We Need Change in Health Coverage

By ART CULLEN

We were glad to sit down for a visit with Sen. Bernie Sanders on Aug. 20 after his campaign stop at Better Day Café in Storm Lake, Iowa. Our previous impressions have been set by his speeches: fists waving, calling for a revolution, angry for a cause. On a personal level he is funny, candid, engaging, you could say charming as he gave Peach the newshound a pat. And he scares the wits out of the health care industry, which sucked a $100 billion profit last year while poor sick people go wanting.

Well he should. The woman working at the convenience store wishes she hadn’t lost 30 pounds because she can’t keep food down. She is waiting to get on health insurance for the necessary surgery. Until then, she starves. A 63-year-old friend awaits eye surgery because he cannot afford the copay on his insurance. He is too young for Medicare and works like a dog to afford his health insurance premium. What’s it matter if his vision disappears because he is broke? We heard those two unprompted stories the same day we spoke with Sanders. They are two more reasons we need universal health care.

“The American people understand the current system is a disaster,” Sanders told us. “In poll after poll, the overwhelming majority support Medicare for All once you explain it to them. … But the corporate elite in this country don’t want Bernie Sanders to be President, because they love this system.”

We scratched out the costs with Sanders: With the deductible, co-pays and premiums, this small-business owner will pay about $27,000 this year out of pocket for health care. Under Medicare for All, there would be no co-pays or deductibles or caps on coverage. We would spend no money out of pocket on health care, and there is no doubt that we would spend far less in higher taxes than we do in current health-care costs. We know that costs would be lower based on the experience of Medicaid in Iowa: The state managed health care — Medicaid — for the working poor and disabled for $400 million less annually than the private sector can manage it currently, and provided better service. Almost every senior citizen loves Medicare, just like every veteran prefers comprehensive free service from the VA.

A criticism is that unions have been negotiating for better health insurance for years in lieu of higher pay. But Jesse Case, leader of Iowa’s Teamsters Union, tells us that’s a false choice. “The cost of health care is the number one issue at the bargaining table and eats up money that could be put into workers’ paychecks,” he said. “I’m a strong believer in healthcare for all. The rest of the world is way ahead of us on this issue.”

Sanders would require that unions be allowed to renegotiate their contracts with health care costs directed to wages or other benefits.

Sen. Elizabeth Warren agrees with Sanders. His support is holding firm, while Warren is gaining momentum. Kamala Harris has not done well waffling on the issue. Other candidates defending the private health care industry are polling so poorly they can barely make the debate stage. If Joe Biden took a more progressive view he might foreclose Warren or Sanders altogether. Health care is the Number One issue among likely caucus-goers, with most concern revolving around affordability. Biden wants to build on the Affordable Care Act, which has been stripped down and left for dead in the alley, as affordability and accessibility issues mount. We need something more than an Obamacare restoration — we need universal health care.

Call it what you want — a public option, MedicareX, whatever. But make public insurance available to anyone. There is not much substantial disagreement among Democratic candidates on that point; it is a matter of pace. A real public option that offers comprehensive health care to anyone will mortify the health care industry, because it will provide real competition in rural states like Iowa. Eventually, it will doom private health insurance just as Medicare for All will, and likely along the same time frame of five to 10 years.

Again, it has been proven over three years with Iowa Medicaid that the health insurance industry cannot compete with a well-run state program. We should be flexible about how we get there. But get there we must. Small businesses, which everyone says they care about, cannot afford the current arrangement. That woman in the convenience store is working hard and trying to be a good citizen. She needs health services now, not in October. The system justifies her suffering. That should be a matter of conscience for us all. And maybe that’s what really bothers people about Bernie Sanders or Elizabeth Warren, who are standing on a principle: You know they are right, but you are going along with a system that is sucking you dry and keeping people ill.

Art Cullen, managing editor of The Progressive Populist, won the 2017 Pulitzer Prize for editorial writing in his day job as editor of The Storm Lake Times in Northwest Iowa. His book, “Storm Lake: A Chronicle of Change, Resilience, and Hope from a Heartland Newspaper,” was published by Viking Press in October.

From The Progressive Populist, September 15, 2019

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