President Joe Biden has stopped short of supporting Medicare for All, saying he prefers to expand the Affordable Care Act. (Photo: Shutterstock)
(Bloomberg) –Progressive Democrats are reviving their Medicare for All plan this week, part of a push for universal health coverage they say is even more urgent after the coronavirus pandemic exposed and exacerbated disparities in the U.S. health-care system.
The bill has little chance of passing this Congress with Republicans and moderate Democrats opposing its wide reach, but the measure lays out progressive priorities for transforming a health care system worth nearly a fifth of U.S. gross domestic product. The plan would eliminate private health insurance and require the federal government to establish a single-payer program that covers all U.S. residents.
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Representative Pramila Jayapal of Washington State, the head of the Congressional Progressive Caucus and one of the bill's sponsors, said the American public increasingly supports a larger role for government in health care.
"While this devastating pandemic is shining a bright light on our broken, for-profit health care system, we were already leaving nearly half of all adults under the age of 65 uninsured or under-insured before Covid-19 hit," Jayapal said. "And we were cruelly doing so while paying more per capita for health care than any other country in the world."
President Joe Biden has stopped short of supporting Medicare for All, saying he prefers to expand the Affordable Care Act. But advocates for a more comprehensive approach say overhauling the entire system in one piece of legislation would yield more savings and provide better outcomes for patients.
"It would be a tough lift in the Senate, but it's an important time to be laying the groundwork," said Eagan Kemp, a health-care policy advocate for Public Citizen, a consumer advocacy nonprofit. "Passing Medicare for All at once is sort of the most advantageous because you then get all of those savings, but we also support improvements in the health care system."
The limitations of the American health system have been especially apparent during the global pandemic. Millions of people were left without health insurance when they lost their jobs. Unequal access to care contributed to the pandemic's disproportionate impact on communities of color.
"The speed at which countries like Taiwan and New Zealand were able to respond — and the much higher death and infection rates that we have over comparably wealthy countries, all of which have some sort guaranteed health-care system — for us really highlights why this debate is so crucial right now," Kemp said.
Opponents argue that a single-payer model would increase wait times and lower the quality of care, in addition to the necessary increase in taxes and government spending. Shifting the full health-care burden to the federal government would cost more than $30 trillion over 10 years, according to some estimates, although advocates say total health spending could decrease in a centralized system that could negotiate drug prices and cut administrative costs.
Even though the U.S. spends more on health care than any other country in the Organization for Economic Cooperation and Development, life expectancy has decreased in recent years, according to a 2019 report.
Premiums rise
And costs for consumers continue to increase. Annual premiums for employer-sponsored family heath coverage rose 55% over the past decade, to $21,342 in 2020 with workers paying $5,588 toward the cost, according to a survey conducted by the Kaiser Family Foundation.
Representative Debbie Dingell, a Michigan Democrat and another Medicare for All sponsor, criticized the current U.S. system that she said "prioritizes profits over patients and ties coverage to employment."
"Medicare For All will build an inclusive health care system that won't just open the door to care for millions of our neighbors, but do it more efficiently and effectively than the one we have today," Dingell said. "Now is not the time to shy away from these generational fights, it is the time for action."
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