The reason Republicans haven't come up with a credible plan to replace Obamacare over the last seven years is because they've never thought it was important for all Americans to have access to health care. "Replace" was only recently tacked onto their dogged, unthinking attempts to repeal when they realized that taking away health insurance from 20 million Americans wouldn't be very popular.
Obamacare — the Affordable Care Act, or ACA — was a step in the right direction but it's unsustainable. No health insurance program can work when the pool is made up of the sick, the poor (or the struggling middle class) and the elderly. The health insurance corporations have always cherry-picked the healthy and the wealthy — that's how they've made such obscene profits for themselves (that and by charging enormous premiums and then denying care to their customers at every opportunity). They're dropping out of the ACA because insuring people who are most likely to need health care (including those with pre-existing conditions) hurts their profit margins. I can guarantee that the Republican plan will become known as the UCA — the Unaffardable Care Act.
The only way a system can work is to include everyone in the pool. The solution is single payer health care — Medicare that insures every man, woman and child in the state with expanded coverage including mental health, dental, vision, drugs, long-term care, medical supplies and complementary and alternative medicine. Judging from other more detailed bills proposed in the California Legislature in the past, it will most likely be paid for by a payroll tax that's not connected to any employer, thus freeing people to seek fulfilling work instead of hanging onto jobs that make them ill simply because they provide "benefits." It will save individuals and businesses money by eliminating insurance company profits and most of the billing staffs of care providers, by negotiating prices for drugs and durable medical equipment, and by making global payments to hospitals, thus eliminating fee-for-service.
Sound like pie in the sky? We're the only industrialized nation that doesn't provide universal health care. They all spend far less than we do and their citizens are healthier.
California can lead the nation in fixing a broken, callous health care system that's breaking the back not only of individuals and businesses but of the national economy. We spend more than 17 percent of our gross domestic product on health care — 50 percent more than the next highest spender (France) and double what the United Kingdom spends. These statistics are even more alarming when you consider that Americans see medical professionals far less often than people in countries with universal health care. Ever-increasing deductibles and copays combined with inadequate coverage — frequently leaving out vision, dental and mental health, for instance — cause us to delay seeking care for as long as possible or to avoid it altogether. And that's for the people who actually have insurance. Millions still don't, even under Obamacare.
The Trump administration's attack on the ACA (among other threats to civil rights, environment and education) has galvanized millions of Americans. This is our opportunity to wrest control of our health from the giant insurance companies with their army of lobbyists in D.C. and the state legislatures. As for those who say Medicare for All gives the government too much power — the government is us — if we choose to take it back from the corporations. A Pew Research report says 60 percent of Americans think government should be responsible for ensuring health care coverage for all Americans.
The economic arguments are overwhelmingly persuasive but, at heart, this is a moral issue: You don't deny health care to people because they can't afford it. Health care is a human right.
On Feb. 17, state senators Ricardo Lara and Toni Atkins introduced legislation to replace private medical insurance with a single payer system covering all 38 million Californians, including its undocumented residents. Call North Coast Sen. Mike McGuire (445-6508) and urge him to cosponsor Senate Bill 562, the Healthy California Act. Learn more about single payer health care at www.heal-ca.org and www.healthcareforallcalifornia.org.
Margaret Emerson is a T'ai Chi instructor and writer working toward repealing our ruthless patriarchy and replacing it with a partnership culture built around community, compassion and human rights. She lives in Arcata.
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