Oppose for-profit cartels through Medicare for All

Stand up to Bully #1 Big Pharma with Improved Medicare for All. Shows cartoon of guy holding Epipen with 500% markup.

by Bill Semple and Burton St. John

Read this piece in the Boulder Daily Camera

While as many as 12 million Americans have lost health care coverage with the arrival of COVID-19, the Partnership for America’s Health Care Future (PAHCF) is rallying. This is a special kind of partnership, better called a cartel, made up of the insurance, drug, and large hospital corporations, spending their millions to talk the majority of Americans (and their political leaders) out of their desire for Improved Medicare for All (IM4A).

For example, The Intercept noted that PAHCF went on a $2.7 million “spending spree” through the middle of March to attack a now-shelved public option proposal in Colorado. The PAHCF wants us fighting about a public option that would leave for-profit insurance in place, to distract us from the real deal, IM4A. Now, reports The Intercept, PAHCF is spending money to point out how private health care will help solve the COVID epidemic.

There are signs, however, that COVID-19 has further exposed the systemic weaknesses in our for-profit health care system. Most pressing is the failure of linking jobs to health care coverage. With the economic downturn, more than 500,000 newly unemployed in Colorado are now on Medicaid, with fully 30 percent of all Coloradans on Medicaid.

And all the signs are that, as the economy struggles, key segments of our workforce, particularly essential workers of color, are notably vulnerable. For example, about half of all Latino construction workers have no health care coverage. More broadly, 60 percent of all retail workers (including grocery store workers) have no employer-provided health insurance.

In sum, COVID has exposed how the for-profit U.S. health care system has made it difficult, and often impossible, for Americans to access affordable health care coverage. And, if the perverse incentives of for-profit imperatives are not addressed, the increased costs of COVID-19 will be shifted on to more Americans, making affordable coverage even more problematic. One 2020 study from the City University of New York found that COVID-19 would impose a minimum of $163.4 billion in direct medical costs in the U.S. Because hospitals use profits from insured patients to offset the costs of treating the uninsured, they will likely raise premiums to recoup these losses. Several have already indicated they will raise premiums significantly over the next year (with some reports as high as a 40% jump in one year).

This counterproductive cycle can be broken. We can spend less to cover everyone with great health care. We can assure that essential workers have and can afford the health care that is essential. We can address the health accessibility inequities experienced by black, brown, and Indigenous communities.

This calls for a two-prong approach – one to address the immediate-term problem of COVID cost-shifting, and one for addressing the ongoing systemic problems of the for-profit health care system.

For the immediate term: U.S. Rep. Pramila Jayapal and Sen. Bernie Sanders have introduced the Health Care Emergency Guarantee Act, HR-6906 and S3790, respectively. This is a game changer. It would cover any out-of-pocket charges for those with insurance, and all health care costs for those with no insurance, for the duration of the pandemic. While it doesn’t gain the administrative simplicity and cost savings of a single-payer system, it would give many Americans the profound security of being able to afford care, especially now.

To address the ongoing systemic problem, the gold standard is IM4A. Rep. Jayapal and Sen. Sanders have each introduced bills in the House and Senate establishing IM4A (HR-1384 and S-1129). We need the administrative simplicity and dependability of Medicare for all, especially the lower overhead that comes when everyone is covered by a single, not-for-profit payer.

COVID-19 has revealed more about our for-profit health care system cartel and how it stymies access to affordable care. The way to address this malady is through a straightforward cure: IMFA’s “everybody in, nobody out.”

Bill Semple, Board Chair, Colorado Foundation for Universal Health Care
Burton St. John III, Professor, Public Relations, CU-Boulder

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