Back when Obamacare
was being negotiated, Congress could have circumvented the private
insurance industry by simply expanding Medicare to cover everybody.
Medicare isn't perfect, of course, but it remains one of the most
popular institutions in America because its single-payer model
guarantees access to decent, cost-effective healthcare rather than just
meager health insurance.
Whenever scandal arises in Washington, D.C., the fight between the two
parties typically ends up being a competition to identify a concise
message in the chaos—or, as scientists might say, a signal in all the
noise. This week confirms that truism, as glitches plagued the new
Obamacare website and insurance companies cancelled policies for many
customers on the individual market.
Amid the subsequent noise of congressional debate and cable TV outrage, Republicans
argued
that the signal is about government—more specifically, they claim the
controversies validate their age-old assertions that government can't do
anything right. Democrats
countered
that the signal in the noise is about universal healthcare—Obamacare is
a big undertaking, they argue, and so there will be bumps in the road
as the program works to provide better health services to all Americans.
This back and forth is creating an even more confusing cacophony—and
further obscuring the signal that neither the two parties nor their
health industry financiers want to discuss. That signal is about the
need for
single-payer healthcare—otherwise known as Medicare for all.
One way to detect this signal is to consider the White House guest list.
In trying to show that he was successfully managing the Obamacare roll out, the president last week
staged a high-profile White House meeting
with private health insurance executives—aka Obamacare's middlemen. The
spectacle of a president begging these middlemen for help was a
reminder that Obamacare did not limit the power of the insurance
companies as a single-payer system would. The new law instead cemented
the industry's profit-extracting role in the larger health system—and it
still leaves millions without insurance.
The second way to see this single-payer signal is to behold the
Obamacare-related congressional hearings.
During the proceedings, you've been hearing a lot about the insurance
enrollment website that the government is paying millions to insurer
UnitedHealth Group to build. But you're not hearing much about actual
healthcare. That's because the insurance industry wrote the Affordable
Care Act, meaning the new statute's top priority isn't delivering health
services. Obamacare is primarily about getting the insurance industry
more customers and government contracts, whether or not that actually
improves health services.
The third way to see this single-payer signal is to simply experience the confusion about Obamacare for yourself.
If you've managed to successfully log onto
Healthcare.gov,
you probably have been treated to a wave of perplexing information
about different kinds of private insurance plans and premiums. In other
words, you haven't seen a simple, standardized and guaranteed form of
healthcare coverage like the kind provided by the single-payer
government-administered Medicare system. You've likely seen the same
maddeningly labyrinthine private insurance system that works to
ration—and often deny—access to healthcare.
It didn't have to be this way. Back when Obamacare was being
negotiated, Congress could have circumvented the private insurance
industry by simply expanding Medicare to cover everybody. Medicare isn't
perfect, of course, but it remains one of the most popular institutions
in America because its single-payer model guarantees access to decent,
cost-effective healthcare rather than just meager health insurance. It
also does a good job of preventing profit-taking middlemen from getting
between patients and their physicians.
Obamacare doesn't do all that. It certainly includes some important
reforms, but it doesn't do what a single-payer system does—it doesn't
guarantee better healthcare or a more simple health system.
Those Democrats who pretend it does are just as dishonest as the
Republicans who ignore Medicare and pretend government cannot
effectively manage healthcare. All of them are making noise to drown out
the single-payer signal.
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