Unifying Around Universal Healthcare
March 25, 2020
Ninety-two percent of working-age adults believe that affordable healthcare should be a right in this country. Regardless of party affiliation, the vast majority of Americans support this position. And yet, this election cycle, the political messaging surrounding healthcare has been dominated by rhetoric that divides us. From a president who claims (falsely) that he is protecting people with preexisting conditions, to one of the two remaining Democratic candidates (Sanders) who champions Medicare for All (“he wrote the damn bill!”, after all), Americans can feel trapped by these polarized positions. And that can be a scary place, particularly with the explosion of fear around the coronavirus epidemic. But we don’t have to be trapped. There is a path forward that can unify us.
We first need to commit to making healthcare a right in this country, like K-12 education is. Our lives depend on it—the coronavirus scare is reminding us of how interconnected we are, and that our health is not an individual matter. Other countries have gotten to universal healthcare, and they all found a way that fits their culture and values. So can we.
As the presidential election moves forward, we need to step up and demand that every candidate supports making healthcare a right, as other countries have, and that they’ll take a pragmatic path to get there. We need to, because we need universal healthcare in America.
While pushing to make healthcare a right in this country, candidates cannot ignore the facts. Most Americans say healthcare is one of their top priorities in this election. For many Americans, this means they want their out-of-pocket costs reduced. They are deferring needed care because they can’t afford their prescriptions and deductible payments. (One-fourth of insured Americans who are taking prescription drugs struggle to afford their prescriptions and one-third of insured Americans have trouble paying their deductibles.) Any health reform plan needs to address affordability to gain broad-based support.
Moreover, many Americans like and want to keep their current coverage. They don’t want to be told it’s going to be replaced by a government-run program. Polls show that this is particularly true for the over 150 million Americans (close to half of the population) who are covered by their employer.
Americans also want freedom of choice. Their healthcare is currently delivered in a marketplace that gives them choices. A government-run program would be the opposite of this, and they don’t support that. (Even those who love Medicare are often unaware that Medicare is government-run.) Also, most Americans have voting preferences that lie in the middle of the political extremes. There are actually more Americans registered as independents than as either Democrats or Republicans.
We can move toward realizing our shared belief in the right to affordable healthcare by recognizing these facts and building on what we already have in place, not eliminating it. The details don’t have to be worked out before the election—indeed, they can’t be without knowing the full makeup of Congress.
As a first step, we can build on the Affordable Care Act (ACA) by expanding subsidies to bring the program more in line with Massachusetts, which has the highest rate of coverage in the country (only 3% are uninsured). The ACA already has the support of the majority of Americans and allows working Americans to keep the insurance they have. Joe Biden has proposed something similar to this.
We can then supplement the ACA by creating a limited public option that could serve as a safety net for people who lose their coverage or don’t enroll in another public program. That way, people who don’t have job-based insurance, or who can’t afford that insurance, have another alternative. Versions of this have been called “Medicare for those who want it” or “Medicare for America.” There are many variations of these ideas, all with the potential to improve coverage and affordability. Joe Biden has proposed a version of this.
The bottom line is that Americans want affordable healthcare coverage and the peace of mind that it won’t disappear. Every candidate, including the incumbent in the White House, should support making healthcare a right. Democratic candidates, in particular, need to unify around this message, and then commit to acting on that during their first term. Detailed plans aren’t necessary at this stage of the process. But candidates need to show that they’ve learned the lessons of our health reform history, and that they are willing to compromise and take pragmatic steps. As the coronavirus scare reminds us, we need a leader who can unify our country around our collective health and well-being. That should include unifying more voters around a shared vision of healthcare for all.
About the Author
Rosemarie Day is the founder and CEO of Day Health Strategies, which helps to implement national health reform. She’s been working in healthcare and related fields for more than 25 years, including as the founding deputy director and chief operating officer of the Health Connector in Massachusetts, where she helped launch the award-winning organization that established the first state-run health insurance exchange in the state. She also served as the chief operating officer for the Massachusetts Medicaid program. Rosemarie lives in Somerville, MA; Marching Toward Coverage: How Women Can Lead the Fight for Universal Healthcare is her first book. Connect with her @Rosemarie_Day1 or at rosemarieday.com.