Obamacare repeal gives hope for advocates of single payer healthcare

A rally in support of universal healthcare in Los Angeles. (Photo credit: Larry Buhl)

The U.S. Senate worked long hours this week, with Democrats holding all night floor protests and Republicans casting simple-majority votes in the wee hours. In a 2:00 a.m. vote Friday, the GOP approved another controversial cabinet nominee: Affordable Care Act foe and Medicare voucher proponent Tom Price, who took the oath of office just hours later.

Last month the Republican-led congress passed legislation to begin dismantling the ACA, also known as Obamacare, which as of March, 2016 insured 20 million Americans. Republicans have promised to replace it, but have yet to present a single plan they can all agree on.

Health care advocates and a growing number of Americans say the demise of Obamacare is a chance to push for something better, a single payer health care system, or Medicare for all. FSRN’S Larry Buhl reports from Los Angeles.

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At a recent Los Angeles rally for affordable health care, Valerie Ewald of the California Nurses Association had a direct message for President Trump: “He says, and I quote verbatim, ‘We’re going to have a health care that’s far less expensive and far better.’ Unquote. We say, we can help you Mr. President. All you have to do is give us Medicare for all.”

In 2010, when healthcare reform was being debated in Congress, a government-funded option, like Medicare for All, or single payer, wasn’t on the table. President Obama said the compromise, the Affordable Care Act, or Obamacare, was at the outer edge of what was politically possible. The ACA reformed the most notorious abuses of the private insurance system but it didn’t always contain costs. And thanks to a Supreme Court decision, governors could refuse to take federal money that would make it more affordable.

Republicans in Congress vilified the ACA from the start, saying it removed patient choice and created bureaucracy. And they voted to repeal it more than sixty times.

Now Republicans control two branches of government, and they have the chance to pass an alternative. But they don’t have one, at least not one they agree on, and nothing the Democrats would find acceptable. House Speaker Paul Ryan promises something will pass this year, but he hasn’t given details. Last month Kentucky Senator Rand Paul offered an Obamacare replacement that consisted mainly of a tax credit for insurance.

At the Los Angeles rally, advocates saw a silver lining: a new chance for single payer health care.

“Our people need to be taken care of,” says Violet Benton. “We don’t need people dying at the ER door or on the street.”

“We should have a way to pay into a public health care system where they will be provided with the health care they need,” remarks Robert McGill.

“The only way to affordably and effectively cover everyone is single payer, or a Medicare for all expanded to everyone,” Jennifer Levins says.

They’re not alone in saying universal health care is a right.

In a recent Monmouth University poll, respondents said health care costs were a bigger concern than terrorism. And in a 2016 Gallup Poll, 73 percent of Democrats, and even 41 percent of Republicans, favored replacing Obamacare with federally funded healthcare for all.

“The Republicans have nothing up their sleeve in terms of actually meeting the goals they promised their voters they would meet,” explains Steffie Woolhandler, a professor at CUNY School of Public Health, Hunter College and co-founder of Physicians for National Health Care. “The insurance industry and drug industry hate the idea of national health insurance. They spend hundreds of millions of dollars to lobbying state and federal politicians to try to block it. But I believe in democracy. I think if the majority of Americans want something, they’ll be able to hold politicians feet to the fire and get it.”

Most health policy analysts, even those who favor single payer, say moving from a hybrid public-private health system to one fully funded by the government, like Canada’s or Denmark’s, would be impossible to achieve quickly.

Harold Pollack is a health policy researcher at the University of Chicago. He says single payer would be ideal, but that its advocates need to work through the complexities.

“What do we do with rural hospitals that have narrow margins? How do we somehow get the politics to work so that it’s realistic for lower reimbursement rates to really happen?” Pollack asks “There’s also how do we deal with all the existing structures of Medicare and private insurance? If you thought ACA was complicated, wait until you get to the transition problems that we would have if we truly went to a single payer.”

Few Americans want to go back to the way things were. In recent town hall meetings across the country voters have been expressing anger at Republicans for repealing the ACA without a replacement.

And here at the LA rally, participants say if Congress doesn’t replace it with something better, they’ll remember it at the voting booth.

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