Supporters of the social insurance model breathed a sigh of relief when President Obama failed to include any reference to a “grand bargain” in his January 27 State of the Union address. “This is a huge shift that comes as a direct result of Americans of all political stripes calling for Social Security benefits to be expanded—not cut,” says Michael Phelan of Social Security Works.
Instead, the President called for a “year of action” that would focus on inequality. Proposals include a much-needed increase in the minimum wage and earned income credit, universal pre-kindergarten, addressing women’s wage inequities and expanding assistance for unemployed Americans.
While these proposals, if enacted, may put a small dent in the vast and growing inequalities generated by the U.S. political economy, much more needs to be done. And, as Dr. Martin Luther King said in 1966, “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”
The U.S. for-profit healthcare system is the most unequal healthcare system in the developed world and social inequality helps make U.S. healthcare the most expensive in the world. Obama could have linked healthcare justice to his call for a year of action. But he chose to focus on celebrating the advances in the Affordable Care Act (ACA). He spoke about the continuation of dependents up to age 26 on their parents’ insurance policy, the prohibition of the use of pre-existing conditions to deny coverage and the incremental addition of coverage through insurance exchanges.
Surprisingly, he did not challenge the 25 states who have cynically and heartlessly opted out of the expansion of Medicaid to all individuals and families earning up to 138% of the federal poverty level, a decision that, a recent study has shown, will cost over 7,000 lives per year. Nor did he begin to prepare the American people for the inevitable buyer’s remorse when they discover that their newly purchased private insurance plans saddle them with narrow provider networks and huge co-pays and deductibles.
Also absent were any proposals to address the new stresses and pressures that the ACA places on collective bargaining. Indeed, the day before the speech, Laborer’s President Terry O’Sullivan and UniteHere President D. Taylor sent a letter to Senator Harry Reid and Representative Nancy Pelosi about the many union members and other working Americans faced with losing their coverage and having to spend thousands of dollars for inferior coverage on the exchanges. “It would be a sad irony if the signature legislative accomplishment of an administration committed to reducing income inequality cut living standards for middle income and low wage workers,” they wrote.
The President challenged the Republicans to “stop trying to repeal a program that is helping people” and come up with constructive reforms of their own. “If you have specific plans to cut costs, cover more people and increase choice, tell America what you’d do differently. Let’s see if the numbers add up.”
In fact, this week, the Republicans finally unveiled their own healthcare plan that doesn’t pass the stink test. It would allow insurance companies to use pre-existing conditions to deny coverage, turn Medicaid into a voucher program and force most Americans to pay a tax on their employer-provided health insurance.
While the Republican Plan would make things worse for everyone except the healthcare profiteers, there is a simple solution that meets all the President’s conditions: make healthcare a right for everyone in America. A single-payer, Medicare for All plan would cover everyone, cost less and allow free choice of doctors and providers.
Let’s make this year our year of action for healthcare justice. Following the lead of Vermont more and more state campaigns are planning to take advantage of the innovation waivers allowed under the ACA beginning in 2017 to blaze a path towards single-payer. Senator Sanders has opened up a new front in the U.S. Senate with his American Health Security Act. HR 676 now has 55 sponsors. And unions everywhere are looking to connect their members’ fights at the bargaining table with a broader movement for healthcare for all.
Let’s take a page from the Social Security movement. They didn’t rest on their laurels after defeating the chained CPI. Rather then circle the wagons, they issued a call to expand Social Security that is resonating with Americans from all political persuasions.
Finish the job! Guarantee healthcare for every worker by guaranteeing healthcare for all!