SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
single-payer
Americans Are Angry About Their Health Insurance—With Good Reason
As a physician, I have seen patients suffer and die in order to pad the bottom lines of corporate health insurers—and in recent years I have seen this problem getting much worse.
Jan 01, 2025
How should we react when a man is shot to death on the street on his way to work? Our humanity tells us that we should be shocked and horrified—and feel that something is deeply wrong with such a brazen act of murder. Ideally, we would do what we could to help sooth the survivors, condemn the violence, and bring the perpetrator to justice.
So why did hundreds of thousands of people have the exact opposite reaction when UnitedHealthcare CEO Brian Thompson was executed in New York City last month? Because Americans are furious with health insurance corporations—and they have every right to be.
In the immediate aftermath of the shooting, many Americans took to social media not to mourn, but to celebrate. Caustic posts about prior authorization and denied medical claims were common. Sympathetic statements were met with rancor—and in the case of UnitedHealth Group’s own statement, over 70,000 “laugh reactions” before the company made that tally private. Even verbose political figures like Elon Musk and President-elect Donald Trump declined to comment for days. This shooting touched a raw nerve.
The health insurance industry doesn’t have a communications problem, it has a profiteering problem—and no amount of marketing will convince people who have already been burned.
As a physician who’s treated countless victims of gun violence, and who’s life’s work is to care for all of my patients, I found this response to be deeply unnerving. But I also can’t waive it away with simple explanations like online radicalization or trolling. Something much deeper is at play.
For decades, health insurance corporations like United have been growing more powerful and more profitable. How do they generate these profits? By taking in as much money as possible in premiums and paying out as little as possible in medical claims. Over time, they have tried everything from requiring “prior authorization” of care, to excluding high-quality providers from their networks, to imposing a Byzantine series of charges including ever-growing copays, coinsurance, and deductibles. When all else fails, many insurers simply deny claims.
Behind each of these practices are millions of Americans who are made to suffer. I hear these stories routinely in my practice, and they never become easier to stomach. I have seen patients with aggressive cancer who avoided seeing a doctor for months because they feared bankruptcy; patients with chronic conditions like diabetes who are denied treatments that would improve their quality of life; and gunshot victims whose fight to recover and gain a semblance of normalcy is complicated by their health plans saying no, no, and no again.
I have seen patients suffer and die in order to pad the bottom lines of corporate health insurers—and in recent years I have seen this problem getting much worse.
These are the stories that Americans are sharing in this fraught moment. We have to ask ourselves: Are we listening? And what are we going to do about it?
Insurers like UnitedHealthcare will have their own responses. Their PR teams will no doubt work overtime to marginalize aggrieved voices and to highlight what they consider to be the “value” of their health plans. Expect to see glossy commercials and towering billboards touting the “peace of mind” that Americans should enjoy knowing that their medical needs are “covered.” But the health insurance industry doesn’t have a communications problem, it has a profiteering problem—and no amount of marketing will convince people who have already been burned.
Behind the scenes, corporate insurers will no doubt lobby for the preferential treatment they have come to expect. Our newly elected Congress may acquiesce, or they may decide that the industry needs to be regulated—a strategy that has failed to live up to its promise.
Republicans and Democrats have made separate attempts to combine federal requirements with federal largesse in order to make corporate health insurers play nice. But both the Affordable Care Act and the Medicare Advantage program have only succeeded in ballooning the profits of firms like United—without improving Americans’ health or sparing their wallets.
It’s also clear that violence is not the answer, both on a purely human level and because corporate insurers will simply not be moved. UnitedHealthcare will have a new CEO in short order, and it will be that person’s responsibility to boost profits and make shareholders wealthier. Responding to patients’ cries will not serve these ends, so it is not in the cards.
What would help is a proven reform proposal that is long overdue: a single-payer national health program. Such a system would provide universal coverage and comprehensive benefits—with zero out-of-pocket costs. It could be easily implemented given the gargantuan sums we spend on healthcare in this country, and it would be a boon for those who are suffering, and for those who are fearful.
Americans are crying out in pain—and are recognizing that they are not alone in their pain. We should listen to these cries and we should finally, after decades of delay, do something about it.
Keep ReadingShow Less
Why Didn't the Covid-19 Pandemic Result in Medicare for All?
Nobody should die in the richest country on Earth because they can’t afford health care. But this what happens day after day after day, whether we're experiencing a pandemic or not.
Nov 25, 2024
In 2002, the American economist Victor R. Fuchs wrote that “national health insurance will probably come to the United States in the wake of a major change in the political climate, the kind of change that often accompanies a war, a depression, or large-scale civil unrest.”
You couldn’t have designed a crisis much better suited to deliver us this outcome than Covid-19. In 2020, the U.S. faced the largest public health emergency in its history, at a time when 28 million Americans did not have health insurance and millions more were underinsured.
The faulty, patchwork nature of our health care system greatly compounded the effects of the pandemic. In fact, a study by the Proceedings of the National Academy of Sciences (PNAS) found that the U.S. could have seen around 338,000 fewer deaths from Covid-19 if we’d had universal coverage and we could have saved billions in health care costs associated with hospitalizations from the disease.
Nobody should die in the richest country on Earth because they can’t afford health care. The Covid-19 pandemic should have made clear once and for all how irrational and cruel our system is. We are the only developed nation that doesn’t guarantee health care to all citizens. As a result, tens of millions of Americans every year suffer without access to basic medical care, while insurance companies are allowed to make record profits. There are people in America who have to ration prescription drugs, while a few miles over the border in Canada, they could get these same pills at a fraction of the cost. There are people who have to forgo life-saving surgeries, because they can’t afford the procedures. Roughly a third of all GoFundMe campaigns in the U.S. go to people raising money for medical treatments.
In April, 2020, a nurse in the intensive care unit of a New York City hospital named Derrick Smith, wrote on Facebook that one of his patients asked “who’s going to pay for this?” before being intubated and placed on a ventilator, seemingly more concerned about the cost of the procedure than what the outcome would be. These would end up being his last words.
Meanwhile, the CEOs of 300 health care companies collectively made more than $4.5 billion in 2021, according to Stat News. The obvious conclusion is scathing.
Lockdown orders during the pandemic led to a massive spike in unemployment, yet despite significant job losses, the number of insured Americans actually increased, primarily due to emergency Medicaid eligibility policies. This amounted to the government (at least, partially) performing the function of a national health care system – i.e. filling gaps in coverage left by the private insurance industry. Unfortunately, as pandemic-era emergency measures ended, millions of Americans lost this coverage and private insurance returned to business as usual.
A number of factors contributed to America’s poor pandemic performance relative to other countries; a slow government response in terms of travel and testing, PPE shortages and delays in testing rollout. But it’s almost certain that addressing Covid-19 would have been easier if everyone had health insurance. According to the consumer health advocacy organization Families USA, roughly 40% of Covid-19 infections were associated with lack of health insurance.
In general, gaps in insurance coverage tend to accelerate the spread of diseases. People are less likely to get tested if they don't have insurance for fear of large medical bills. The more people who have insurance and a relationship with a primary care physician, the more cases can be diagnosed and treated quicker, thus reducing the likelihood of serious infection. Slowing the spread also reduces the strain on hospitals, making it easier to treat all patients.
There were some countries with single-payer that fared poorly during the pandemic. Italy, for instance, was hit very hard, in part because they had a lot of people in the vulnerable age range. However, many of the best-performing countries, particularly outside of Europe (New Zealand, South Korea), were those with single-payer systems. Taiwan, which transitioned to a single-payer system in the 1990s, achieved Covid-19 zero without a lockdown.
There were other factors which should have made Covid-19 uniquely suited to deliver us major health care reform. Unlike a number of other public health crises (the opioid epidemic, homelessness), Covid-19 received near-constant media coverage. It was front-and-center in everybody’s mind for three years. It also came on the heels of two back-to-back election cycles in which Medicare For All was a key issue in both debates and public policy discussions.
Public support for Medicare For All was at an all-time high in 2020. And in 2021, when Rep. Pramila Jayapal introduced the legislation, it was co-sponsored by a majority of Democrats in the House. Nothing like that had ever happened before. Even according to right-wing outlets like the Pacific Research Institute (PRI), Covid-19 led to a significant spike in support for single-payer.
Why, then, did nothing happen? One major problem was that the pandemic kept people inactive. The public was too atomized and immobile for any effective, coordinated response to cohere. The pandemic created a lot of pent-up anger, much of which got unleashed in the summer of 2020 via the Black Lives Matter protests, coming at a time when many people had been stuck in lockdown for months, many without jobs. When the spark was lit, it quickly became a lightning rod for solidarity and popular discontent.
The biggest problem is that single-payer health care is opposed by some of the most powerful special-interest groups in the country; the private insurance industry, pharmaceutical companies, and the for-profit hospitals. Health care is a massive sector of our market economy, a multi-trillion-dollar a year industry, so despite widespread popular support for the program, there is currently no mechanism strong enough to bring this public pressure to bear on politicians.
If we are to rise to the level of the rest of the developed world and guarantee health care to all citizens, we need to constitute an organized popular opposition which can participate in shaping public policy. Ideally, this will mean grass-roots initiatives backed by a strong labor sector—unions in the nursing, trades, and service sectors working in conjunction with local advocacy groups. We must capitalize on the momentum built up in 2020 and continue to push single-payer forward. If we organize and act to exercise our power, this is hardly a utopian goal.
Keep ReadingShow Less
Medicare for All Advocates Welcome Obama DNC Remarks as 'New Opening for Reform'
The former president said Democratic nominee Kamala Harris "knows we can't stop" at the Affordable Care Act.
Aug 21, 2024
A brief aside in former President Barack Obama's 35-minute speech at the Democratic National Convention Tuesday night provided a glimmer of hope that a Kamala Harris victory in November could be a catalyst for transformational change to the United States' disastrous for-profit healthcare system.
Obama—who before becoming president described himself as a "proponent of a single-payer universal healthcare program"—told Democratic delegates, leaders, and activists gathered inside the United Center in Chicago that the party should be "proud of the enormous progress that we've made through the Affordable Care Act," the 2010 law commonly known as Obamacare.
"But," the former president added, "Kamala knows we can't stop there, which is why she'll keep working to limit out-of-pocket costs."
Obama's remarks were far from an explicit endorsement of Medicare for All, a longstanding progressive goal that Harris backed as a senator and continued to support—at least in name—as a 2020 presidential candidate.
But longtime single-payer advocate Michael Lighty told Common Dreams on Wednesday that Obama's acknowledgment that the ACA has not been nearly enough to rein in the nation's out-of-control healthcare costs and crack down on the rampant abuses of the for-profit insurance industry "signals a new opening for reform" if Harris defeats Republican nominee Donald Trump.
"I was struck by the juxtaposition of 'access to affordable coverage,' which is the usual centrist frame for healthcare reform, and this reference to going beyond the ACA," Lighty said in response to Obama's comments. "It recognizes that rising costs overall and out-of-pocket costs especially are unsustainable."
"The cost frame is good for Medicare for All advocates," he added, "if we 'prosecute' the argument for the savings generated by Medicare for All."
Research has repeatedly shown that a Medicare for All system of the kind envisioned by Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.)—the leading single-payer advocates in Congress—would cost less than the status quo while providing everyone in the U.S. with comprehensive insurance coverage for free at the point of service.
Under the nation's current for-profit system—which leaves tens of millions of Americans uninsured or underinsured and struggling to afford their out-of-pocket costs—annual healthcare spending is projected to rise to $7.7 trillion by 2032, according to federal estimates.
"It is clear that the North Star of a Harris-Walz administration is consistent with what Senator Bernie Sanders said from the DNC stage last night: guaranteeing healthcare to every person in this country."
Despite co-sponsoring Sanders' Medicare for All bill in the Senate in 2017 and campaigning on a proposal that donned the "Medicare for All" label during the 2020 Democratic primary, Harris has not made the popular progressive idea part of her 2024 platform.
A Harris campaign official toldPolitico earlier this week that Medicare for All is "no longer part of" the vice president's healthcare policy agenda, which has thus far focused largely on slashing prescription drug costs and relieving the burden of medical debt.
But Medicare for All advocates, who have seen support for the proposal surge at the state and local levels amid federal inaction, are not disheartened by the vice president's decision to sideline single-payer in her 2024 campaign.
Alex Lawson, executive director of Social Security Works, pointed to the newly unveiled Democratic platform's support for expanding Medicare benefits to include dental, vision, and hearing services as part of a viable "path forward."
"It is clear that the North Star of a Harris-Walz administration is consistent with what Senator Bernie Sanders said from the DNC stage last night: guaranteeing healthcare to every person in this country, so if you get sick you get the care you need," Lawson told Common Dreams. (The Democratic platform states that "healthcare should be a right in America, not a privilege"—a line popularized by Sanders.)
"As president," said Lawson, "it is clear that Kamala Harris would use every tool at her disposal to rein in the corporate greed, delays, and denials of the current system and continue building step by step towards a goal of universal guaranteed healthcare."
Rose Roach, national coordinator of the Labor Campaign for Single Payer, offered a similar assessment, telling Common Dreams in an email on Wednesday that while President Joe Biden "was clear that he did not support Medicare for All," he "supported important improvements to traditional Medicare that begins to build the public infrastructure we'll need for Medicare for All when it does pass"—specifically the drug price negotiation program and new constraints on corporate-run Medicare Advantage plans.
"The Labor Campaign for Single Payer believes VP Harris is equally committed to securing and protecting traditional Medicare and will work with the movement to continue the work of stabilizing our public Medicare program," said Roach. "Improving and expanding traditional Medicare, protecting it from the privatizers who are overbilling Medicare while inflicting obstacles for enrollees to access care via onerous prior authorizations and outright claims denials, is job one."
"Doing so not only offers the infrastructure building we need on the pathway to Medicare for All," Roach added, "but it also makes traditional Medicare affordable for enrollees, unions who negotiate retiree health benefits, and even for employers who offer retiree benefits. It's a win-win."
Keep ReadingShow Less
Most Popular