Here’s
one of many indicators about how broken
the United States health care system is:
Guns seem to be easier and cheaper to
access than treatment for the wounds they
cause. A survivor of the recent mass
shooting in Half Moon Bay, California, reportedly said to Gov.
Gavin Newsom that he
needed to keep his hospital stay as short
as possible in order to avoid a massive
medical bill. Meanwhile, the suspected
perpetrator seemed to have had few
obstacles in his quest to legally obtain a semi-automatic weapon to
commit deadly violence.
Americans are at the whim of a bewildering
patchwork of employer-based private
insurance plans, individual health plans
via a government-run online marketplace,
or government-run health care (for those
lucky enough to be eligible). The coverage
and costs of plans vary dramatically so
that even if one has health insurance
there is rarely a guarantee that there
will be no out-of-pocket costs associated
with accessing care.
It’s hardly surprising then that the
latest Gallup poll about
health care affirms what earlier polls
have said: that a majority of Americans
want their government to ensure health
coverage for all. In fact, nearly
three-quarters of all Democrats want a
government-run system.
Gallup also found that a
record high number of people put off
addressing health concerns because of the
cost of care. Thirty-eight percent of
Americans said they delayed getting
treatment in 2022—that’s 12 percentage
points higher than the year before.
Unsurprisingly, lower-income Americans
were disproportionately affected.
Women are especially impacted, with more
women than men delaying treatment as per
the same Gallup poll. The findings were
consistent with results
published by researchers at New York
University’s School of Global Public
Health—that women’s health care was
increasingly unaffordable, compared to
men’s—in a study that solely focused on
people with
employer-based health coverage. Imagine
how out-of-reach health care is for
uninsured women.
Added to that, Republican-led abortion
bans have
made it even harder for American women to
obtain reproductive health care. On the
50th anniversary of the recently
overturned Supreme Court decision Roe v.
Wade, abortion providers in
Massachusetts, for
example, reported a steady stream of
people driving to their state—one where
abortion remains legal—to access care.
President Joe Biden and the Democratic
Party appear to think that this grim
status quo is perfectly acceptable.
Democrats’ reliance on the Obama-era
Affordable Care Act (ACA) as a bulwark
against Republican opposition to any
government intervention in health care
seems to be resoundingly successful—on
paper. In December 2022, Biden touted the
fact that 11.5 million Americans, a record high number, had
signed up for ACA plans during the last
enrollment period. He said, “Gains like
these helped us drive down the uninsured
rate to eight percent earlier this year,
its lowest level in history.”
His administration, rather than working to
fulfill what a majority of his party’s
constituents want—a government-run health
care system—has continued instead to tweak
the ACA by extending a period of
discounted monthly premiums for private
insurance plans. Such tweaks are not
permanent. Neither are they a panacea for
accessing adequate care. If anything, they
are a façade protecting profit-based
private insurance companies.
A survey by the
Commonwealth Fund found that although the
number of insured Americans is now at an
all-time high, more than 40 percent of
those who bought ACA plans and nearly 30
percent of those with employer-based plans
were underinsured—that is, the plans were
inadequate to cover their health care
needs.
By focusing solely on the number of people
who had health plans as a measure of
success, the White House is participating
in a great coverup of the ongoing American
health care tragedy.
Meanwhile, just over the horizon from
Biden’s celebration of record numbers of
ACA signups is the fact that millions of
people currently enrolled in the Medicaid
government health plan could lose access
because of the end of an emergency
provision that
allowed for “continuous enrollment.” That
provision expires at the end of March
2023. If all Americans were automatically
enrolled in government-provided health
care regardless of eligibility, this would
not be a concern.
Right-wing sources, so terrified that too
many Americans want a government-run
health system, are busy shaping public
opinion against it. The Pacific Research
Institute’s Sally Pipes published an
op-ed about
how Canada’s national health system was a
good reason why the U.S. should not have a
similar program. Using the deadly logic of
a free marketeer, she wrote, “In Canada,
health care is ‘free’ at the point of
service. As a result, demand for care is
sky-high.”
The implication is that charging people
for service would reduce the demand, just
as it would for, say, an electric vehicle.
In Pipes’ world, people are accessing
health care just for fun, and if they were
charged money for it, their ailments might
resolve themselves without treatment.
The Heritage Foundation also
published an attack on Britain’s National
Health Service (NHS), gleefully claiming
that it is “cratering,” and warning that
it is a lesson for American liberals who
might support a similar “single-payer”
system in the United States.
The Wall Street Journal’s editorial board
published a similar
warning,
claiming that the NHS was “failing
patients, with deadly consequences.”
It’s puzzling why the Pacific Research
Institute, Heritage Foundation, and Wall
Street Journal appear unconcerned about
the 330,000 Americans who
lost their lives during
the COVID-19 pandemic simply because they
don’t live in a nation with a universal
health care program.
The U.S. spends nearly twice as
much per
capita on health care than other
comparable high-income nations. According
to Health Affairs,
excessive administrative costs are the
main reason for this discrepancy—these are
nonmedical costs associated with
delivering health care in a patchwork
system of employer-based private health
and publicly subsidized plans. In fact,
“administrative spending accounts for
15–30 percent of health care spending.”
Again, right-wing media outlets and think
tanks appear unconcerned by this
disturbing fact. They only want to
convince Americans that a government-run
health plan is a bad idea. And, sadly, the
Democratic Party leaders like Biden seem
to agree implicitly.
The National Union of Healthcare Workers
together with Healthy California Now created an online
calculator for
individuals to determine how much money
they would save if the U.S. had a
single-payer system.
I have an employer-based health care plan
that is considered very good. Using the
calculator, I determined that I would save
more than $16,000 if California, the state
where I live, had a single-payer system.
That’s money I could be saving for my
children’s higher education or for my
retirement.
The victims of mass shootings, like the
Half Moon Bay survivor, are saddled with
high costs of care on top of the trauma of
having been shot. Every year, there are
more than 80,000 survivors of
injuries from
firearms in the United States. Having a
single-payer health care system would not
fix our epidemic of gun violence. But it
would certainly make it easier to bear.
Canada and Britain’s state-run systems of
health care may be imperfect, but they are
a vast improvement on the
survival-of-the-fittest approach that the
U.S. takes.
This commentary was
produced by Economy
for
All, a
project of the Independent Media
Institute.
BlackCommentator.com
Guest Commentator, Sonali Kolhatkar
is the host and producer of Uprising, a
popular, daily, drive-time program on
KPFK, Pacifica Radio in Los Angeles
and co-director of the Afghan Women's
Mission, a US-based non-profit
organization that works with the
Revolutionary Association of the Women
of Afghanistan (RAWA).