“WHEREAS, expanding health care coverage for every American should be done in a thoughtful, fiscally responsible manner which may include expansion of Medicare partially or fully;”

City of Atlanta Resolution 20-R 4316

On Monday, September 21, the Atlanta City Council passed the above resolution in order to “ensure fiscally feasible and appropriate health care coverage for all resident of the United States.” The Democrat-controlled U.S. House of Representatives should do the same.

I’m very active on progressive social media sites. A significant number of progressives are turned off by Biden (note: I will vote for him). One reason that is often given is his refusal to consider Medicare for All and his fallacious fiscally oriented arguments against it (see below for the facts).

However, last year Assistant House Speaker Ben Ray Luján (D-N.M.), number four in the House leadership, came out in favor of Medicare for All. It’s past time that Pelosi and the rest of the leadership follows his example, motivating progressives to vote blue in November. 

The future of the Democratic Party is dependent on the Party having a clearly spelled out progressive platform, which was sorely lacking in both 2016 and 2020. Simply attacking Trump as an incompetent buffoon (although true) and his misguided supporters as “deplorables” didn’t work then and may not be any more effective in November unless minorities, the young and progressives see a reason to come out to vote.

Healthcare (including Trump’s COVID-19 fiasco) is the number one issue on the mind of voters and the underlying reason why the Democrats took the House in 2018. And, with the probable new SCOTUS being stacked 6-3 with conservatives, there is a very good chance the ACA may not survive at all when the court considers it after the election. 

Even so, when 113 million of us are either still without healthcare insurance or underinsured, simply saying we should maintain the ACA (Obamacare) is clearly insufficient to motivate many voters. It’s surprising that a politically wise pro like Pelosi seemingly does not understand this fact. 

She and the Democrats need to aggressively make a two-fold argument for single payer: 

  1. the current system doesn’t work well and needs major change;
  2. Medicare for All is affordable and less costly in the long run.  

On the first point, per a Gallup 2015 study, Americans are much happier with Medicare (77 percent positive) than with private insurance (69 percent positive). Also, both premiums and deductibles are rising rapidly for employees, as well as causing a drag on company profits and making us less competitive internationally.  

In 2018, the cost for family coverage was $19,616…triple what it was 20 years ago. This also represented a 5 percent increase over the year before, significantly more than the average raise. Plus, 29 percent of the above amount came directly out of the pockets of employees. From the standpoint of these employees, the situation is not projected to get any better, only worse. The politicians saying Americans don’t want to give up their private insurance ignore these facts at their peril. 

On the second point, there is an excellent economic feasibility study (11-18) by the UMass-Amherst Political Economy Research Institute (PERI) which proves that single payer is cost-effective and financially viable. PERI indicates that there are 9 percent of the population uninsured (28 million residents) as well as another 26 percent underinsured (another 85 million people) and unable to make high deductibles and so forth to obtain needed care.

Due to the increase in Americans served under single payer, if there were no changes to the system national healthcare expenditures would go up from $3.24 to $3.63 trillion. However, that’s before accounting for cost savings obtained via single payer, estimated to be 18 percent. Most of these savings will come from drops in Rx pricing (6 percent) and obvious decreases in admin costs (9 percent). PERI states that Medicare for All: “is not only economically viable but could actually reduce health consumption expenditures by about 9.6 percent.” 

This assumption is backed up by a recent Lancet article/study and OECD studies which have shown that other developed nations with universal coverage have a much lower per capita cost. For example, in 2017 the cost per capita for the US was $10,290, while the cost for Italy was $3,541. Many studies indicate that France has the best healthcare system in the world, yet its per capita cost is only $4,902. Meanwhile, we spend 17 percent of our GNP on healthcare while Italy spends 9 percent and France 11 percent. Maybe that’s why our infrastructure is literally collapsing, and our children cannot afford to pay for public colleges and universities without incurring massive debt. 

We need to move on real health financing reform… and we need to move now before the election to motivate progressives. Madam Speaker, you have little time to get on board before November 3.


Image Credit: the Medicare for All card was created by LikeTheDew.com.

Jack Bernard

Jack Bernard

Jack A Bernard is a retired SVP with a national healthcare corporation. He was Chair of the Jasper County, Ga Board of Commissioners and Republican Party. He was also on the Board of Health for Jasper County and is currently on the Fayette County BOH. Bernard has over 100 columns published annually, primarily in the South.