The failure of the Republican Party to pass the American Health Care Act (AHCA) is a major victory for the movement. It was a market-based plan that would have worsened insurance for most people in the United States and undermined our public insurances, Medicaid and Medicare. The movement held Republicans accountable and instilled fear in enough of them that they could not risk voting for such extremist legislation.
The AHCA revealed divisions within the Republican Party. Supporters were mostly the ‘Ryan Republicans’. Opposition came from the Freedom Caucus, the Tea Party Republicans who wanted a more extreme bill, and a few ‘moderates’ who recognized the political cost they would have paid if the unpopular AHCA had passed. A poll found that only 17 percent of voters supported the AHCA.
The impact of the resistance movement, which spoke out at Republican town halls, held rallies and marches, protested at Paul Ryan’s Wisconsin office and sent massive numbers of emails and phone calls into congressional offices, was so evident that even the corporate media and leading Democrats gave the movement credit. Without pressure from below, the Republican divide would not have been so large.
The resistance movement created a political environment that made the Congressional Budget Office (CBO) report on the AHCA explosive. When the CBO reported that the AHCA would result in 24 million more people uninsured, there was a large public outcry. Ryancare would have been ‘dead on arrival’ if it had made it to the Senate. Then, when the Republican leadership redrafted the bill, the CBO report came out even worse. The amended version cost $150 billion more over ten years than the original and did not reduce the number of uninsured.
President Trump supported efforts to pass the AHCA, playing the role of “team player” with Paul Ryan, even though it violated many of his campaign promises for a new health law, i.e. it cut Medicaid and Medicare, it did not provide everyone with health coverage and it would have increased costs of insurance. However, Trump did not seem very upset at the defeat. He said that he is open to addressing health care again during his term in office.
Next steps: Mobilize for the health care people need
During the debate on health care, the Democrats were right in their criticism of the AHCA and Republicans were right in their criticisms of the ACA, but neither was right in their solution. The bi-partisans share a common mistake: they treat health care as a commodity, a profit center for investors and big business interests. Neither treats health care as a public good, a human right that is a necessity for all. No one who spoke during the debate on Friday dared to urge what the country really needs: National Improved Medicare for All.
While defeating the extremist Republican version of market-based health care is a victory, the country is still left with the Affordable Care Act (ACA), another market-based system. It allows pharmaceutical companies to overcharge on essential drugs and ensures investors make significant profits from for-profit hospitals, private insurance and healthcare products.The essential understanding that we must share with everyone is that insurance is an investment vehicle to make money for investors, not to provide health care. They make money by charging the highest premium they can and paying the least amount for health services. They are a very costly middleman that is not needed.
The United States would be able to provide high quality comprehensive benefits to everyone for the amount of money that is being spent on health care now if we cut out the waste. A national improved Medicare for All system would greatly simplify paperwork, saving $500 billion per year. And a national health program could control drug prices by negotiating fair prices, rather than allowing the highest pharmaceutical prices in the world. It would also end commodity-based health care and instead treat health care as a public necessity where there is universal access to a national health system paid for up front by taxes. Other industrialized nations recognize that welfare systems are inherently inferior to universal systems. When everyone is included in and uses the same system, it raises the quality of the system.
It is the job of the movement to put expanded and improved Medicare on the political table. The test for the movement that stopped the AHCA is whether it can pivot and build the movement for what the country needs to do in order to solve the healthcare crisis.
To win we must force decision-makers to serve us
The leadership of both parties in power will not put expanded and improved Medicare on the political agenda. We have reported on research showing the U.S. is an oligarchy that serves the wealthy and puts their interests over the necessities of the people. To win the health system we need we must challenge the corporations and Wall Street investors who put profit over health; and we must push members of both parties to support National Improved Medicare for All.
This week, Dr. Carol Paris of Health Over Profit for Everyone and the president of Physicians for National Health Program interrupted a Trump rally in her home state of Tennessee to demand Medicare. At many of the ‘protect ACA’ rallies we saw advocates for Medicare for all, often taking over the meeting when Medicare for all was mentioned. We need more aggressive actions mobilizing for improved Medicare for everyone.
We have allies in the power structure. There is already an excellent bill developed by advocates for a national health plan and introduced by Rep. John Conyers (D-MI) that has 73 co-sponsors. Senator Bernie Sanders said he will be introduce a similar bill in the Senate.
We need to push more people to co-sponsor these bills and we must push those that sponsor them to do more. Sponsors need to put these bills on the political agenda. They need to hold meetings in their communities about the solution to the U.S. health crisis and urge people to become active in supporting their bill. They need to speak about expanded and improved Medicare for all and write about it in order to help build the movement that will support it.
The universal healthcare movement cannot be partisan. The health care we need will not become law without support from both parties, perhaps without the support of future independent and third party candidates. We need to push on multiple parts of the power structure and pull people to our side. Every power holder needs to see the growing movement mobilized for Medicare for all.
There are signs that we may already have unusual allies. Trump may be hearing from people in his circle of advisers that it is time to transform the healthcare system and “drain the swamp” of the healthcare profiteers (profit in health care was illegal until Nixon). The NY Times reported that a friend and adviser to President Trump, Christopher Ruddy, the CEO of Newsmax, has recently been urging Trump to consider Medicare for all.
Steve Bannon has been telling people that the problem with the AHCA is that it was “written by the insurance industry.” He is absolutely right, and the same is true for the ACA, which was written by an insurance executive who was put on the Senate Finance Committee to write the Democratic bill.
The President may be more open to Medicare for All than we realize. During the presidential campaign, Trump promised a great healthcare plan where everyone was covered and costs were controlled. Only expanded and improved Medicare can achieve those goals. During his career, President Trump has spoken in support of a Medicare-type national health system that covers everyone at least five times.
Both of the market-based approaches, the ACA and the AHCA, have proven to be politically unpopular. The ACA cost the Democrats control of the House in 2010, when they lost 52 seats, and helped Hillary Clinton lose the election when voters received their increased premium notices the week of the election. The Republican approach was so unpopular it had under 20% support in the polls and could not even get out of one chamber of Congress, even though the Republicans have a large majority.
Both the ACA and the AHCA have also demonstrated they are failed approaches, i.e. they do not cover everyone, control prices for individuals, provide adequate insurance coverage or control costs for government. These experiences demonstrate it is time for all of us to push for what we need National Improved Medicare for All. Join our campaign Health Over Profit for Everyone.
Time to solve the U.S. healthcare crisis
With tens of millions without insurance and tens of millions more without adequate insurance, there are tens of thousands of deaths annually because of lack of access to health care. There are hundreds of thousands of bankruptcies due to medical illness. Yet, because of the corruption of Congress by those who profit from the healthcare system (like Paul Ryan raising money from the profiteers during the debate), this crisis continues. Think about that – tens of thousands of annual deaths and hundreds of thousands of bankruptcies when the U.S. knows how to solve the problem because the solution has been in place since 1965 for two very costly populations, the elderly and chronically ill.
Medicare is a made-in-America solution that has been proven effective, has minimal bureaucracy, covers everyone and produces excellent health outcomes. This is a campaign the people can win.