Now that the most recent effort by the Republican party to repeal the Affordable Care Act has crashed and burned in the Senate, the possibility that Republicans might actually have to talk with Democrats about ways to improve the health care system in the U.S. has become a more realistic possibility.

In fact, as Politico reports, it has already started happening, with a very quiet effort undertaken by a bipartisan House group that’s been meeting under the radar for the past month. The group, known as the Problem Solvers Caucus, is exploring ways that the ACA might be stabilized —something that’s essential if the program is not to collapse under the Trump administration.

And other prominent lawmakers are talking, too — with progressives from Senators Elizabeth Warren, D-MA and Chuck Schumer, D-NY to former President Jimmy Carter weighing in on the debate — about single-payer insurance. Most Democrats are reluctant to get involved in the Medicare-for-all/single-payer debate, but many progressives believe that now is the time to push for a more radical solution to health care.

And while a Trojan Horse opportunity presented itself to vote for single-payer during Republicans’ efforts to kill the ACA in the form of an amendment presented by Senator Steve Daines, R-MT to advance single-payer in an effort to get progressive and moderate Democrats squabbling over the issue, Democrats uniformly opposed the measure, led by Senator Bernie Sanders, I-VT, who led single-payer supporters in refusing to fall for the ploy.

But another Sanders, Bernie’s wife, Jane O’Meara Sanders, has taken an additional step in the quest to get people talking about what’s at stake on health care. Jane Sanders, a founding fellow of The Sanders Institute, a nonprofit educational organization, joined National Nurses United to deliver a research paper from the National Nurses Union titled “Medicare For All vs. All the Healthcare Each Can Afford” to the offices of all members of Congress.

The paper, according to the Institute, “analyzes our current fragmented health care system and suggests a system of health care reflecting the nurses’ values of caring, compassion and community.”

“Twenty-eight million Americans are currently uninsured and millions more are underinsured, every piece of legislation currently being debated in Congress continues to leave millions uninsured and underinsured, the U.S. spends $9,451 per person on health care every year. [T]his is nearly two and half times the $3,814 average of other major countries and 58 percent of Americans support a Medicare for All system,” the paper says. It goes on to lay out a plan for changing how the system works — and that system includes the Affordable Care Act.

The paper “begins by examining our market-driven health care system and the failings of our private insurance system.” It goes on to “[include] discussions on why adding a government-run public insurance option to the ACA private insurance marketplaces could not remedy the problems the marketplaces face and on the limitations in care under a market-driven system.” Finally, it concludes “it will examine the major features of a Medicare-for-all system and how our country could provide healthcare as a right, not a privilege.”

Tackling the place of insurers in the system, the consolidation of hospital and physician practices, the amount spent on health care and how little return Americans get for their money compared with systems in other countries, the paper presents an approach in which health care is treated as a right and not a privilege. But since it moves away from a market-driven approach, it certainly will not be popular with some of the biggest players in the field: insurers and health care providers.

However, if it at least gets people talking in Washington about alternatives to the current state of affairs, it might achieve its stated goal of “broaden[ing] the discussion to go beyond insurance coverage to a debate about creating a healthy society, with our citizens as the focus.”

Instant Insights /

Sanders Institute delivers Medicare-for-All research paper to Congress

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