For as long as most of us can remember, America has been trying to come to grips with the way its citizens get health care coverage.
While people in most of the rest of the world's industrialized countries have long had health coverage under some form of a single-payer system, we have been fighting this battle since the days of President Harry Truman.
The result has been chaotic. Until Congress finally passed the Affordable Care Act during Barack Obama's first term, tens of millions of Americans didn't have health care coverage, and were forced to instead rely on taxpayer-subsidized emergency room care if they got health care at all.
Bankruptcies caused by astronomical doctor and hospital bills had become common. People with pre-existing conditions couldn't buy insurance. There were numerous documented cases of poor people suffering early deaths because they opted not to see doctors, worried they faced financial ruin.
The ACA — or Obamacare, if you prefer — didn't solve all the problems. It did succeed in covering nearly 30 million more people, and while Republican members of Congress tried for seven years to kill it, the ACA gained popularity among the people, enough popularity that the GOP has now failed to end it on three occasions since Donald Trump took office.
The obstructionism has prevented it from achieving its full potential (and Trump can still cause more mischief if he cuts funding for the poor people's subsidies), but even if that hadn't occurred, there still would be several million Americans without coverage because the law still has shortcomings.
Finally, after all these years, a significant number of the nation's political leaders are taking a serious look at single-payer or, as Sen. Bernie Sanders calls it, Medicare for All.
Predictably, the special interests and the "anti-socialist" ideologues are pulling out all the stops to oppose such a "radical" idea — so radical, in fact, that most of the rest of the world buys in to a single-payer system. It was the sudden interest in single-payer that prompted the Senate's last-gasp effort to kill the ACA. Insurance companies, which have long skimmed up to 20 percent of administrative costs off the top of health bills, claim Medicare for All would be another government-run boondoggle.
The right-wing Hoover Institute publishes papers claiming that other countries don't really have single-payer, even while everyone in countries like England, Canada, France, Germany and countless others is covered birth to death. The old canard that in Canada, for instance, citizens have to wait months to get procedures accomplished (as if we aren't faced with those kind of waits here) have been trotted out. As a Canadian once told me, no one in Canada has ever had to declare bankruptcy because of his or her medical bill.
And, of course, there's the claim that the whole idea is unaffordable and would add trillions to the national debt. Even liberal economist and New York Times columnist Paul Krugman buys in to that and insists Democrats would be better off trying to strengthen Obamacare. Good luck with that with this Congress and president.
Ignored is the fact that the U.S. already spends twice as much on health care as any other civilized country with results that are far less spectacular than those countries'. While a Medicare tax increase would certainly be necessary to expand coverage, the cost would be more than offset by the elimination of insurance premiums that both employers and employees pay.
Plus, administrative costs that tack an additional 20 percent on to health bills would be replaced by a Medicare program that has averaged a 2 to 3 percent overhead through the years.
Perhaps it's folly to think that a single-payer system could survive this Congress and perhaps other ideas, like the one favored by former Wisconsin Blue Cross/Blue Shield CEO Tom Hefty to provide Medicare Advantage (the Medicare option that allows recipients to buy into private plans) to everyone could gain favor.
But it's well past time to get this idea on the front burner and design an uncomplicated, bipartisan system that does work for everyone.
Dave Zweifel is editor emeritus of The Capital Times. firstname.lastname@example.org and on Twitter @DaveZweifel
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