Medicare for All Progress in 2020

The Fight for Medicare for All Made Some Important Progress in 2020

The fight for Medicare for All is one of the most important in the United States today. And despite the many horrors of 2020, the movement demanding an end to our privatized health system actually made some headway this year.

With a national death toll quickly approaching 350,000, the need for a universal, single-payer health care system has never been more urgent.

As 2020 comes to a close, we are no closer to winning a national health program in the United States than we were before COVID-19 struck, even amidst so much physical and financial suffering. But it would be a mistake to discount the entire year as a total loss.

Despite immense challenges and setbacks, there were moments during 2020 that offered hope in the movement for Medicare for All. Here are some of the highlights of both.

Coronavirus Pandemic

Much has been written about how the coronavirus pandemic laid bare the fact that everyone, even those fortunate enough to have health insurance, is vulnerable to sickness and death under our cruel and disjointed health care system. But Medicare for All supporters know, America has been in a perpetual public health crisis for more than a hundred years.

Even before the pandemic, as many as 250,000 Americans died each year from medical errors alone. As horrific as it is for 14.6 million people to lose their health insurance as a result of widespread job loss, that statistic is dwarfed by the 87 million Americans who already lacked insurance or were underinsured before 2020. Meanwhile, racial health inequalities were exacerbated by COVID-19.

A more important lesson to draw from the pandemic is that public health crises are not inevitable. In contrast to our multitiered system, Medicare for All would provide a single tier of coverage to everyone in the United States, regardless of income, employment status, disability, gender, or immigration status.

Single payer would eliminate financial barriers like exorbitant deductibles and copays, and strengthen our ability to respond to current and future public health crises by ensuring our tax dollars go toward meeting human needs.

A doctor and a nurse review the clinical records of a COVID-19 patient. (Leopoldo Smith / Getty Images)

The pandemic has been a humbling and disappointing experience for Medicare for All advocates who hoped that the catastrophe of COVID-19 would coalesce a movement toward a national health program in the United States. The reality is the pandemic’s devastation and the disastrous response of the Trump administration forced Americans to focus on survival and meeting their material needs.

The reasons that so many Americans are desperate for Medicare for All are clear. How we win transformative health reform comes down to our ability to build on the momentum fomented, in part, by Bernie Sanders’s 2020 presidential campaign to broaden the appeal for Medicare for All and mobilize a mass movement around it.

Workers Claim Their Essential Status

While many people have continued on selflessly as “essential” workers, the designation has been a death sentence for some. The coronavirus doesn’t care if you are a prisoner transporting dead bodies for $2 an hour, a meat packer at a poultry plant, a stocking clerk at a grocery store or a worker at a long-term care facility.

As the pandemic has shown, when workers don’t get the things they need to do their jobs safely, people die. That realization is what prompted workers like Chris Smalls and thousands of others to walk off their jobs or stage protests throughout 2020 — many of them without the protection of organized labor. Smalls and his coworkers organized a strike in March over lack of safety precautions at an Amazon warehouse in Staten Island.

“How essential are we if we’re spreading this virus to customers?” Smalls told VICE News in March. “Amazon is a breeding ground for the coronavirus. We’re going to be the second wave. Right now, I’m trying to prevent that.”

Amazon allegedly fired Smalls for taking a stand, but his protest inspired other workers around the country, like Tre Kwon, an ICU nurse, to organize a protest outside her workplace demanding better personal protective equipment (PPE).

Frontline health care workers are particularly vulnerable to contracting the virus because they work so closely with COVID-19 patients. Over fourteen hundred frontline medical workers are estimated to have died from COVID-19 as a result of unsafe working conditions, including a lack of PPE and testing.

In the face of mounting health risks and unbearable workloads, frontline health care workers not only earned the deserving admiration from the public, they have used the attention to speak out.

“We are afraid for our patients,” Kwon said at a demonstration outside of Mount Sinai hospital. “We are afraid for our families. We are afraid for our lives.”

Medical Staff Protest outside of Mount Sinai Hospital on Friday April 3, 2020. (Theodore Parisienne / New York Daily News)

In California’s East Bay, more than three thousand hospital workers went on a five-day strike that forced major concessions from their employer, including the elimination of an unelected Board of Trustees whose perpetual mismanagement, workers claimed, turned deadly during the COVID-19 pandemic. Later, another five thousand workers in Chicago rallied against their bosses over unsafe staffing levels and poverty wages.

The words and, more importantly, the actions of workers like Smalls and Kwon underscore the connection between workers’ safety and the public at large. Those links will have spread long after the pandemic is over if we ever hope to win a national health program.

Physician Groups Buck the Status Quo

The year started off on a promising note with the release in January of a position paper in support of single-payer health care published by the American College of Physicians (ACP), the country’s largest specialty society with 159,000 members.

“For a century, most U.S. medical organizations opposed national health insurance,” wrote Dr Steffie Woolhandler and Dr David Himmelstein, cofounders of Physicians for a National Health Program. “The endorsement of the American College of Physicians of single payer reform marks a sea change from this unfortunate tradition.”

Later in August, amid the worsening coronavirus pandemic, the 3,300-member Society of General Internal Medicine (SGIM) endorsed the ACP’s policy prescription.

The ACP is the second-largest physician group in the United States after the American Medical Association (AMA), the country’s most prominent and powerful physician group and the third largest lobbying group, behind only the National Association of Realtors and the US Chamber of Commerce.

What effect, if any, the ACP and SGIM endorsements will have upon the AMA (whose conservative leaders led numerous successful campaigns to thwart efforts to pass compulsory health insurance legislation as early as 1920 right up until today) is anyone’s guess.

In 2018, the AMA joined with organizations representing private health insurers, medical device manufacturers, and pharmaceutical and hospital executives to form a benign-sounding corporate front group called the Partnership for America’s Health Care Future whose goal is to “change the conversation around Medicare for All” — in other words, to halt it.

Caving to pressure from a coalition of physicians, workers, and grassroots organizers, the AMA abruptly withdrew from the partnership in August 2019. The American College of Radiology eventually exited the group as well.

Doctors have actually been among the most adversely affected by our market-driven health care system. Like other frontline health care workers, some doctors have succumbed to COVID-19 or been fired by their employers for speaking out about the lack of safety measures and PPE.

We can take heart that more white coats are using their credibility and respect to convince their colleagues of the need for a more equitable health system. But until conservative physician groups like the AMA are forced to change their priorities or at least are neutralized from thwarting comprehensive health reform, much more work is needed to empower the growing enthusiasm for single-payer among medical students and the majority of practicing physicians who already support Medicare for All to speak out.

Private Health Insurers Make a Killing

Humana, Anthem, and other private health insurers posted blockbuster profits even in the face of hundreds of thousands of deaths from COVID-19 and 14.6 million people losing their employer-sponsored coverage as a result of the economic meltdown. UnitedHealth Group alone pocketed an additional $4.1 billion in revenue during the first quarter.

“Americans are getting sick & dying, and doctors [are] risking their lives to save them, in this crisis,” tweeted Wendell Potter, former vice president of corporate communications for Cigna and industry whistleblower. “Meanwhile, health insurance companies are denying coverage & squeezing doctors to generate record profits. That’s the story of healthcare in America today.”

The Wellmark Blue Cross and Blue Shield building in downtown Des Moines, Iowa. (Tony Webster / Flickr)

The earnings reports were released in conjunction with announcements that the corporations would provide “proactive relief” to financially strapped and sick customers in the form of rebates, a shameless ploy intended to soften the corporations’ naked greed in a time of unfathomable suffering.

Thanks to Potter, we knew that the private health insurance industry exists to extract money by denying Americans health care when they need it. Now we know they can make even more dough even — perhaps especially — during the worst public health crisis in the United States in more than a hundred years. That alone should be reason enough for us to demand Medicare for All and to eliminate the private health insurance industry.

Canada’s Single-Payer System Is Upheld

In September, the Supreme Court of British Columbia beat back a legal challenge that threatened to transform Canada’s Medicare program from a universal, single-payer system into a two-tiered system based on an individual’s ability to pay for care rather than on need.

The “Cambie trial” was the culmination of ten years of legal maneuvering by Dr Brian Day, an orthopedic surgeon and the CEO of the Cambie Surgical Centre, a private, for-profit clinic based in Vancouver.

What does an attack on Canada’s universal health care system have to do with medical care in the United States? A lot.

Single-payer advocates have long pointed to Canada’s Medicare program as a model for what an American national health care program could look like. American neoliberals know this, of course, so they have worked tirelessly for decades to amplify the efforts of corporations and allies like Day who want to put health care in Canada in the hands of the free market.

The Cambie trial specifically highlights the influence of right-leaning think tanks within the Atlas Network, a vast collection of nearly five hundred organizations in more than ninety countries, who have a shared interest in promoting a neoliberal health care agenda that favors privatization, direct payment, limited government, and any other policy that increases market dominance under the guise of freedom of choice but which often leave patients with little or no choice about their medical care.

For example, each year in Canada, the Vancouver-based Fraser Institute releases a special report called “Waiting Your Turn,” which details the length of time that Canadians must wait to receive medical care.

Conservative think tank leaders in the United States like Sally Pipes of the Pacific Research Institute routinely cite the wait time report to smear single-payer in her congressional addresses, public debates, and in editorials published in mainstream news outlets. Pipes, meanwhile, uses her think tank’s PR apparatus to characterize Day as a “crusader” fighting to liberate patients from the Canadian health care system.

Working in unison, Atlas affiliates create a kind of echo chamber that allows them to sow doubt about the efficacy of single-payer health care in virtually every corner of the globe. It isn’t merely “intellectual support” that Day and others receive from these right-leaning organizations. The Atlas-affiliated Canadian Constitutional Foundation donated $5 million to spearhead Day’s legal team, which is expected to mount an appeal to the Supreme Court of Canada.

“Most Canadians are unaware of how our healthcare system is under attack,” said Karen Palmer, a health policy adviser to Canadian Doctors for Medicare, an advocacy organization that opposes efforts to privatize Canada’s universal health care program. “I think the constitutional challenge to our health care system has caused some to sit up and pay attention because there is a lot at stake.”

Discrediting Canadian Medicare serves private interests like Day, but it is also used to undermine the Medicare for All movement here in the United States. Health care advocates on both sides of the forty-ninth parallel must remain vigilant in the face of coordinated efforts to privatize our social goods.

Medicare for All on the Ballot

At a time when political divisions in the United States appear to run deep and wide, universal public goods like Medicare for All are poised to fill the breach.

Despite a million-dollar ad campaign from the Partnership for America’s Health Care Future to keep it under wraps, Medicare for All emerged from the 2020 Democratic primary and the general election a clear winner.

One exit poll, among many, conducted by Fox News of all places recently demonstrated that the majority of Americans — 72 percent  are united in their desire for a publicly funded, universal health care system regardless of their political loyalties.

Not only is it now expected that progressive candidates back Medicare for All, their support for the reform could determine whether they are elected or not. “Every single candidate that co-sponsored Medicare for All in a swing district kept their seat,” noted Rep. Alexandria Ocasio-Cortez.

If these political gains one day result in the passage of a national health program, the credit belongs to the growing network of grassroots organizers who used the electoral campaigns of Bernie Sanders, Mondaire Jones, Phara Souffant Forrest, and others as vehicles to communicate to Americans the importance of public goods like health care.

It is because of their work connecting people around shared struggle that the movement has been elevated to heights not seen since the 1940s when single payer enjoyed the support of two-thirds of the American public, the major labor unions, and even the president.

As Frances Gill, a medical student and organizer with the Democratic Socialists of America’s Medicare for All campaign, told me, “The popularity of [Medicare for All], the broader group of people who want nothing less — these are things we won over the last couple years and are going to be very powerful tools going forward.”

A North Carolina Health Care Union Victory

In September, 1,600 nurses at Mission Health hospital in Asheville scored the largest labor victory in the South since 1975 when they won union representation with National Nurses United (NNU) in the face of a brutal union-busting campaign during the pandemic by the country’s most largest hospital corporation, HCA Healthcare.

The victory could be a big boost for other workers in North Carolina and the rest of the anti-union South. It also has the potential to invigorate the Medicare for All movement in the region, which will almost certainly play a pivotal role in the reform’s passage.

Although single-payer was not a focus of the Mission nurses’ union campaign, the frontline health care workers often talked about how their jobs have been made impossible because of the profit motive of health care corporations like HCA.

The very groups that have linked rights in the workplace with the health of their patients have been nurses and health care unions, most notably NNU. For that reason, the nation’s largest nurses’ union devotes significant resources to winning Medicare for All.

Mission Hospital nurses organizing their first union listen to community leaders during a rally in Asheville, North Carolina in March 2020. (Christine Rucker)

The health reform represents such a threat to HCA’s bottom line that it joined the Partnership for America’s Health Care Future in order to stymie the single-payer movement.

Not only would Medicare for All eliminate the private health insurance industry, it also has the potential convert for-profit hospital conglomerates like HCA into nonprofits and reign in the profit motive for every hospital through the use of global operating budgets that would make it easier to ensure that public money is spent on services that produce healthy outcomes instead of bloated administrative departments or expensive medical equipment designed to attract well-insured patients.

Medicare for All would also give a boost to health care workers like the nurses at Mission who want to unionize, because hospitals would be barred from using public money to bankroll union-busting campaigns.

The Mission campaign exemplifies how workers can and must overcome political and class divisions in order to work together with their communities not only to secure power in the workplace but to win public goods like Medicare For All. Expect to see more skirmishes like this with hospital consolidations and closures continuing into 2021. As the coronavirus has shown us, the survival of our communities depends on it.

“HCA has 180 plus hospital systems, clinics, and outpatient surgery centers,” Mission nurse Susan Fischer told me during an interview for Jacobin earlier this year. “They’re just buying up the Southeast, and these hospitals are going to need unions to make sure that their patients and communities are safe when they walk through the doors of that hospital.”

“Until we can get Medicare for All, this is what we have to do,” she said.

Questions of Strategy and Movement Building

In 2020’s last weeks, comedian and podcaster Jimmy Dore called on Rep. Alexandria Ocasio-Cortez and other progressive members of the Squad to force a floor vote on Medicare for All in open defiance against Speaker Nancy Pelosi and other centrist Democrats. The call ignited passionate debate on the Left as Medicare for All advocates scrutinized the strategy.

Some people, including AOC herself, rejected Dore’s appeal on a strategic level, fearful that the political fallout from the vote’s assured defeat would set the growing Medicare for All movement back on its heels. Others embraced the tactic, excited by the chance to expose congressional Democratic leadership for their refusal to support universal health care in the face of overwhelming need during the COVID-19 crisis.

Judging from the debate around the floor vote proposal, it is clear that the passion and excitement to fight for Medicare for All continues to burn bright despite the pandemic. Regardless of whether a vote on Medicare for All vote actually takes place in 2021 or not, we need more discussion of our tactics and strategy going forward. If we can’t, we’ve already lost the fight.

Jonathan Michels is a freelance journalist and health care worker based in Durham, North Carolina.

Originally appearing in Jacobin.

 https://www.jacobinmag.com/2020/12/medicare-for-all-2020-coronavirus-progress


Replay: NCM4A's Emergency Human Rights Day Press Event for Medicare for All

On Thursday, December 10, a grassroots coalition of frontline workers, including physicians and city workers, along with human rights advocates from around North Carolina held an emergency press conference at the N.C. General Assembly in light of the staggering increase in COVID-19 infections in the United States as the national death toll approaches 300,000. December 10 also marks the 72nd anniversary of the signing of the United Nations’ Universal Declaration of Human Rights in 1948. In the midst of the worsening coronavirus pandemic with one person dying every minute in the U.S. from COVID-19, International Human Rights Day is an opportune time to highlight the intrinsic value of every person and the tragic results of denying people their basic human rights, including rights in the workplace, the right to economic security from unemployment and deprivation and the right to healthcare.

Watch the full #HumanRightsDay press event replay:

 


NCM4A Advances Medicare for All Demand with Human Rights Day-Related ‘Bill Burns’

N.C. Healthcare coalition plans multiple public events to reassert healthcare as a human right.

Our communities have an urgent need for healthcare relief and the North Carolina Medicare for All (NCM4A) coalition believes it's necessary to mobilize now to achieve the health justice we desperately need. As some of us are forced to make hard choices about the coverage we can afford during open enrollment, too many others remain totally locked out. We believe we all deserve better than a corrupt, profit-driven health system and an administration that seeks to uphold the status quo.

This moment in history demands systemic change. Expanded and Improved Medicare for All, a single-payer healthcare system, is within our grasp. To work toward this end, NCM4A will hold public events to reassert healthcare as a human right and mark International Human Rights Day. On December 12, the coalition plans 'NC Bill Burn' events in Asheville, Durham, and Charlotte, which will observe COVID-19 safety precautions.

The Durham Bill Burn event will be held from 4:30pm-6:00pm at SEEDS (706 Gilbert St, Durham, NC 27701), where we will invite people to share their story about struggling with medical bills and symbolically burn their paper bills in a community- and power-building event. The group will encourage donations to local mutual aid groups, including Bull City Mutual Aid and the Fed Up food distribution program led by NC Raise Up and NC Poor People’s Campaign. Click on the link to find info on the Charlotte Bill Burn (12/10 at 6pm) and the Asheville Bill Burn (12/10 at 6:30pm).

(We recommend these guidelines to stay safe when participating in this event: https://bit.ly/NCBillBurnSafety)

Leading up to the Bill Burn events, the NC Medicare for All Coalition will also be co-hosting an Emergency Press Conference on Thursday, December 10 in front of the N.C. General Assembly to address the worsening COVID-19 crisis and advance demands for Medicare for All, as well as health and safety protections and union rights for essential workers.

The surging global pandemic is compounding the existing healthcare disparities in North Carolina and beyond. We will not stand idly by while our country’s unaffordable private health insurance system degrades and bankrupts people and their families. Americans owed $88 billion in medical debt in 2018, and nearly half (45%) of people surveyed said they feared a medical event would bankrupt them. More than 45,000 Americans die annually because they cannot afford healthcare. Around 90 million Americans are uninsured or underinsured, while millions of people with employer-based health insurance are burdened by ever-increasing premiums, deductibles, and co-payments, often making their coverage too expensive to use. 

Despite the fear-mongering, we believe Medicare for All represents true freedom -- to change jobs, start a business, ensure the health of loved ones, and live a life free from medical debt. In this critical moment at the dawn of the Biden-Harris administration, the North Carolina Medicare for All Coalition won’t relent until the dignity of every individual is recognized by providing truly universal healthcare through Improved Medicare for All.

COVID Precautions: The hosts at this bill burn bonfire will enforce Covid-safety precautions, including masks worn by all individuals (including when speaking) and the number of guests around the fire will be restricted to ensure social distancing guidelines, with markers on the ground to serve as a guide. Extra masks and sanitizer will be available for guests. We are encouraging people to drop-in to the event to share their story and some time around the fire, then rotate out to allow more people to join.

About the NCM4A Coalition: Comprised of more than 30 organizations and grassroots groups in North Carolina, the NC Medicare for All Coalition is uniting people across the state to pass comprehensive, single-payer, improved Medicare for All. We are mobilizing North Carolinians and pressuring our representatives to ensure that all our communities have equitable access to quality healthcare.


Statewide Healthcare Coalition to Hold Emergency Human Rights Day Press Event

Emergency Press Conference On Human Rights Day to Address the Worsening COVID-19 Crisis and to Demand Medicare for All

SPEAKERS TO INCLUDE MEDICAL PROVIDERS, ESSENTIAL WORKERS, FAITH LEADERS AND HUMAN RIGHTS ADVOCATES

This Dec 10 press conference was initiated by the North Carolina Medicare for All Coalition, including Health Care for All N.C. and the Southern Workers Assembly. (Click for Facebook event) (Click for press release published on Common Dreams website)

Raleigh, NC – On Thursday, December 10, a grassroots coalition of frontline workers, including physicians and city workers, along with human rights advocates from around North Carolina will hold an emergency press conference at the N.C. General Assembly in light of the staggering increase in COVID-19 infections in the United States as the national death toll approaches 300,000.

December 10 also marks the 72nd anniversary of the signing of the United Nations’ Universal Declaration of Human Rights in 1948. In the midst of the worsening coronavirus pandemic with one person dying every minute in the U.S. from COVID-19, International Human Rights Day is an opportune time to highlight the intrinsic value of every person and the tragic results of denying people their basic human rights, including rights in the workplace, the right to economic security from unemployment and deprivation and the right to healthcare.

Dr. Uma Tadepalli, a physician and health advocate from Durham, said, "Our healthcare system was a rip off before COVID-19, but now that millions have lost their jobs and their job-sponsored health insurance, it is an utter failure. We're already paying for everyone to have healthcare, and then some, but we haven't been getting it. As a physician, I want people to have the peace of mind that they won't break the bank when they do what they need to take care of themselves.”

Lawmakers’ egregious refusal to guarantee healthcare to all Americans during the coronavirus pandemic not only shows how out of touch they are with their own constituents but constitutes a direct violation of the U.N.’s Universal Declaration of Human Rights, which states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including...medical care and necessary social services..."

Despite deep political divisions, most Americans share similar human values. As a Fox News poll recently demonstrated, the majority of people 72 percent regardless of their political affiliation, are united in their desire for a publicly-funded universal healthcare system, more commonly known as Improved and Expanded Medicare for All.

Medicare for All would cover every American regardless of income, occupation, disability, gender or immigration status and eliminate financial barriers like exorbitant deductibles and copays. Medicare for All is how we move away from job-sponsored health insurance that has failed us, and a punishing medical system that enriches the few at the expense of the many.

Dominic Harris, a util­i­ty tech­ni­cian and pres­i­dent of the Char­lotte City Work­ers Union, chapter of UE Local 150, said “We work too hard to turn around and give a bunch of the money we make to people that don't want for anything. While COVID-19 is causing pay cuts and job losses, insurance companies are making billions off of our pain and suffering. Medicare for All is a cheaper and better way of doing insurance in America.”

In addition to revealing the inadequacies of our current healthcare system, COVID-19 also underscores the interdependence of basic human rights and the tragic results of denying these rights. Without essential workers’ human right to “just and favourable conditions of work,” they have been denied access to COVID-19 testing, proper protective equipment (PPE) and physical distancing.

We have seen that as Americans age, they often lose their basic right to safety and security. Though tragic, it’s not surprising that many nursing homes become funeral homes during the pandemic.

In some states, if people with disabilities make more than a certain amount of income per year, they are at risk of losing their Medicaid eligibility. With the pandemic, their very lives are now at risk by the very people who are caring for them – frontline and domestic workers who didn’t have the right to proper testing and safety protocols.

As the number of coronavirus cases surge, our families, friends and neighbors will continue to die, but our healthcare system was a catastrophe even before the pandemic. We don’t only have a common predicament, we have a shared answer: Medicare for All, a healthcare system based on meeting human needs instead of private interests.

Please join us on Thursday, December 10 at 10:00 AM in front of the N.C. General Assembly Building at 16 West Jones Street in Raleigh.

Speakers will address these and other demands and take questions from the press.

As a follow-up action the North Carolina Medicare For All Coalition will be holding a series of Medical Bill Burns in Charlotte, Asheville and Durham where participants will burn their medical bills and share their stories in opposition to our inhumane for-profit health insurance system. 

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A note about COVID-19: The coronavirus pandemic makes this press conference all the more urgent, however, we want to minimize the risk of infection as much as possible so we will follow Gov. Roy Cooper’s Phase 3 Guidelines as outlined by DHHS for outdoor public gatherings. The press conference will be held outdoors not to include more than 50 participants. All participants will be required to wear face masks and remain physically distanced by 6 to 10 feet.

 


NCM4A Vows to Push NC Officials and New Administration to Embrace Improved Medicare for All

Citing popular support for universal healthcare and NC’s high uninsured rate, the newly formed healthcare coalition plans actions around International Human Rights Day

Even with the resolution of the 2020 election, we remain in the midst of a dire healthcare crisis in North Carolina and the country as a whole. The surging global pandemic is compounding the existing healthcare disparities in North Carolina and beyond. The North Carolina Medicare for All Coalition (NCM4A) refuses to accept senseless deaths and a “return to normal" when normal means over 45,000 Americans dying annually because they cannot afford healthcare.

Despite the notion of a democratic government, it’s clear that the economic interests of the private insurance and health care industries are superseding the will of the American people. As a statewide coalition representing thousands of supporters, NCM4A is committed to challenging duplicitous politicians who serve donors instead of constituents, hiding behind platitudes like promising “access” to healthcare or saying “healthcare is a right” without policy or votes that match their rhetoric. In districts where incumbents are blocking progress on a national healthcare system, this coalition will find and support new unbought and unbossed candidates who will fight for universal healthcare to meet the needs of every person.

We will not stand idly by while our country’s unaffordable private health insurance system degrades and bankrupts people and their families. Americans owed $88 billion in medical debt in 2018, and nearly half (45%) of people surveyed said they feared a medical event would bankrupt them. Medical bills are the leading cause of personal bankruptcy despite the Affordable Care Act.

Within this unjust system, Black, Latinx, Indigenous, and other marginalized people are forced to bear the harshest impacts. Dying of Covid at higher rates, people of color also account for 54 percent of North Carolina’s uninsured while making up only 37 percent of the population. Health justice is racial justice.

Furthermore, an estimated 257,000 North Carolinians lost their health insurance and jobs during the first six months of the Covid-19 pandemic. With more than 1.1 million N.C. residents already uninsured at the start of the pandemic, recent job losses have increased our state’s uninsured rate to 20 percent for people under age 65. Only seven states have higher uninsured rates.

Nationally, nearly 90 million Americans are uninsured or underinsured, and millions of people with employer-based health insurance are burdened by ever-increasing premiums, deductibles, and co-payments, often making their coverage too expensive to use. Introducing a public option will not resolve the fundamental problems of commodified healthcare that enriches private insurance companies, large hospital systems, and pharmaceutical companies at the expense of patients.

Fortunately, Improved Medicare for All is a comprehensive solution and studies show it will cost less in the long term. Medicare for All is also a winning issue. In poll after poll, the majority of Americans have declared their preference for a universal, government-administered healthcare system. A 2020 Morning Consult poll pegs support for Medicare for All at 55 percent of voters nationally, while a 2020 Fox News exit poll found support as high as 72 percent of all voters.

This moment in history demands systemic change. Expanded and Improved Medicare for All, a single-payer healthcare system, is within our grasp. To work toward this end, NCM4A will hold public events to reassert healthcare as a human right and mark International Human Rights Day. Events will include a December 10 press conference with multiple speakers in Raleigh and “Bill Burn” Bonfires December 12 across North Carolina, which will observe Covid-19 safety precautions.

As some of us are forced to make hard choices about the coverage we can afford during open enrollment, too many others remain totally locked out. We believe we all deserve better than a corrupt, profit-driven health system and an administration that seeks to uphold the status quo.

Despite the fear-mongering, we believe Medicare for All represents true freedom -- to change jobs, start a business, ensure the health of loved ones, and live a life free from medical debt. In this critical moment at the dawn of the Biden-Harris administration, the North Carolina Medicare for All Coalition won’t relent until the dignity of every individual is recognized by providing truly universal healthcare through Improved Medicare for All.


Common Dreams 2020-11-23

Biden Ran on a Return To Normalcy, but There's Nothing Normal About the American Health Care System

In poll after poll, Americans have indicated their preference for a universal, single-payer health care system. Compromise and half-measures are not acceptable. Medicare for All remains the goal.

Our dysfunctional health care system remains an outlier among the rest of the developed world for not providing universal health coverage. (Photo: Joe Newman via Public Citizen/flickr/cc)

Our dysfunctional health care system remains an outlier among the rest of the developed world for not providing universal health coverage. (Photo: Joe Newman via Public Citizen/flickr/cc)

The federal response to the deadly coronavirus pandemic under President Trump has been a public health disaster with nearly 250,000 Americans dead and no clear end in sight.

In sharp contrast, President-elect Joe Biden pledged to mount a serious response against the coronavirus. Biden implored Americans in a recent speech to continue to wear face masks and announced a panel of health care experts to begin to counter a surge of COVID-19 hospitalizations throughout the country.

On the matter of health reform, however, the president-elect offers measures that would merely bolster and even expand the same private health insurance system that has generated increasing profit during the pandemic while depriving the country of the resources necessary to produce an adequate supply of PPE. Physicians, nurses and other frontline health care workers are fighting COVID-19 with their hands tied behind their backs.

Biden ran on returning the country to normalcy, but there was nothing normal about the American health care system even before the pandemic. In fact, our dysfunctional health care system remains an outlier among the rest of the developed world for not providing universal health coverage.

The American health care system devours an ever-increasing share of our economy with health spending accounting for an astounding 17.9 percent of the GDP, the highest in the world. Yet we have little to show for it. Americans suffer some of the worst health outcomes compared to other industrialized nations. Even before the coronavirus hit the U.S., life expectancy was on the decline. Our infant and maternal mortality rates are higher than those of any comparable country, and racial and ethnic disparities in infant and maternal mortality are getting worse.

The quality of American health care isn’t any good either. Shockingly, more than 250,000 Americans die each year from medical errors. That’s nearly as many as the amount of people that have died from COVID-19 as of this writing.

Is that the kind of return to normalcy that Americans want, need, or deserve?

The answer, of course, is no.

In poll after poll, Americans have indicated their preference for a universal, single-payer health care system. An exit poll on election day conducted by Fox News revealed that 72 percent of voters wanted a government-run health care system. 

That publicly-funded system, more commonly known as Expanded and Improved Medicare for All, is within our grasp. All we need to do is call out those Senators and Congresspeople who are in the pockets of the private, for-profit health care industry. According to Open Secrets, health care providers, Big Pharma, medical equipment manufacturers, and drug and medical product retailers pumped $178 million into the 2020 election cycle so far. Separately the insurance industry (including but not limited to health insurance) added another $85 million. The new kid on the block, adark-money group called the Partnership for America’s Health Care Future, has been targeting Democrats who support either Medicare for All or the “public option” in its 2020 election year ad campaigns. No wonder legislators continue to ignore the clear desire of their constituents for a health care system that puts the public, not the shareholder, first.

For health care reform advocates who want to purge profiteering from health care, returning to “normal” is not an option.

More than 10 years after the passage of the Affordable Care Act (ACA), 87 million Americans remain uninsured or underinsured. The ACA has not changed the fact that medical bills continue to push millions of people into personal bankruptcy, with Americans having borrowed a stunning $88 billion to pay for medical treatment in 2018 alone. Nor has the ACA halted the inexorable increase in premiums, deductibles and copayments that are blocking access to care for millions of workers and their families who have employer-based group health insurance that is too expensive to use.

Biden’s public option plan, which would enable people to enroll in publicly-funded insurance plans that would compete against private insurers on the ACA’s marketplace exchanges, won’t change this picture either. A 2013 analysis conducted by the Congressional Budget Office predicted that a public option would have “minimal effects” on the number of uninsured. For a real world example, we need only to look at the abysmal failure of the nonprofit health insurance co-ops that were given a similar mandate to compete with private insurance under the ACA. Out of the 26 original co-ops, only three exist today.

The public option is destined to fail as long as private health insurers are allowed to thrive. They will find new and increasingly sophisticated ways to undermine public insurance by cherry-picking the healthiest subscribers for themselves and shunting the more expensive, chronically ill patients to public insurance, compromising the potential savings that universal public financing of health care would yield.

While the historic election of Biden and Harris removed the immediate threat of a draconian take-down of the ACA, it does not augur well for the kind of transformative social change that Americans need right now. The struggle continues. Compromise and half-measures are not acceptable. Medicare for All remains the goal.

Jonathan B. Kotch, MD, MPH, a board-certified specialist both in Pediatrics and Preventive Medicine, is Research Professor Emeritus in the UNC Gillings School of Global Public Health.

Jonathan Michels is a freelance journalist and health care worker based in Durham, North Carolina.


OpEd Charlotte Post 2020-08-13

Opinion

Medicare for All would reduce racial Inequities in America
Pandemic exposes, widens gaps in health care
 
Published Thursday, August 13, 2020

by Dr. Jessica Schorr Saxe

STOCK PHOTO
Medicare for All would close gaps in racial inequality in American healthcare.

The American healthcare system is expensive, inefficient, and plagued by racial inequities.

The COVID-19 pandemic shines a harsh spotlight on those deficiencies, particularly for Blacks and other minorities. George Floyd’s murder has forced the country to give long overdue attention to finally establishing racial justice. Now is the moment for us to definitively address healthcare, along with other critical issues of racial justice.

The United States has performed dismally compared to other developed countries. With 4% of the world’s population, we have had 25% of COVID-19 cases. Cases and deaths rise at alarming rates, while many other countries have controlled the spread. In the U.S., Black and Hispanic communities have borne the brunt of the impact with three times the rate of infection and twice the rate of death. In Mecklenburg County, Black people accounted for 40% of the deaths not connected to long-term care facilities.

The main difference between the U.S. and the more successful countries is our lack of a national health program with universal coverage and coordinated health planning. Several of our failures point out how improving and extending Medicare to everyone might have helped with Covid-19, especially for Black people.

Before the pandemic, millions of Americans were already uninsured or underinsured (insured but unable to afford medical care), with Blacks disproportionately affected. Many people deferred testing or treatment for fear of expense. The is the precise opposite of the response needed to protect us all. People who have been exposed or are feeling sick need to be tested so they can be treated and isolated. Their contacts must be traced and quarantined as needed to prevent spread. Instead, many people are dying and suffering severe illness after delaying care. Many who tried to do the right thing and sought testing and care were stuck with large bills.

The pandemic has worsened our pre-existing condition of insurance inadequacy. The surge in unemployment has predictably resulted in millions losing employer-based coverage. Many will remain uninsured, especially in North Carolina and other states that didn’t expand Medicaid. Even those eventually able to secure other insurance will suffer major disruption as they navigate a new bureaucracy to acquire it and may be forced to change providers and medications.


This is the poison pill of our system: just when individuals most need health insurance and our country most needs them to have it, it’s vanishes into the ether.

Why have Black Americans suffered disproportionately from the COVID-19 pandemic? Multiple reasons include inadequate insurance prior to the pandemic, loss of access due to loss of employment, being essential workers, and having less ability to work from home. Black Americans are also more likely to have underlying conditions that put them at higher risk for complications or and death. These conditions are not due to genetics, but to racism, indirectly through its effects on education, economic security, housing, and exposure to air pollution; and directly through the stress of racism itself.


Medicare is the most popular health insurance in the country. Black Americans should take particular pride in it, as Dr. Montague Cobb, president of the National Medical Association, led Black doctors in supporting Medicare, while the almost entirely white American Medical Association opposed it. Because of the hard work of the NMA and the NAACP, hospitals had to integrate to accept Medicare money.


Just as Medicare led to hospital integration in 1966, Medicare for All can be a major step toward eliminating racism and racial inequities. With everyone in the same system, everyone would be eligible for high-quality care. By cutting the connection with employment, no one would lose their coverage if they lost their job. Everyone could get care during a pandemic, protecting their health and that of the public. People with high-risk conditions wouldn’t feel forced to work just to keep their insurance. And everyone could get their necessary preventive or chronic illness care, pandemic or not.

It’s now more obvious than ever that our employer-based health system has failed us. As the pandemic has so harshly proved, it’s time for Medicare for All.

Dr. Jessica Schorr Saxe is a retired family physician in Charlotte who is chair of Health Care Justice—NC. Write her at HCJusticeNC@gmail.com.


LTE Charlotte Observer 2020-08-01


LTE Charlotte Observer 202-07-29


LTE News & Observer 2020-07-29



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