Achieving Universal Healthcare in the United States

There are two things to really know about: 1) Our healthcare system is broken 2) We can start fixing it now.

My brother and I have severe food allergies: dairy, eggs, peanuts, and tree nuts, to be exact. If we have an allergic reaction, we would need an instant shot of the Epi-Pen while we wait for EMS ambulances to come to the house (in fact, this happened to me earlier this year). For us, Epi-Pens are a matter of life and death. For others, like former Mylan CEO Heather Bresch, they are rather lucrative price tags for their bottom lines.

The stories of price-gouging on medications for conditions ranging from food allergies to asthma to diabetes to depression to anxiety and many others help illustrate the stakes of the healthcare debate. Failures in healthcare come with very dire consequences, and a broken healthcare system causes much unnecessary suffering. While healthcare is not a new issue, and has always been one of great importance, recent events have pushed us in the direction of transforming our health sector.

First, healthcare costs have stayed unreasonably high in America, for both the government and for working families. It has been a long-term crisis years and decades in the making. Because of the action-or rather inaction-of the federal government, we fell behind the curve in the transformation of the healthcare system since the 1980s. As with other federal programs under the iron fist of “Reaganomics,” the healthcare system more bureaucratic and more focused on administrative paperwork at the expense of care and providing services. Naturally, this led healthcare costs for working and middle-class families to skyrocket, leaving many families and households behind. The working poor and those on the edges already were driven even closer to the brink of debt and bankruptcy (past short-term inflation has not helped with that either).

We can see this in both processes and outcomes. Our country spends twice as much for healthcare as many other countries do. Spending that takes a toll on budget finances that could be invested into other services and programs. Yet, health outcomes for all kinds of demographics and communities are far worse than those of other nations, like the United Kingdom, France, Germany, Spain, and Scandinavian nations as well. It’s true that most of these nations have fewer people and are less diverse, but it does not explain why our mostly private sector healthcare system incurs enormous financial costs for our government (as well as the working and middle classes), while these nations that have mostly, if not completely, government funded healthcare systems that should theoretically be even more expensive to provide. It does not explain the various obstacles that have to be overcome in our American healthcare system, from disproportionate to no coverage at all for behavioral and substance abuse issues, to medical bankruptcy and debt, high costs for basic care and prescription drugs, delay times in care from appointment times and prescription deliveries, the wasted time devoted to filling out large masses of administrative paperwork, and more.

These unnecessary costs stifle our economy, and take a toll on the physical, emotional, social, and cultural well-being of all our communities. We have a devastating maternal mortality crisis in the South that disproportionately impacts black and brown Americans. We have healthcare deserts and education deserts in Rural America, stretching across Appalachia, the Black Belt, the Rio Grande Valley, and far beyond. We have broader racial and geographic disparities in our national healthcare system that hurt the poor and the needy, and a dire opioid emergency. We have a system that forces people to ration their insulin, not take the proper medical treatments and cures they need, and keeps people from getting the care they also need unless an acute medical crisis forces them to.

Increased mortality rates, increased likelihood of severe pre-existing conditions in distressed communities, diseases that disproportionality impact regions like Appalachia and the Black Belt. These are all symbols of a healthcare system that doesn’t serve the public good and that doesn't help working families and households.

But it does fill the pockets of private health insurance companies, as well as the pharmaceutical industry.

Not to say there hasn’t been any progress made. In 2010, the Affordable Care Act was passed and signed into law, which had a variety of tangible benefits (and it would have had even more had not for Joe Lieberman, currently a leader of the No Labels 2024 ballot campaign, who filibustered original versions of the plan). The ACA has protected dependent young adults, tried to bridge the physical vs. mental health care divide, allowed the states to expand Medicaid, and made sure people with pre-existing conditions were covered. President Joe Biden has continued strengthening the Affordable Care Act and making its enrollment system even easier for consumers, and is poised to make even more progress in the Inflation Reduction Act. There are other proposals on the table to lower insulin costs further and import cheaper prescription drugs from other countries-such as Canada. Great work has been done, and there’s still more to do.

First, we believe the transition to a Medicare-for-All single-payer system has immense benefits that puts us in line with many developed countries in Europe and Asia that have shown such a system works. This is not a new idea, and is quite in line with Democratic policy priorities going all the way back to FDR. FDR, after all, proposed a national health insurance system, and Harry Truman later (and unsuccessfully) lobbied for it in a Republican-dominated Congress. Other esteemed Democrats like LBJ, Ted Kennedy, Chris Dodd, Paul Wellstone, Russ Feingold, Tom Harkin, and of course, Bernie Sanders & Elizabeth Warren, all supported proposals to implement a universal healthcare program.

Having a simplified system like this would substantially decrease the administrative layers of bureaucracy in place, reorganize the system so the federal government covers the costs of healthcare costs by all sorts of providers, and ensure that prescription drugs remain affordable. Families & households would indeed save enormous costs that would otherwise be levied in the various co-pays, deductibles, and surprise bills that exist today. It would be a long-term benefit to the crisis we face today.

We realize this would be an enormous task that would take a considerable amount of resources to implement and strengthen-especially if it is to be done in a certain amount of time. And since the proposal is not on the table, we will have to seek other immediate solutions to address this broken system-that perhaps could get us closer to the proposal outlined above.

There is a bill to lower the eligibility age for Medicare and to expand Medicaid further which has been supported by Senators Sherrod Brown of Ohio and Bob Casey Jr. of Pennsylvania. This may be even more necessary considering the demand for Medicare and Medicaid coverage for middle-age demographics unable to afford the care they need for a variety of services. That includes indirectly environmental hazards and the challenges posed by the climate crisis. Senators Sanders and Warren have backed a proposal to expand healthcare coverage to include costs for dental, eyeglasses, & hearing aids services. More drug price caps are on the table. Efforts to take on price gouging and strengthen supply chains exist too. So is the CHIP program for child health insurance. We can also push to support community health centers and local systems that deal with the drug crises in our country, as well as boost behavioral care groups, and expand disability care programs that are in desperate need of assistance in many parts of our nation. Any of these existing proposals would have real, tangible benefits for ordinary Americans.

And finally, there is the ongoing push for a public option. Families like mine have had enough of insurance companies like Blue Cross. Families like mine would like to be in part of a national healthcare system that has a Medicare/Medicaid buy-in. It has been demanded for a long time-even by former President Barack Obama. President Biden has voiced his support for this too. Having an option would place less pressure on families like mine that have to hassle with wealthy and greedy private companies to do their own jobs. Most people who have Medicare and Medicaid want to keep it, and many people who have private insurance want to ditch it.

On any of these reforms, we just need some amount of political courage and goodwill to move the needle forward as we have in the past. Even if there is some pushback. We all might remember when Republicans denounced Social Security as a step towards socialism with government watching where we go and what we do. We all might remember when Republicans denounced Medicare and Medicaid as programs that would result in government-run healthcare and would make our system more complicated and ineffective. We all know the time when Republicans went after the Affordable Care Act, calling it socialized medicine and a liberal wish list. All of these instances of apocalyptical fear-mongering have failed to come to fruition time and time again. Indeed, these government programs and services have left quite a legacy.

In an election that will be defined by inflation aftershocks and all the long-term costs of living, from education, childcare, eldercare, & housing, to grocery & energy prices, supply chains, and more, we could also have a meaningful conversation to address a healthcare system that has been long-broken.

Other Notes on this Past Weekend:

Congrats to the one and only Jesse Jackson on his great work with Rainbow/PUSH.

Will Fair Maps prevail, or be further hit by new losses in the summer redistricting battles?

A fascinating CNN Sunday Special on Immigration.

Here’s more on the unprecedented & ongoing Hollywood Strikes in California.

With this FTC Probe on ChatGPT, how do we think about AI/Big Tech regulation and consumer safety in the years to come?