It may be difficult to remember now, but there was a time when healthcare reform was seemingly a political ‘third rail’, due to the controversial and divisive nature of the issue. Health care, for too long, was viewed as an ideological and political issue, up for debate prior to every national election, but never truly under consideration. Democrats to their credit, embraced the idea of universal healthcare more than half a century ago, but have not been able to create a powerful enough coalition, coupled with strong public sentiment, to drive necessary and full-fledged reform through. As the only major developed nation in the world without a universal healthcare system, one would assume that we would be striving to remediate this dereliction of national duty, but we as a nation have not even fully come to the conclusion that healthcare is in fact a right.
Our 42nd President, William Jefferson Clinton, electoral mandate in hand, famously attempted to pass through his plan for universal healthcare shortly after being inaugurated in 1993. Unfortunately he was not able to follow through on his campaign promise due to Democratic Party infighting, as well as a fierce and concerted effort by the Republican Party, libertarians and health insurance providers to deny his proposal. There was a general consensus after President Clinton’s healthcare defeat that healthcare reform in the United States of America was perhaps an issue too complicated and too divisive to receive serious consideration at the national level. It was not until Barack Obama’s election in 2008, that healthcare reform was once again viewed as an achievable goal. Even as he defied odds and signed the Patient Protection and Affordable Care Act(ACA)into law in March of 2010, the debate of the bill was extremely contentious and polarizing and serious concessions had to be made in order to secure support from key Democratic legislators.
Although the passing of the ACA was a momentous achievement and did succeed in lowering the uninsured rate, protecting those with pre-existing conditions, and curbing ever-rising insurance premiums, it was far from a perfect law. Concessions during the bill’s debate stripped important measures, such as a public option, which would have provided a government funded plan at a lower cost than the private insurance plans on offer. Also, the fact that the bill was passed without a single Republican vote, created a unifying cry, emboldening the entire party and birthing a new, fiery and passionate faction, known as the Tea Party. Like President Clinton’s Democratic Party in 1994, Barack Obama’s Democratic Party paid the price for their foray into healthcare reform, losing their majority in the House of Representatives in 2010. Congressional Republicans, in totality, opposed the bill and attempted to repeal all or parts of it, over 60 times and until the recent American Health Care Act of 2017 (H.R. 1628), currently being rewritten by the Senate, had been unsuccessful.The ACA’s long-term survival seems to be in limbo as ideologues on both sides wage continuous war to save and fix or repeal and replace the law.
Unlike many other policy issues currently on debate, healthcare access and provision is a life and death issue for millions of Americans and hundreds of thousands of Virginians. As partisan squabbles fill Congress and State Legislatures, regular Americans face daunting medical costs, ever-rising premiums, and large insurance providers whose sole objective is maximum profit. As a nation that embraces its place at the forefront of the industrial world, it is imperative that we move past questions of whether healthcare access is a right or whether the return is worth the cost and establish a single-payer healthcare system, like every other major industrial nation on this planet.
What seems to be missing from the current healthcare reform debate is the general will of the American people. The public has shown a propensity to support healthcare reform with public polls showing that a majority of people support greater government involvement in health care in the United States. One of the most popular provisions of the ACA was the expansion of Medicaid. Under this provision, Medicaid eligibility was expanded to allow nearly all low-income individuals. Due to the Supreme Court’s ruling in 2012, however, which ruled that states would not lose federal Medicaid funding if they waived the option to expand those services under the ACA, 32 states, including DC, have extended Medicaid with 19 waiving the option. In states that have not provided this extension, such as Texas, the uninsured rate has remained steady with a lack of improvement when it comes to emergency room costs and medical bill payment. States like Kentucky and Arkansas, which did expand Medicaid, saw the direct opposite. Here in Virginia, Republican lawmakers have unfortunately declined to extend Medicaid to more than 400,000 Virginians. Democratic governor, Terry McAuliffe has supported the expansion efforts and it is now a major point of contention in the 2017 gubernatorial race as Democratic primary opponents, Lt. Gov. Ralph Northam and former Rep. Tom Perriello both call on Republicans to make the morally and economically beneficialdecision and extend Medicaid to Virginians in need.
Although Virginia is one of the ten wealthiest states, it ranks 23rdnationwide in uninsured. Even more jarring is the fact that the number of uninsured continues to increase while it decreases nationally. In almost every healthcare metric, Virginia struggles, with decreases in employer provided healthcare coverage, and rising numbers of people dying due to their lack of healthcare access. The current healthcare system is not working for the US and especially not for Virginia. It is time to implement universal healthcare, removing the handcuffs on millions of Virginians, allowing them to focus on their lives, families, and economic ambitions.
The ACA was a large step in the right direction and confirmed this country’s ability to carry through successful reform but it has become painfully obvious that it is not the panacea for our healthcare ills. If providing every American with fundamental access to healthcare, no matter their income, is not enough of a selling point, perhaps the economic boon of a single-payer system will do the trick. Although we as a country spend more on each person’s healthcare than any developed nation, numerous studies have shown that Americans are no healthier than citizens of other developed nations and lag behind in infant mortality and life expectancy. More of our gross domestic product (GDP) goes towards healthcare than any other developed nations, yet we see less positive economic impact. ACA alone, flaws and all, is projected to reduce the federal deficit by $143 billion over the first decade.
As with any government provided service, one asks, “How will we pay for this?” The United States of America already spends over $3 trillion on healthcare each year. Implementing a single-payer structure, as seen in Sen. Bernie Sanders’ plan, will save Americans $6 trillion over the next ten years. Other single-payer plans such as Rep. John Conyers’ U.S. National Health Care Act (H.R. 676) see similar cost savings and economic impact. Studies have shown that his plan, which replaces insurance premiums with taxes, would trigger hundreds of billions of dollars of immediate savings due to the removal of insurance company and hospital overhead and billing costs. Analyses show savings of $350 billion and up. It is no wonder that we are the lone outliers in the industrialized world when it comes to installing a single-payer system.
Now more than ever, there is general consensus on the topic of universal healthcare in the United States. The swiftness of our current administration movements to dash the ACA and replace it with a neutered law that punishes the Americans most in need makes it imperative that we coalesce around single-payer healthcare. On a national level we have seen the marked improvements in the healthcare environments of states that embrace Medicaid expansion and seen the continued decline in states such as Virginia that have refused these extensions. It is time that we catch up with the rest of the industrialized world by prioritizing the health and wellbeing of our citizens and providing them with a foundation to live happy, healthy and financially stable lives, without the worry of catastrophic healthcare costs driven by profit hungry insurance companies. As Republicans scramble to throw together a plan that can replace our current healthcare law, we must take advantage of this moment and secure healthcare for all.