freedom of choice. This is quite dishonest.
Workers don’t have the choice to keep their plan. That is their employer’s prerogative. Rising costs have been forcing employers to shop around for plans that are cheaper for them and more expensive for their employees. Private insurers restrict your choice of doctors by authorized networks. They restrict your access to health care by cost with deductibles, co-pays and other out-of-pocket expenses. Under single-payer, your insurance is funded by progressive taxes and you can go to any doctor or hospital. You don’t get a wallet biopsy when you see your doctor.
Recently, the Los Angeles Times and the Kaiser Family Foundation conducted a nationwide poll and found that “(s)oaring deductibles and medical bills are pushing millions of American families to the breaking point, fueling an affordability crisis that is pulling in middle-class households with health insurance as well as the poor and uninsured.”
Times reporter Noam N. Levey writes:
“The explosion in cost-sharing is endangering patients’ health as millions, including those with serious illnesses, skip care. … Half said costs had forced them or a close family member to delay a doctor’s appointment, not fill a prescription or postpone some other medical care in the previous year. … Hardest hit in the cost shift are lower-income workers and those with serious medical conditions such as diabetes, heart disease and cancer — who are more than twice as likely as healthier workers, according to the Times/KFF poll, to report problems paying medical bills and to say they’ve cut back on spending for food, clothing and other household items.”
Many desperate people are turning to charities and GoFundMe to get necessary health care. This is outrageous. It is time for us to stand up and fight.
this opinion column does not necessarily reflect the views of Boulder Weekly.
