Following the stunning
collapse of Trumpcare, Bernie Sanders is leading the fight by progressives to
win single-payer.
The failure of Trumpcare to
pass the House on Friday was a devastating defeat for both the nascent
administration and the GOP. For seven years, Republicans railed against
Obamacare, promising to “repeal and replace” the law as soon as they could.
Trump himself pledged to do so repeatedly on the campaign trail and from the
Oval Office.
Yet despite controlling both
houses of Congress and the presidency, Republicans could not get a bill through
their own caucus in the House. Speaker Paul Ryan, one of the bill’s architects,
admitted,
“This was a disappointing day for us.”
Democrats understandably
responded with glee. However, besides Bernie Sanders, their side of the aisle
offered little in the way of a counter proposal for how to address the very
real problems with Obamacare.
Trump and Ryan correctly
predict that the issues with the current healthcare system—from rising premiums
to insurers pulling out of exchanges—are only going to get worse over the
coming months and years.
Part of the reason is that
Republicans will do everything in their power to make sure these problems
intensify. Health Secretary Tom Price, a longtime opponent of Obamacare, has
considerable leverage to disrupt the already fragile system set up by the
Affordable Care Act.
But the fundamental failures
of Obamacare stem from the law's reliance on the private market. Why are
insurance companies such as Humana and Aetna fleeing the exchanges? Why are
premiums spiking for many middle-class Americans? Because private companies are
responding to the logic of capital: Maximize profits while reducing costs.
When Republican governors
reject Medicaid expansion, more sick, low-come people require insurance
coverage—the healthcare consumers who are the most expensive to treat. This, in
turn, creates a disincentive for insurers to offer affordable plans through the
exchanges, and, as a consequence, providers pull out of markets and costs rise
for everyone.
This trend is sure to continue
if nothing is done to fix the system, and the only fix that will work is to
expand the risk pool and include everyone. With such a system of universal
coverage, costs would be spread out evenly and illness would no longer be seen
as a liability in determining the costs and benefits of care.
Any real long-term solution
must take this question of the market head on by moving to eliminate the
private healthcare insurance industry.
The real alternative
So how can Democrats respond
to the problems with Obamacare and the coming sabotage? The answer is simple,
and incredibly
popular: Push for a single-payer, Medicare-for-all system.
Bernie Sanders, the most
popular politician in America and open democratic socialist, plans to
introduce legislation
creating a Medicare-for-all system in the Senate in the coming weeks.
Democratic National Committee Deputy Chair Keith Ellison, a co-sponsor of a
Medicare-for-all bill in the House, has reiterated his support for the measure.
And as Dave Weigel reports
at the Washington Post, more Democrats are coming around to the idea. Even
Nancy Pelosi, who recently said
of Democrats, “We're capitalists, and that's just the way it is,” is voicing
support for single-payer.
A single-payer plan would mean
the United States would finally join the rest of the developed world in
guaranteeing healthcare to all citizens regardless of their income. And it
would greatly reduce
costs.
Plus, as Medicare for All
organizer and longtime prisoner justice advocate Mariame Kaba recently explained,
it directly speaks to the needs of working people by building off of an already
incredibly popular program:
What you need in an organizing
sense is you need an issue to be able to appeal to people. Medicare is what we
have that is the most close to a kind of socialist policy in place around
healthcare. It’s the one that people understand, that they already have…You
organize around the things that have material, direct, and urgent impact on
people’s lives, and then you push those people through that fight into fighting
for other things together.
The barriers to passing
single-payer in the current political terrain are significant. Republicans want
to move in precisely the opposite direction, separating government from
healthcare. And moderate and conservative Democrats have historically been resistant
to such a plan.
But following the spectacular
failure of the Republican bill, momentum is on the side of the opposition. This
creates an opportunity that progressive groups are hoping to seize.
Organizations such as National
Nurses United, the Working Families Party, the Democratic Socialists of America
and the Progressive Campaign Change Committee all hope to organize the
grassroots in order to take
advantage of this newfound push for single-payer.
From demand to reality
Much reporting on the GOP failure
to pass Trumpcare has focused on Republican infighting, but the massive
outpouring of resistance from the public played a critical
role. Phone calls from constituents went 50-1
against the bill, and recent congressional town
halls have been mirror images of those crashed by Tea Party protesters
during the fight over Obamacare.
A continuation of this citizen
engagement will be needed to move the country closer to a single-payer system.
In states such as Rhode
Island and California,
local activists are pushing proposals for single-payer. And while the bills
supported by Sanders and Ellison are unlikely to pass now, they provide
Democrats with a rallying point to demand a truly universal healthcare system—a
proposition supported
by 58
percent of Americans.
This would also open the door
to proposals that lay the foundation for single-payer, whether it’s allowing
the import of cheap pharmaceuticals from Canada and other countries,
introducing a public option on the exchanges or lowering the Medicare age to
55—a popular idea that nearly became law with the passage of Obamacare before
it was torpedoed
by then-Sen. Joe Lieberman. Lowering the Medicare age would clear the path for
eventually taking it all the way to zero.
The crashing and burning of
Trumpcare will benefit millions of Americans. Yet millions continue to live
without affordable healthcare. Making single-payer a demand provides a clear
message to politicians: Where do you stand? It also provides an opportunity to
call out the hypocrisy of Trump, who as a candidate promised
“insurance for everybody.”
Single-payer would do that,
and it would cost considerably less than the current system. That is a clear
and simple message, and it's a winning one for 2018 and beyond.
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