In the last couple of weeks, Bernie Sanders’ renewed call for Medicare for All has brought health care back into the national spotlight. The current market-based health care system not only leaves millions of people without insurance, but by treating our health care as a commodity rather than a fundamental right, it extracts enormous profits by using deductibles, co-insurance, out-of-network fees, and other tricks to restrict our access to needed care. The more that insurance companies restrict our care, the more money they make. It’s a zero-sum game, and we’re the pawns.
Universal, publicly financed health care — often called Medicare for All or single payer — directly challenges blind market fanaticism. It recognizes that health care is a fundamental human right necessary to our ability to live dignified lives, and that there is never justification to deny anyone something so fundamental. It recognizes that putting a sticker price on health care treatments inevitably denies poor people access to care, so that health care must always be provided free at the point of service. And it recognizes that all of us in society are interdependent: we cannot keep ourselves healthy on our own, and we’re all better off when we band together to make sure that all of us are as healthy as can be. Publicly financing health care, in other words, treats health care as a public good. Rather than commodifying health care and treating our illnesses as an opportunity for someone to reap profits, universal, publicly financed health care puts people first.
Even with the Affordable Care Act, as Sanders points out, 29 million people are still uninsured, and millions more have insurance but because of deductible and other fees still can’t afford to get the care they need. Some36,000 people die every year because they are barred access to care, and even families who manage to pull together enough cash to pay for care struggle immensely: medical debt is the cause of 62% of all bankruptcies. Obesity, diabetes, addiction and other preventable and treatable diseases are sweeping through our communities at appalling rates, but rather than joining together to protect our public health, we’ve let market zealots cow us into struggling to maintain insurance coverage and stay healthy on our own. One of the great ironies of this is that we pay vastly more for this broken health care system than any other country, and much more than we would if we financed universal health care as public good.
For anyone who has studied the options, there is simply no question that universal, publicly financed health care is both the most sensible and the most just and equitable policy choice for American health care. Sure, the insurance industry has a huge stake in opposing change, and a tiny cadre of cold-hearted reactionaries is apparently willing to let people get sick and die (particularly poor people, people of color, immigrants, women, and transgender people) for the sake of upholding its ideology. But why do so many political and media elites choose to reject universal, publicly financed health care and instead protect the private insurance system?
Single payer, they say, is just not politically feasible. And it’s true: if we’re expecting any one candidate or elected official to be able to muster the political power needed to single handedly topple the insurance industry and change the political discourse, we’re only setting ourselves up for disappointment once again. Winning universal, publicly financed health care is a huge political lift, but that’s precisely why it matters.
Transitioning from treating health care as a commodity to treating it as a human right and public good challenges the very existence of the parasitic health insurance industry, as well as the pro-market ideology that has dominated political discourse for the last 35 years. Politicians in Washington can’t and won’t do this on their own, and this is not a fight that a cadre of policy analysts and advocacy groups can win. This is about building power to demand that we put people ahead of profits by coming together as a society to support one another through public programs, public taxation and other tools for collective action. That is a fundamental shift, and it will take a social movement with a bold vision, smart strategy, and thousands upon thousands of deeply engaged, organized, and politicized grassroots leaders to make this happen.
A vigorous movement for universal health care, though largely ignored by the media, is growing. Advocates have been working for decades to make the case for single payer, and strong movements are now active in states across the country. These grassroots organizations have been slowly building power on the ground to shift the political possibilities in their states. From Maine to New York, Pennsylvania, Maryland, Colorado and Oregon, they’ve surveyed people and found overwhelming support for recognizing health care as a human right, demanding that the government be held accountable for ensuring that right, and moving to publicly financed health care.
The visionary members of the Vermont Workers’ Center built a movement for health care in the Green Mountain State and have pushed far closer to winning universal health care than observers thought was possible. The Workers’ Center and its fellow campaigns in the Healthcare Is a Human Right Collaborative (a coalition that I’m involved with) are models for how movements can change what’s politically possible by strategically organizing people in their communities who are directly impacted by the health care crisis, poverty, racism and other ills. As people who are impacted move from disengagement to action, they become powerful leaders who draw deep wisdom and passion from their experiences.
Health care is a moral issue, and one that resonates deeply with people’s values across party identification, race, age, and other lines of division. If you ask people to share their health care stories, genuinely listen, and help people connect their own experiences to the experiences of others and to a larger political and economic analysis, people are able to overcome the narratives that push each of us into private suffering, and they get angry. Then if you enable people to work together, support people in taking on growing leadership, and engender a sense of solidarity and commitment to a common cause, you can channel that anger into powerful political action. This is long, hard work, but this is how movements grow.
Make no mistake: this is not just a fight about health care. It’s a fight that’s connected with workers’ struggles, because health care is a fundamental right that should never depend on where we work, whether we’re full time or part time, or who signs our employment contract. It’s connected to our struggles for our rights to education, safe air and water, transportation, and participatory budgeting, because our public budgets are how we, as a society, collectively meet our shared needs. It’s connected to the liberation of people of color, immigrants, women and transgender people, because inequitable access to health care is mutually reinforced by racial and gender inequities across every other sector of society. From these connections grow opportunity: all social justice movements can include universal, publicly financed health care within their visions and their strategies, and by building deep strategic partnerships with other movements, health care organizers can turn the tide.
This is not a fight that anyone paying attention can sit out and let others take on. Winning this fight would immeasurably improve our health and financial security for the rest of our lives and for every generation to follow. It would also mark a momentous shift from blind reverence for the dehumanizing market mythology that dominates our lives today to a society in which we recognize our common needs and interests and share a commitment to protecting and caring for one another through sickness, through health and through all stages of our lives. But we can’t look to Bernie Sanders or anyone else to usher in such a momentous change. We have to look to ourselves.
Ben Palmquist is a Campaign Manager with the National Economic and Social Rights Initiative (NESRI).