Medicare for All!

As Vermont becomes the first state in the nation to enact single-payer healthcare coverage, Senator Bernie Sanders (I-VT) and Representative Jim McDermott (D-WA) have introduced legislation to make Medicare for all the law of the land. Called the American Health Security Act of 2011, Senator Sanders said the legislation is necessary because “The United States is the only major nation in the industrialized world that does not guarantee healthcare as right to its people.  Meanwhile, we spend about twice as much per capita on healthcare with worse results than others that spend far less.  It is time that we bring about a fundamental transformation of the American healthcare system.  It is time for us to end private, for-profit participation in delivering basic coverage.  It is time for the United States to provide a Medicare-for-all single-payer health coverage program.”

Sanders and McDermott have strong backing from Arlene Holt Baker, executive vice president of the AFL-CIO; Jean Ross, co-president of the National Nurses United; and Greg Junemann, president of the International Federation of Professional and Technical Engineers.  All three groups are encouraging this fight for real reform.  “Providing a single standard of high quality care for all is a priority for registered nurses who have seen their abilities to act as patient advocates made more difficult as for-profit interests control more patient care decisions,” said Ross, whose union has been in the forefront of the fight for single-payer. “We commend Senator Sanders and Representative McDermott for their vision and passion to help registered nurses create a more just healthcare system through the American Health Security Act and applaud our brother and sisters in labor for their support,”  Physicians for a National Health Program, which consists of doctors and medical students who want real reform, also are supporting the national legislation, which is unlikely to end up on President Obama’s desk for signature.

Writing in the British newspaper the Guardian,  Sanders says that “Under our dysfunctional system, 45,000 Americans a year die because they delay seeking care they cannot afford.  We spent 17.6 percent of our GDP on healthcare in 2009, which is projected to go up to 20 percent by 2020, yet we still rank 26th among major, developed nations on life expectancy, and 31st on infant mortality.  We must demand a better model of health coverage that emphasizes preventive and primary care for every single person without regard for their ability to pay.  It is certainly a step forward that the new health reform law is projected to cover 32 million additional Americans, out of the more than 50 million uninsured today.  Yet projections suggest that roughly 23 million will still be without insurance in 2019, while healthcare costs will continue to skyrocket.”

All Vermont residents will be eligible for coverage under the system, known as Green Mountain Care.” Originally promoted as a “single-payer plan,” the measure is referred to as a “universal and unified health system.”  Governor Peter Shumlin has said he will sign the bill into law.  “This really is an extraordinarily exciting moment for Vermont,” according to Shumlin.  “We have a long way to travel, but I am convinced we can get healthcare right and this is the bill that will get us there.”

Meanwhile in California, some legislators have revived a bill to create a single-payer healthcare system.  It would replace President Obama’s healthcare reform legislation with a more comprehensive system – one that would cost no more than what people already pay.  Opponents categorically deny that assertion.  One academic observer of healthcare policy said, “If you think the fight over affordable care was nasty, you haven’t seen anything yet.  This plan is going to gore a lot of oxen,” said Gerald F. Kominski, associate director for UCLA Center Health Policy Research.  “No.1 is the insurance industry. They are not about to see their business go up in smoke.”

California’s proposed plan establishes a single- payer “Medicare for All” type of program by pooling the money that government, employers, and individuals already pay and using that money more efficiently by cutting out the middle man – insurance companies.  “There are some 6,000 health plans in California, and health care providers spend about one-third of their resources just getting paid,” said State Senator Mark Leno of San Francisco.  There will be other saving opportunities as well – such as bulk purchasing power for everything from pharmaceuticals to hearing aids, eyeglasses and the investment in primary and preventive care.

When asked if he thought the legislation has a chance to become reality in California, Kominski said, “I’ve seen enough things happen to never say ‘never.’  I don’t know how the ongoing financial crises might change public opinion on healthcare to vote for a more fundamental change of healthcare delivery.”

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