Fight for Democracy, Part 18: Healthcare

Let’s review the basics, then get more into the details. The Democratic position is that we need to find a system that insures more people - ideally everyone - and costs people less money. Single-payer, Medicare-buy-in, even keeping and supporting Obamacare (the ACA) are different ways to approach the problem, all of which will result in more people covered. The argument is that no one should be left to die or suffer because they can’t afford care. We are a rich nation full of compassionate people, and we can find a way, fiscally and administratively, to take care of everyone.

Republicans want to keep a profit-driven health care system built around health insurance. First, you need to understand that the principle of insurance, any insurance, is that some people will pay in more than the company will pay out, while some people will get more out than they pay in. It’s the only way to make a profit. This means the health insurance industry is built upon the idea of healthy people paying for sick people. The only way around that is to have no insurance and people just pay for their health care out of their bank account. As anyone who has had any kind of health problem, from a car accident to a bout of pneumonia to breast cancer, those costs are exorbitant and unaffordable for the average person.

So we end up with a profit-driven system that some people opt out of (because they’re healthy and think they will always be healthy) and some people cannot afford. There are 30 million adults (and now growing) who do not have health insurance. Half a million people declare bankruptcy over medical bills every year. Republicans have attempted, and will attempt again, to remove protections for pre-existing conditions and put back in place lifetime limits on insurance expenditures. They’ve already effectively destroyed the individual mandate in the Affordable Care Act and prevented Medicaid expansion in several states. Their plans will all increase the number of uninsured and raise the costs for everyone who is insured, but they do generate large profits for insurance companies and large paychecks for their executives (who then pay large amounts in campaign contributions to Republicans).

To be fair, even most Republicans think everyone deserves health care. They believe that if someone is in a car accident they should receive the emergency surgery that saves their life. They just think that such a thing should bankrupt the poor or anyone who chose not to have insurance. They also tend to agree that people with cancer should get treatment - society will pick up the tab for the uninsured - but only if it isn’t too expensive (lifetime caps) - and it will be more expensive because the uninsured are less likely to catch the cancer early. They think babies born with heart defects should get healed, but then they should be unable to get insurance for the rest of their life - that's what removing protections for pre-existing conditions means. (example: https://www.youtube.com/watch?v=MmWWoMcGmo0) So while many Republican voters think people deserve health care, they don’t feel they deserve health insurance, and they don’t seem to understand that without insurance (or with crappy insurance) most people won’t get decent care. It’s a faith in the market to provide care when the market only cares about profit.

What’s the alternative? There are actually quite a few options as demonstrated by the fact that every other rich country in the world has some form of universal coverage and government-sponsored health care. Let’s focus on the easiest idea because the principles apply to everything. Our government already provides universal health care for everyone over 65: Medicare. And pretty much everyone agrees it’s a good idea. So why not Medicare-for-all? The main argument you will hear against this is the cost. One conservative think tank estimated it would cost $32.6 Trillion (yes, with a T) over ten years. But that same study says that our current system will cost MORE. (https://www.businessinsider.com/bernie-sanders-medicare-for-all-plan-cost-save-money-2018-7) The difference is where your money goes.

Right now, a typical insurance set up works like this. You pay $500/month out of your paycheck for coverage. Your employer kicks in another $500. This means $12,000/year is being sent to insurance companies. Then there’s the $5,000 in deductible you pay to your doctor for a single ER visit or a minor surgery (like a broken finger). But under a Medicare-for-all plan, you pay $500/month more in taxes. Your employer pays $500/month more in payroll taxes. The government gets $12,000/year which it uses to pay health care providers when you use services. Sure, your taxes go up, but your costs do not. In fact, there’s a good likelihood your cost will go down since you no longer have huge deductibles and can get preventative care.

And this doesn’t even get into the benefits. Most arguments skip that part. Medicare-for-all means thirty million people without insurance now get covered. Most people get better health care, and better health care costs less because it catches things earlier. It will literally save lives: for every million people who gain coverage, 10,000 fewer people die a year. It means most of the country won’t have to pay the large deductibles so they won’t face the uncertainty of medical costs. It means people won’t declare bankruptcy over medical bills. It means doctors won’t spend 20% of their time working on insurance reimbursement. All this savings/increased productivity will be poured into our economy which will benefit us all. And people won’t be tethered to crappy jobs because of health insurance. People can explore and innovate knowing they won’t be left for dead if they get sick. They can start new businesses and hire more people because they don’t have to pay rising insurance premiums.

Better health care, for more people, at a lower cost, with side benefits. That’s what Democrats are fighting for and Republicans are actively and enthusiastically fighting against. An issue that will affect nearly every American (except the really rich - they will always have access to the best health care no matter what system we choose (they will just have to pay more taxes if under the Democrat plans)). Vote for your own interest. Vote Democrat.