By Jay D. Brock, M.D.
FXBG Advance (Fredericksburg, Va.), Feb. 5, 2025
You donāt fix a flat tire by emptying out your carās ashtray. That would be absurd. But when it comes to health insurance, thatās exactly how to describe what those in charge are doing. And have been doing for generations: barely acknowledging the staggering problems built into our present health insurance system, and doing everything except the obvious to resolve them.
And the failure is largely bipartisan. Both partiesā establishments have failed to deliver on the two most important requirements of any decent health insurance system: make it universal, and make it affordable.
While a significant number of Washington Democrats support a Single Payer System called Medicare for All, which would finally make health insurance both universal and affordable, the party establishment scoffs at the idea. Support among Washington Republicans is apparently nilātheir attitude seems to be that we canāt have a system that allows people to sponge off the government. So the United States remains the only advanced nation that does not have universal affordable healthcare.
President Obama recognized that no one in their right mind would deliberately design a system like ours. They would instead go for a Canadian-style Single Payer System. But thinking that you couldnāt put the toothpaste back in the tube, and yearning for Republican buy-in that never happened, he opted for incremental change, and we ended up with the Affordable Care Act (āObamacareā). While the ACA made some significant improvements, they were incremental and failed to make healthcare either universal or affordable. Just one example: out of pocket ACA costs can reach $9200/year. Thatās out of reach for too many enrollees, earning the ACA the unfortunate sobriquet āThe Unaffordable Care Act.ā Yet Democratic leadership still touts the ACA as the way to go. Itās an empty promise.
Regarding universal affordable healthcare, Republicans are even worse. They have tried multiple times to eliminate the ACA and its real if inadequate improvements. A group of House Republicans have recently introduced a bill to repeal the Inflation Reduction Act of 2022āan Act which limits out of pocket drug costs for seniors to $2,000 this year. The Administration is eyeing $3.3 trillion in cuts to Medicare and Medicaidāeven though such cuts are unpopular, including with Republican voters.
We are still waiting for President Trumpās āconcept of a plan.ā
We have, however, heard from Trumpās nominee to run the giant Department of Health and Human Services, responsible for Medicare and Medicaid programs that cover about 4/10 Americans. Robert F. Kennedy Jr stumbled when he said that, regarding who pays for healthcare, āwhen healthcare costs hit 20% (of the economy) there are no good options, only bad onesā¦Shifting the burden between government and corporations and insurers and providers and families is like rearranging the deck chairs on the Titanicā¦.Why are healthcare costs so high in the first place? The obvious answer is chronic disease.ā
Good on him for recognizing the role of chronic disease. But reducing the cost burden of chronic disease will take decades to accomplish, and we need affordable healthcare now. And talk about rearranging deck chairs: RFK Jr didnāt bother to mention the roughly one trillion healthcare dollars that are wasted each year in accommodating our current failed health insurance system.
That system canāt provide affordable care for the 3/4 Americans who worry about unaffordable healthcare costs. It leaves 100 million Americans owing $200 billion in medical debt and a half million Americans medically bankrupt every year. Itās why GoFundMeās and free clinics are an integral component of the American healthcare system. Itās why 70,000 Americans die prematurely each year when they canāt afford timely medical care.
None of this would be the case under a single payer system like Medicare for All. It would eliminate that wasted trillion dollars, enable universal affordable healthcare, and still save hundreds of billions of healthcare dollars a year.
The current Administration thinks otherwise. Instead it is on the same path that previous administrations have taken when it comes to establishing universal affordable healthcare: the path to nowhere. Its nominee for head of the Department of Health and Human Services refuses to say that healthcare is a human right. He will likely also push for the further privatization of our healthcare system, which would be a disaster unless youāre ok with your insurance company denying you the care your doctor recommends for you. The Administration intends to do what it takes to cut government spending to fund even more tax cuts for the richest among us: look for cuts to programs for the poor (Medicaid) and for not-so-poor Americans (Obamacare).
Fed up with the system? Worried it could happen to you? (You should be.) Let our smiling Washington politicians know that you disapprove their trying to fix healthcareās flat tire by emptying out the ashtray. Ask them to support real health insurance reform: Single Payer Medicare for All.