Listening to Obama’s health care rhetoric since 2008, I was under the impression his administration would fight on behalf of the 51 million uninsured Americans, not bow to the industry seeking preservation of profits.
The Affordable Care Act (ACA) may allow citizens to find a program meeting their needs, but it does not remove co-pays and ensures the industry rocketing profits by coercing citizens into buying a program that may meet their needs, but not their bank accounts.
In essence, the United States has been sold out by a misnomer for universal coverage.The ACA was crafted by the health insurance lobby and pharmaceutical companies, the very interests that expanded health care was meant to buttress. This moment is a point of shame on the federal government and epitomizes public-private partnerships which jeopardize democracy.
Progressives have long advocated a single-payer system that would mimic industrialized nations with universal coverage. While conservatives bark that universal coverage would ration health care availability, wealth disparity in the United States already rations coverage through expenses.
A single-payer system would organize one bureau (or several regional bureaus) for health care finance, as opposed to many private bureaus that drive up clinical costs. Administration constitutes 31 percent of U.S. health care costs, almost three times other industrialized nations with universal coverage, according to Physicians for a National Health Program (PNHP).
PNHP writes the “potential savings on paperwork, more than $400 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.”
Obviously, this model translates to loss in bureaucratic jobs which keep papers pushing. However, given that these individuals work in administration (and the United States has a surplus of administration), these workers are mobile, capable of finding work elsewhere.
All the same, demand for health care providers will increase, thanks to expanded coverage. Single-payer could put the nursing boom to work. As the ACA inflates bureaucracy, premiums are expected to rise for under subsidized plans, thus exacerbating the administrative obstacle.
The Centers for Medicare and Medicaid Services (CMMS), under the Obama Administration, even admits that cost premiums will rise for two-thirds of small businesses.“This results in roughly 11 million individuals whose premiums are estimated to be higher as a result of the ACA and about 6 million individuals who are estimated to have lower premiums,” according to a CMMS report from February.
As a single-payer system would use the existing Medicare and Medicaid savings system, plus a 2-percent payroll tax on employers, premiums would disappear from the equation and citizens would actually save money. The amount of money individuals spend for health care pales next to the proposed payroll tax.
Finally, provider choice for consumers will be invigorated under a single-payer system. Rather than shop for affordability (which will continue under ACA), consumers could shop for adequacy.
The health insurance lobby is wickedly powerful. Collusion caused the beeline from an inclusive program (the system I pulled from Obama’s early rhetoric) to a coercive one where individuals who fail to sign up are fined, whether or not they find a subsidized program that fits their needs and bank accounts.
The ACA may be a step in the right direction, as some Democrats propose. However, a critical examination of the legislation suggests that it is moreso a mandated buy-in to private providers.
The ACA is piecemeal reform at best, coercive cop-out at worst. Either way, it is neither progressive legislation, nor a bulwark to the health care lobby.
