By Pramila Jayapal
Washington Post, August 1, 2019
In the wake of the second Democratic presidential debate, it is clear that Medicare-for-all has become a defining issue of the 2020 election. Earlier this year, when I introduced our comprehensive, 120-page “Medicare for All Act of 2019,” I expected attacks from big pharma and for-profit insurance companies. But I did not expect misrepresentations from Democratic presidential candidates about what the bill is and is not.
Let’s be clear about the scale of this crisis. The United States currently spends an astronomical $3.6 trillion per year on health care — almost double what peer countries spend — and it is set to increase within 10 years to $6 trillion annually. Pharmaceuticals such as basic insulin cost up to 10 times less in Canada for the exact same drugs. Approximately 500,000 Americans turn to bankruptcy each year because they cannot afford medical costs — and that includes people with insurance.
With so much at stake, facts matter. So let’s get them right.
First, it is a myth that Americans love private insurance. The vast majority of Americans are deeply frustrated with the health-care system — even if they have private insurance. Opponents and pundits often quote polling that suggests support for Medicare-for-all drops when you tell people that their private insurance plan would go away. But when polls accurately describe Medicare-for-all, and explain that you can keep your doctor or hospital, the majority support increases. People are happy to get rid of private insurance; they just want to know they can keep their doctors and hospitals, even if they switch or lose their jobs. Medicare-for-all would let them do so.
Second, it’s wrong to assert that taxes will rise without talking about what health care currently costs Americans in premiums, co-pays and deductibles. The average American family with employer-sponsored insurance incurs more than $28,000 dollars in health-care costs per year, of which about $15,800, or 56 percent, is paid by employers. And many argue they still can’t get the care they need. Americans are smart enough to be asked questions like: Would you be willing to pay more in taxes each month if you saved more money by not paying private insurance premiums, deductibles and co-pays and were guaranteed high-quality health care?
Third, it is simply false that labor unions don’t want Medicare-for-all. Sure, they fought hard for employer-sponsored health insurance plans for their workers. But they, above all others, recognize that the rising costs of insurance premiums are directly related to stagnating wages and, more and more, the pressure of those costs hurts worker power at the bargaining table. Take a look at the unprecedented number of unions that have endorsed our bill, all of which know Medicare-for-all is necessary.
Fourth, comparisons of Medicare-for-all to the GOP’s push to “repeal and replace” the Affordable Care Act are simply unfounded. Republicans are the only ones trying to take away health care. There is absolutely no daylight between leading on Medicare-for-all and fighting to shore up the ACA right now, or stopping the GOP from stripping care away. The Affordable Care Act made profound improvements to our health-care system. But it was never meant to be the end goal, since it does not address the real disease in our system: a profit motive that leaves millions either without access to care, bankrupt or unable to afford medication in the world’s richest country. We can strengthen the ACA and work toward Medicare-for-all at the same time. Even former president Barack Obama agrees.
Fifth, we simply cannot expect to bring down the costs of health care in the United States without taking on the for-profit insurance and pharmaceutical corporations, which are raking in billions of dollars at the cost of American lives. Incremental steps such as a public option might sound appealing but would still leave more than 10 million people without coverage while keeping in place a costly private-insurance middleman that eats up 25 to 30 percent in administrative waste and profits. If we want to achieve true universal health care while containing costs, Medicare-for-all is the only answer.
Finally, Democratic candidates should stop using one-liners from industry front groups and Republican playbooks — such as “Medicare-for-all would shutter hospitals,” or telling seniors that “Medicare goes away as you know it. All the Medicare you have is gone.” These claims — amplified by contributions from the private health-care industry — are designed to incite fear and sow confusion. I’ve spoken with several hospital CEOs who see Medicare-for-all as a lifeline for their hospitals — particularly safety-net and rural hospitals that are barely surviving under the current system. And my Medicare-for-all bill improves Medicare for seniors by adding additional benefits such as dental, vision, hearing and long-term care.
As the debates continue, I hope that my fellow Democrats will take a good look at our bill and get the facts right. The Medicare-for-all movement has overwhelming public support, unprecedented grass-roots organization, and a serious plan that is ready to change our health-care system right now.
Health care is the top issue for voters, and they deserve to know the truth about the solutions we are proposing. I’m willing to debate Medicare-for-all with anyone — but we owe it to all Americans to stick to the facts.
Pramila Jayapal, a Democrat, represents Washington’s 7th Congressional District in the U.S. House.