If I had to name the one issue I was most passionate during the last 20 years, it would be health care. This is the primary issue that caused me to become a Democrat.
I was excited when President Obama signed the Affordable Care Act. This bill was an enormous accomplishment. The number of uninsured Americans is expected to drop from 50 million to about 21 million. And, if we hadn't passed ACA the number of Americans without health insurance would have risen to 59.7 million by 2015 and 67.6 million by 2020.
The Republican alternative to ACA is a total fail - ending Medicare as we know it and Medicaid cuts would cause 44 million more Americans to lose their health care. Combine the Republican plan to repeal ACA with their budget cuts, and we will be living in an America with about 100 million uninsured not to mention millions more people unable to pay the out of pocket costs.
But health care remains a privilege, not a right. There will still be 21 million Americans who don't have health insurance. There are also millions of people who have health insurance but delay or don't get care because they can't afford the out of pocket expenses. That was talked about in Pluto's excellent diary.
I was happy the ACA passed, but I knew there would be much more work to do. But I felt it would be a very long time before we could do more. If it was this hard to pass health care reform with 50 million uninsured, wouldn't it be harder with 21 million?
And then I saw the action in the states. That plus Obama's recent surge in the polls has brought my political energy back. I'm beginning to think single payer may not be harder to pass than ACA - if a few blue states pass it and successfully implement it. And if progressives can frame this debate as a health care system that will save tax dollars, create jobs, and help all Americans, uninsured and insured alike.
The state of Vermont has passed single payer. California could be the next state to pass single payer. There's a movement in New York. And Oregon
What if a few larger states pass single payer health care programs? What if the public learns single payer helps, rather than hurts state budgets? What if the public learns single payer health care can bring businesses to the state? If that happens, I think the health insurance industry will have lost its decades long misinformation campaign against single payer.
In this video, Wendell Potter talks about how important the Vermont single payer bill is. The Canadian single payer system started in the provinces. In 1946, Saskatchewan was the first province to pass a single payer bill. This worked out so well and was so popular, by 1961 all 10 Canadian provinces had passed similar health care plans. Yes, he says the insurance industry will do everything it can to derail single payer health care, but he adds "for the first time in American history, that train has left the station."
There is considerable expert opinion passing single payer would help California's budget deficit. The Health Care Now H.R. 676 single payer website
California currently spends $200 billion annually on a fragmented, inefficient health care system that wastes 30% of every dollar on administration. Under Senate Bill 810, that wasteful spending is eliminated. The bill creates no new spending, and in fact, studies show that the state would save $8 billion in the first year under this single-payer health care plan.
The California One Care S.B 810 overview states:
Private health insurers will be eliminated thus reducing administrative cost from 33%* to under 5 %* The money saved by removing private health insurers will help fund health coverage for all California residents and will provide high quality and fully comprehensive health benefits.
In Vermont, the first year savings from single payer are estimated at $500 million.
In terms of job creation, The California Nurses Association did an extensive study in 2009. The study showed Medicare For All would create 2.6 million new American jobs.
In Oregon, it is estimated implementing single payer health care would create 40,000 jobs in the state.
Imagine - since 1980 the Republican Party has mastered using the false frame tax cuts for the rich create millions of jobs. And a lot of people bought it. What if Democrats through the states could use the correct frame that single payer health care can attract businesses to a state and be one part of an industrial and national recovery program that brings jobs back to the U.S.?
In November 2004, The Nation had an excellent article about how single payer health care is good for business. The California One website states most employers providing health benefits to employees would pass less into the trust fund than they now pay for health premiums thus saving both businesses and workers money. Single payer would also be cheaper on a national level. The article says:
Publicly financed but privately run healthcare for all--including free choice of physicians--would cost employers far less in taxes than their costs for insurance. Universal coverage could also work magic in less obvious ways. For example, employers would no longer have to pay for medical care under workers' compensation, which in 2002 cost them more than $38 billion. Auto-insurance rates would fall for them--and everyone--if the carriers were no longer liable for medical and hospital bills. You'd think that in its own selfish interest, Corporate America would be fighting to replace the existing system with universal health coverage. Yet it doesn't lift a finger.
Is there a way health care advocates could get certain industries to "lift a finger" in the debate going forward? The Nation article shows the cost of manufacturing an automobile is $1,400 less in Canada than in the U.S. because manufacturers don't have to pay health benefits. Single payer health care can also be part of a new and effective industrial policy to bring manufacturing jobs back to America.
The United States spends more on health care per person than any other country, yet we are one of the few countries that doesn't provide care to all its people. We spend almost twice as much as France; yet we rank 37th in health care while France is 1st. What are Americans getting for all the money they spend?
In regard to budget savings, the Nation article continues:
"The United States wastes more on health-care bureaucracy than it would cost to provide health care to all its uninsured." The authors, Woolhandler, Himmelstein and Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, went on to write: "Administrative expenses will consume at least $399.4 billion of a total health expenditure of $1,660.5 billion in 2003. Streamlining administrative overhead to Canadian levels would save approximately $286 billion in 2002, $6,940 for each of the 41.2 million Americans who were uninsured as of 2001. This is substantially more than would be needed to provide full insurance coverage.
The health insurance industry's decades long misinformation campaign against single payer has been very successful in shaping public opinion against single payer health care. But you can't fool all the people all of the time. I'm growing more convinced the "murder by spreadsheet" industry will slowly lose this debate over the next decade. If a couple larger states successfully implement single payer health care, this could very easily set off a chain effect where more states follow both to gain control over health care costs and to attract businesses to their state. And long term, this may be the nail in the industry misinformation campaign coffin.
I wrote a health care diary in August 2010. One topic this diary covers is during the health care debate, it was said 44,789 Americans die every year because they don't have health care. I always believed that figure was grossly understated. And I show it is.
My hope is we one day have an America where health care is a right FOR EVERYONE NO EXCEPTIONS. That we no longer have an America where if you are well to do with good health benefits, you are early diagnosed with illnesses such as diabetas, heart disease, cancer, and your prognosis is excellent or much better but if you are poorer and don't have good health insurance you are late diagnosed, and may die or have serious complications that reduce your life span and/or quality of life.
I believe the path to "Medicare For All" is paved through the states. This trend is going to take a decade, but if a couple states successfully implement single payer this will reframe the national debate and more states will follow.
In closing, this diary is not meant to rehash heated debates between those who favored the ACA and those who didn't. That is a past debate. This diary is all about Where Do We Go From Here? How Do We Finish The Job? I think almost all of us will agree there is more work to do before health care is a right FOR EVERYONE NO EXCEPTIONS.