America Needs A Healthcare System Built For Care, Not Profit

As well as making Americans healthier, Medicare for All would change our understanding of what we can and should demand of our society.
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Protesters gathered outside the New York Stock Exchange in December chanting “Kill the Bill. Don’t Kill Us!” in response to concerns over the Republican tax bill, including potential deep cuts to Medicare.
Protesters gathered outside the New York Stock Exchange in December chanting “Kill the Bill. Don’t Kill Us!” in response to concerns over the Republican tax bill, including potential deep cuts to Medicare.
Pacific Press via Getty Images

The United States pays about three times per capita what the average developed nation pays for healthcare, yet of those countries we have one of the lowest life expectancies, the highest maternal and infant mortality rates, and an astonishingly high number of deaths from preventable diseases.

In addition, nearly 30 million people are uninsured, another 30 million are underinsured, and the rest of us bear increasingly thin benefits with unaffordable premiums, deductibles, and copays.

So how is it that we pay so much for healthcare when our health outcomes are so abysmal and our health coverage so inadequate?

The problem is simple: our employer-based, multi-payer healthcare system is built for profit, not for care. While complaining about Obamacare, health insurance companies are enjoying record profits, their CEOs are making $20 million per year on average, and their administrative overhead is obscene – approximately 18 percent, according to their own numbers, as opposed to Medicare’s 2 percent (if you include Medicare’s private plans – so-called Medicare Advantage – that number jumps to 6.4 percent, evidence of a clear link between privatization and administrative bloat). All this, again, while healthcare quality is declining across the board.

This situation is unacceptable and it’s no surprise that, according to multiple polls, a majority of Americans support a single-payer healthcare system like the one proposed by Senator Bernie Sanders in his Medicare for All Act of 2017.

This bill, co-sponsored by a bevy of Democratic presidential hopefuls, would establish a single, public, universal health insurance system, managed by the federal government, where everyone, regardless of their employment or immigration status, is insured. Making the federal government the “single payer” of claims, thereby eliminating the profit motive in insurance, would allow us to control healthcare costs and devote more money to actually improving care.

It’s easy to look at the statistics on the state of the nation’s health, as well as growing Democratic Party support, and think that Medicare for All is so sensible and so popular that it’s a sure thing should the “blue wave” of 2020 wash over us, but this is far from the case.

The Democrats who have jumped on this bandwagon have only done so because they are worried about alienating the Sanders base, but the party has historically maligned single-payer. However, under pressure from their corporate donors, many current co-sponsors of Medicare for All would likely abandon or severely water down the legislation if they thought they could get away with it.

In truth, neither party is going to support socializing a major industry – one that accounts for more than one sixth of U.S. GDP – without mass political pressure from their constituents. And as Medicare for All inches closer to becoming a reality, the existing healthcare industry will undoubtedly launch a massive propaganda campaign that aims to divide that constituency.

That such a necessary and popular reform is set to attract such vociferous opposition also highlights how the campaign for Medicare for All is part of a much larger political project. It represents a unique opportunity for a newly reconstituted American left to re-engage ordinary working Americans across the country.

In other words, fighting to win single-payer healthcare is a chance to mass organize and unite the 13 million Sanders voters and many more universal healthcare supporters into a force capable of challenging the enormous power of the political and business elite – in this case in the form of private health insurance companies. And once that base has a major victory under its belt, it can be mobilized to demand other transformative reforms.

This is because the realization of Medicare for All, in addition to making Americans much healthier and less anxious about healthcare costs, would change our understanding of what we can and should demand of our society.

Forty years of tax cuts for the rich and benefits cuts for the rest have made many people feel like the unforgiving, lift-yourself-up-by-your-bootstraps world we currently live in is the only one there is. But the experience of walking into a doctor’s office and receiving needed care free at the point of service, after having eliminated an exploitative and inhuman health insurance industry, would introduce a new feeling of political possibility.

It would also create a sense of shared struggle and purpose as the realization of Medicare for All would, for the first time in the history of the United States, establish a universal social program, one that is for every person regardless of age or income bracket, race or gender. It’s an inherently unifying program, and just as much as it would be the fruit of political solidarity, so too would it contribute to a greater sense of social and class solidarity.

Like the NHS in Britain, Medicare for All could be a touchstone for how people view other sectors such as education, transportation, utilities, and housing. And like Jeremy Corbyn’s Labour Party, the left in America can point to the example of a nationalized healthcare system to get people to fight the ruling class with a very simple message: these things are ours, and we’re going to take them back.

Benjamin Y. Fong and Dustin Guastella are organizers with the Democratic Socialists for Medicare for All campaign.

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