“People with low or moderate incomes do not get the same medical attention as those with high incomes. The poor have more sickness, but they get less medical care,” so said the president of the United States in a message to Congress.
No, that wasn’t President Donald Trump in 2020. It was President Harry Truman in 1945, laying out his plan for a national health insurance program and starting a debate that continues today, more than 70 years later. Shortly after Truman’s proposal, Republicans gained control of Congress and, along with the powerful American Medical Association, quashed any prospects of national health insurance.
President Dwight Eisenhower provided tax credits to businesses that offered insurance to their employees. This corporate welfare, sending taxpayer money to private insurance companies, laid the foundation for the current system.
President John F. Kennedy pushed for single-payer health insurance for older Americans, but, again, the AMA defeated it. In a 1961 debate between United Auto Workers union president Walter Reuther and Dr. Edward Annis, a spokesman for the AMA, Annis argued: “This, sir, is socialism, whenever the government provides for the people, whether they need it or not, and it calls the terms under which this provision is made. This is socialism.”
President Lyndon B. Johnson won a landslide victory over Republican Barry Goldwater in 1964. His electoral mandate enabled him to push through legislation creating Medicare and Medicaid.
Johnson signed the bill in Truman’s home in Independence, Missouri, and less than a year later he hand-delivered the first two Medicare member cards to President Truman and his wife, Bess. Medicare and Medicaid have proven to be among the most successful and popular government programs in U.S. history.
Which brings us to today. Central to the Democratic party’s pitched presidential nomination battle is single-payer health care, also known as “Medicare for All.”
Of the candidates remaining in the race, both Sens. Bernie Sanders and Elizabeth Warren support Medicare for All. In the simplest terms, this would remove the eligibility age for Medicare, currently 65 years and older, making the benefits available to all.
Most other candidates support an expansion of the Affordable Care Act, or Obamacare, while ex-Mayor Pete Buttigieg is promoting a hybrid, “Medicare for All Who Want It” plan.
When Sanders says, “I wrote the damn bill,” he’s referring to S. 1129, the Medicare for All Act of 2019. Warren is among 14 Senate Democrats who have co-sponsored the bill. Medicare for All would cover all residents of the U.S., including undocumented immigrants, from cradle to grave.
The medical journal The Lancet recently published an analysis of the bill from the Yale School of Public Health, describing the enormous savings and improved care that would result if enacted. The Yale study found that Medicare for All would save $450 billion annually, from current costs of just over $3 trillion (that’s trillion with a ‘T’).
Improved health care delivery would also save the lives of an estimated 68,000 people per year, people who die simply because they can’t afford to see a doctor.
In addition to costing less, overall health outcomes would improve, most notably for the 38 million currently uninsured people, and the additional 41 million people who are “underinsured,” prevented from accessing their insurance because of deductibles, co-pays, out-of-pocket expenses and so-called out of network costs.
Sanders is constantly asked on the debate stages if he would have to raise taxes to fund Medicare for All, then he’s denied enough time to provide a complete answer. As the Yale study explains, taxes would go up, primarily for the richest 1% of the population. But overall health care costs would go down. Individuals, families and employers would never have to pay a health insurance premium again. Co-pays, deductibles and other costs would be eliminated.
Single-payer health care would essentially put the U.S.’s for-profit health insurance corporations out of business, cutting hundreds of billions of dollars in wasteful overhead and profit-taking. It would also allow the U.S. government to negotiate pharmaceutical costs, which it currently is legally barred from doing, saving tens or hundreds of billions more.
The Kaiser Family Foundation recently released results of national polling on single-payer health care, which found that more than half of Americans support such a plan. Among Democrats, the support jumps to 87%.
The United States health care system currently costs twice as much per capita as any other industrialized country. Yet, health outcomes are worse, with the U.S. ranking lower than over 30 other countries, with higher rates of infant mortality and lower life expectancy.
From Canada to Costa Rica, universal health care is a reality. Perhaps when the reality TV show of the U.S. presidential election is over, sensible national health policy can become a reality here, too.