Medicare for All talking points

Our health care system is broken

• Our country’s broken health care system produces some of the worst health outcomes in the industrialized world—the U.S. has the highest rate of infant mortality, and the highest number of avoidable deaths—and devours an ever-increasing share of our economy with health spending accounting for a astounding 17.9 percent of the GDP.
• Despite the improvements of the Affordable Care Act, 28 million Americans remain uninsured, without access to primary care that could prevent costly and life-threatening diseases.
• In addition, 41 million Americans are underinsured, facing prohibitively expensive co-pays, premiums, and deductibles that limit access to care.
• Even if you are one of the 175 million Americans with insurance, illness and injury continue to push patients toward income instability and bankruptcy. According to a 2018 Gallup poll, Americans borrowed a whopping $88 billion over the last year to pay for health care!

Right now, our health care system is centered around profits, not people

• In the United States, the struggle for the human right to health care has been a struggle waged against the private health care interests like the insurance and pharmaceutical industries and the American Medical Association (A.M.A.).
• A.M.A. members have taken some steps to ameliorate their past misdeeds, but as long as they oppose a universal, single-payer health care they will remain on the wrong side of history.
• For more than a century, market-driven medicine and the A.M.A. have worked to quash efforts towards national health insurance. Today, they continue to support reforms aimed at hijacking the universal healthcare movement to prevent an “everybody in, nobody out” national health care program.

But we believe health care should be focused on meeting human needs, not corporate profits

• As healthcare providers, we believe profits and markets are anathema to health. Denying care to the sick to extract profits is an abomination worth standing up against.
• We do not live in isolation from each other and our greatest public health victories have been won through building public infrastructures to protect and sustain our health. Our inequitable health system makes our health contingent on the needs of the market instead of human needs. This inhumane system divides our communities and individual patients into nothing more than parts of financial payers and consumers.
• Any healthcare reform that includes medical profiteers, including the insurance industry, is not putting the health and wellness of patients first. The only real health care reform provides the same care for all Americans: the same care for the uber rich and the urban poor, for Wall Street financiers and rural farmers, for the high-tech jet set and working-class families.
• Single-payer health care is a reform but one that has huge implications. The right to health care is relevant to every person and has the potential to empower other human rights struggles.
• This is a moral campaign that we’re waging. Single payer loudly proclaims that human beings have intrinsic value simply because they are human. No other cause seems to sum up what it means to be human—birth, life, pain, death—than health and health care.
• We demand that insurance companies, Big Pharma and the A.M.A. stop funding misinformation campaigns and peddling reform measures that only fracture our healthcare system even more, dividing people up into plans that ensure that some have a little and others, a lot.
•  As medical students, physicians and healthcare workers, we didn’t take an oath to a political party, or to health care corporations or to insurance companies. We are the face of health care and we demand what most Americans already know: market medicine has got go!

The answer to our collective heartache is Medicare for All

• • H.R. 1384 (Medicare for All Act of 2019)
    • Introduced by Rep. Pramila Jayapal (D-WA), HR 1384 now has 117 co-sponsors.

• Why is Medicare for All better than what we have?

• • • • All U.S. residents are eligible.
      • Offers comprehensive benefits including vision, dental, and long-term-care services.
      • There would be no premiums and no cost-sharing.

• What changes?

• • • • Most current sources of coverage, including the current Medicare program, Medicaid, and all private insurance is eliminated.

• What stays the same?

• • • • The Veterans Administration health program and Indian Health Service.

• When do we get it?

• • • • People 55 or older and 18 or younger are immediately covered and everyone else is transitioned into the program within two years.

• What happens to the people who work in the private health insurance industry?

• • • • The staggering complexity of our current insurance driven health care system requires a tremendous number of administrative staff and resources, costing around 30% of all U.S. health care expenditures. Yes, Medicare for All will eliminate many administrative jobs but in turn it will create many more health care jobs to accommodate the tens of millions of patients that will now be able to receive health care. So, there will be a significant net gain in jobs as a result.
      • Medicare for All is a job creator, and the House of Representatives Medicare for All Act (HR 1384) includes provisions for job retraining and other assistance for displaced administrative workers who’s old administrative jobs would no longer be needed in the far simpler and cost effective Medicare for All national health care program. In fact, HR 1384 provides financial support for five years for people who lose their jobs because of the new program.

• How does it decrease the profit motive in health care?

• • • • No more private insurance!
      • People could buy supplemental insurance to cover benefits not included in the program, but insurers cannot sell duplicative benefits.
      • Global budgeting
        • Secretary would establish a national health budget and to allocate funds to new regional health administrators across the country though global budgets with hospitals, nursing homes, and other institutional providers.
          • Institutional health providers’ budgets could not be used for nonpatient care including capital projects, profits, marketing, or payment incentives or bonuses. Health providers would have to apply for approval of capital projects, such as purchases of new or replacement technology, which would be funded separately.

• How is it paid for?

• • • People would pay more through progressive taxation with the amount varying across the income distribution.
  • For more information, see the Commonwealth Fund comparison tool

However, transformational health reform like Medicare for All will not be won with only a policy

• Private health insurers, pharmaceutical companies and banks (which have ensnared millions of Americans indebted by medical expenses) stand to lose too much if America moves to a single-payer system. They have and will continue to fight to keep the money flowing for as long as they can.

So if we can’t just rest on the merits of good legislation, what can we do?

• We organize. As former PNHP President Dr. Andy Coates points out, “Of all the social reforms that could transform the country, single payer seems to me the most likely to happen. Still, we don’t have a mass movement of millions of people pushing for this, and that is what it will take.”
• Our healthcare crisis requires a collective solution. The people with “skin in the game” is where we’ll find the answer; the poor, the elderly, the disabled, workers, teachers and students. Medicare for All, despite benefiting everyone, will not be won by appeasing profiteers but instead will require us to choose between corporate interests and each other.

Single payer is a reform but it has radical implications. The right to health care is relevant to every person and has the potential to empower other human rights struggles.