Everyone is getting behind
this prescription for a better healthcare system. But what is it exactly?
sin•gle-pay•er health•care
noun
1. A healthcare system in
which a sole insurance provider—for us, Uncle Sam—covers all citizens.
2. One of the more dependable
spaces in “Bernie Sanders Speech Bingo.”
“Most of the health economists
I know would love to see single payer—Medicare for all.” —New York
Times columnist Paul Krugman, who nonetheless opposes single payer because
he considers it “too heavy a [political] lift”
Why Would We Want This?
Our current system of private,
for-profit insurance and its elaborate architecture of premiums and co-pays
leaves 28 million uninsured, which could go up if Obamacare is repealed. Plus,
many of those with insurance still can’t afford the care they need. With the
GOP threatening to kick another 20-some million off by repealing Obamacare,
more and more people are embracing the radical notion that maybe poor people
shouldn’t die just so corporate stockholders can make a few extra bucks.
Progressives in Congress have been proposing single payer for decades, and
Sanders is expected to put forward a new bill shortly. This time, thanks to
constituent pressure, even some mainstream Dems are starting to fall in line.
But That Could Never Work
Actually, it has! Canada has
had a single-payer system since 1984; Taiwan’s has been around since 1995. The
Finns have a localized single-payer system with per capita health expenditures
less than half those in the U.S.—and they live longer, too. Even here we have a
single-payer system for seniors, called Medicare.
What Are We Waiting For?
Those holding their breath for
Trump to sign Bernie’s healthcare bill have long since suffocated, but there’s
room for cautious hope in the states. California came close in June, when a
single-payer bill spearheaded by the nurses union passed the state Senate
before being shelved in the Assembly. Some progressives worry that a
state-level single-payer policy could be less financially stable than a
national one, but others see it as an achievable first step. After all, Canadian
single payer started
in a single province.
Today Blue Cross, Tomorrow the
World
Nationally, there's energy
behind an “Expanded and Improved Medicare-for-All” bill, lowering the qualifying age for
Medicare from 65 to 0. It would also eliminate cost-sharing and cover a wider
variety of care, taking a step toward the more ambitious goal of fully
socialized medical service, where all facets of health provision—hospitals,
dentist visits, pharmaceuticals and, hell, even veterinary care—are detached
from the whims of the market and distributed freely and equally in the public
sphere.
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