Editor’s note: This commentary is by Lee Russ, of Bennington, who is a retired legal editor and freelance writer.
[T]he great majority of Americans — 70 percent or more — support the idea of “Medicare for All” as the answer to the fragmented, expensive and inadequate system of insurance-based health care we now have. That’s enough support to scare the companies that make tons of money off that broken system, so they have formed an alliance to once again fend off what most Americans want: a sensible universal health care system. They call their alliance the Partnership for America’s Health Care Future (PAHCF).
Members of this “partnership” include America’s Health Insurance Plans (AHIP), the association of 1,000+ companies that sell commercial health insurers to many millions of Americans; the Blue Cross Blue Shield Association (BCBSA) whose members also sell commercial health insurance; the National Association of Health Underwriters (NAHU), an association that promotes the business interests of companies that sell health insurance; the Pharmaceutical Research and Manufacturers of America (PhRMA), the association of drug companies; the Federation of American Hospitals, an association of for-profit hospitals; the Council of Insurance Agents and Brokers an association of “200 of the world’s top commercial insurance and employee benefits brokerages”; the National Retail Federation; the American Medical Association (AMA); the American College of Radiology (ACR); and several others.
It is clearly dominated by those who make money — lots and lots of money — from our current health care system that relies on insurance. This is not a partnership that will ever reach the conclusion that we need a truly universal, efficient system like Medicare for All. Based on the partnership’s own internal documents, the group will campaign specifically to “change the conversation around Medicare for All,” then “minimize the potential for this option in health care from becoming part of a national political party’s platform in 2020.”
The whole point of the partnership is to play around with a few changes at the edges of our current system to mollify the people demanding change, while preserving the status quo under which many Americans get inadequate care that in some cases, actually causes their deaths. If they succeed, Americans will continue to suffer when they can’t afford commercial insurance premiums and go “uncovered” with the health consequences that follow; when they choose high deductible policies because they can’t afford better coverage and end up sick, dead or deeply in debt; when they can’t afford the medicine they need and skip it or cut down the dose and end up sick or dead; when they stay up nights surrounded by bills and try to figure out how to pay rent, buy food and still get the health care they need; when they do go get care that they cannot afford and end up so deep in debt that their lives are altered for the foreseeable future; when they delay going to a doctor to avoid a cost they really can’t afford and the delay makes them far sicker or kills them.
Much of this harm is worse than would be inflicted in a physical assault, yet the people who cause this kind of harm can’t be punished because “it’s just business, not a crime.” Worse yet, many of the people who perpetuate all these harms end up richly rewarded in terms of money and status. Nor do they seem much discomfited by what they do because, again, “it’s just business” and “those are the breaks” and “that’s just an unfortunate reality.”
Adding insult to injury, this campaign to stave off Medicare for All will be funded by the very people who need Medicare for All: us, the vast population of people who pay into the current system. The partnership’s activities, from direct lobbying of legislators, to producing “research” that suits their needs, to expensive PR campaigns, will all be paid for by the premiums insurers collect, the profits that drug companies and commercial hospitals make, the commissions that the agents and brokers make, and so on.
And, of course, the partners are largely the very same people that have produced the current health care nightmare that spurred the public interest in Medicare for All. Having created the nightmare and seen it spur a sane attempt to fix it, they simply formed a new organization and will now pretend to fix the nightmare by preserving it.
The partnership will attempt to paint Medicare for All as “extreme,” and “too disruptive” to the system. Medicare for All is only extreme if you assume that the current system is “normal” and anything significantly different is extreme by definition. It is only disruptive because the current system is so woefully inadequate that disruption is the only way to cure it.
The GAO explicitly concluded back in 1991 that “If the universal coverage and single-payer features of the Canadian system were applied in the United States, the savings in administrative costs alone would be more than enough to finance insurance coverage for the millions of Americans who are currently uninsured. There would be enough left over to permit a reduction, or possibly even the elimination, of copayments and deductibles…”
We didn’t take that opportunity. Now, although we have an enormous GDP, one dollar out of every five of that GDP is spent on health care. Walmart is experimenting with providing mental health services in its stores. A Michigan woman is fundraising on GoFundMe to raise the cost of anti-rejection drugs because the transplant center won’t put her on the waiting list for a heart until she proves she can afford those drugs. Medical bills are more likely to bankrupt you than losing your job.
Playing around the edges of our health care system won’t solve the problem. Improved Medicare for All would. It’s up to the people to decide once and for all that it is worth fighting for better care, for more people, for less money. And it will certainly be a fight to get there, given that Open Secrets documented over $400 million in health care lobbying so far this year (through late October).
Speak up if you want a sane, safe and efficient health care system. And be on the lookout for the propaganda from the Partnership for America’s Health Care Future.
