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<H1>Obamacare’s Empty Victory</H1></DIV>
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<DIV class=cat-date-line><SPAN class=cat-date-line2><A
title="View all posts in Organize!"
href="http://www.popularresistance.org/category/organize/"
rel="category tag">Organize!</A></SPAN> <SPAN class=cat-date-line3><A
href="http://www.popularresistance.org/tag/barack-obama/" rel=tag>Barack
Obama</A>, <A href="http://www.popularresistance.org/tag/health-care/"
rel=tag>Health Care</A>, <A
href="http://www.popularresistance.org/tag/single-payer/"
rel=tag>Single-Payer</A> </SPAN><BR><SPAN class=cat-date-line4>By Margaret
Flowers, <A
href="http://www.indypendent.org/2014/05/02/obamacare’s-empty-victory"
target=_blank>www.indypendent.org</A><BR>May 5th, 2014</SPAN><BR></DIV>
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<P>It feels truly Orwellian that progressives are applauding the forced purchase
of private health insurance — one of the most hated industries in the United
States — while the right is opposing a model that originated from their
political leaders. The Affordable Care Act (ACA) is a step farther on the path
to total privatization of our health care system, not towards the health care
system that most Americans support: single payer Medicare for all.</P>
<P>In the months leading up to the March 31 deadline to obtain health insurance,
ACA supporters united around their mission to enroll people. Volunteers knocked
on doors and tabled in their communities. Celebrities and athletes tweeted and
labor unions ran robocalls. The media buzzed with speculation about whether the
ACA would succeed or fail. March 31 felt like election night. And after it was
over, ACA supporters clapped each other on the back and celebrated.</P>
<P>Obamacare survived. But now that the law is implemented and the dust is
settling, it’s time to question what this actually means for health care and
what we should do now.</P>
<P>Before President Obama was elected in 2008, Drs. David Himmelstein and
Steffie Woolhandler, two of the co-founders of Physicians for a National Health
Program, raised a crucial question in their report, “Our Health Care System at
the Crossroads: Single Payer or Market Reform?” They outlined the health care
crisis and how past reforms were taking us toward increasingly “threadbare
insurance coverage.” Knowing that health care reform would be front and center
for the next few years, they argued that as a nation, we had a choice to make.
We could stay on the same path toward a market-based health care system or take
an evidence-based approach and create national single payer health
insurance.</P>
<P>With the ACA, we have now passed that crossroads and are headed down the road
to a completely market-based system of privatized health care. This is not
something to celebrate. Dr. Adam Gaffney recently wrote an excellent history in
Jacobin on the turn we have taken away from the concepts of universal health
care and economic justice to a neoliberal model. We are inundated with market
rhetoric telling us how wonderful it is to have the choice of shiny silver
insurance in the brand new marketplace. Insurance plans are called products and
we are consumers of them.</P>
<P>The problem with these public relations messages is that having health
insurance doesn’t guarantee access to health care and health care doesn’t belong
in the marketplace. As patients, we do not have a choice of whether or not to
purchase health care when we need it. Delaying or avoiding necessary care can
and does have serious consequences. And we can’t predict how much health care we
will need or when we’ll need it. In a market-based system, profits are the
bottom line and people receive only the amount of health care they can afford,
not what they need.</P>
<P>The ACA is transferring hundreds of billions of public dollars to the private
insurance industry to subsidize plans that leave people underinsured, unable to
afford care and at risk of financial ruin if they have a serious accident or
illness. And even at its best, tens of millions of people will remain without
insurance.</P>
<P>Most of the 7.5 million people who purchased health insurance on the
exchanges were already insured. More than 80 percent bought the lower-tier
silver, bronze or catastrophic plans with the hope that they would not get sick.
These plans have the lowest premiums but require that patients pay thousands of
dollars out of pocket before insurance kicks in, and then pay 30 to 40 percent
of the cost of covered care. The result is that underinsured people will
continue to self-ration, delay or avoid care due to cost, as 80 million of us
did in 2012.</P>
<P>The ACA includes regulations, but as usual the insurance industry has ways to
work around them. Many insurers had caps on out-of-pocket costs waived. Insurers
also found a way to “cherry pick” the healthiest customers by leaving cancer
centers and major medical centers out of their networks. In fact, most of the
new plans have narrow and ultra-narrow networks that shift more of the cost of
care onto patients because care outside of insurance networks isn’t covered. And
while insurance companies cannot drop individuals when they get sick, they can
stop selling their plans in areas that don’t make a profit. Some are already
doing this, which means the competition that was supposed to emerge did not.
Instead, in 515 of the poorest counties in 15 states, only one insurance company
is available on the health exchange. And greater consolidation of the health
care system is underway through mergers and acquisitions.</P>
<P>Our public insurances, Medicaid and Medicare, are being increasingly taken
over by private insurances in the form of Managed Care Organizations and
Medicare Advantage. They compete for the healthiest patients and siphon more of
the health dollars for profit, salaries and administration than public
insurances. Top advisors to the White House expect our public plans to be rolled
into the health exchanges in the near future with subsidies, a plan similar to
Congressman Paul Ryan’s voucher proposal.</P>
<P>Nations that treat health care as a public good and not a commodity have
universal coverage that costs less and produces better health outcomes. And in
polls, some two thirds of Americans support single payer. Now our tasks is to
shift the national debate away from how many people have insurance to what type
of health care system we support. Efforts to do this are taking place at both
state and national levels.</P>
<P>State efforts to educate and organize for universal health systems are using
a human rights framework. This started with the Health Care is a Human Right
campaign in Vermont that is working to create universal coverage, and similar
organizing is happening in Maine, Pennsylvania and Maryland. An essential
component of this organizing model is to develop leadership within communities
that are uninsured or underinsured. States such as Washington, Oregon, Colorado
and New Mexico also use human rights messaging in their campaigns.</P>
<P>State health reform faces significant barriers because federal legislation is
needed to allow the creation of a state single payer system. However, state
campaigns are essential because they push state health policy to be the
strongest it can be and build an informed and organized grassroots movement that
can also push for solutions at the national level.</P>
<P>Legislation for single payer health systems exists in Congress. In the House,
Congressman John Conyers (D-MI) has introduced HR 676, “The Expanded and
Improved Medicare for All Act,” in every session since 2003. So far it has 56
co-sponsors. In late 2013, Senator Bernie Sanders (I-VT) introduced SB 1782,
“The American Health Security Act,” in the Senate. National organizations are
working together to encourage more members to sponsor them and a national lobby
day is happening in Washington, D.C., on May 22.</P>
<P>On a personal level, I have chosen to be a conscientious objector to the ACA.
I cannot in good conscience give my support to the very industry I am trying to
eliminate. Being a conscientious objector is a decision that people have to make
for themselves. So far nearly 500 people have joined me by signing a petition at
PopularResistance.org.</P>
<P>Some people speculate that the ACA will bring us to single payer some day
because it will fail. This will only happen if we fight for it. Every day that
we delay, people suffer and die in this country unnecessarily. Neil H. Buchanan
says it best, “The ACA is as good as it gets, when it comes to basing a health
care system on private insurance, and it is simply not good enough. Even as the
ACA takes effect, therefore, we need to start planning to make it
disappear.”</P></DIV>
<DIV id=crp_related class=crp_related>
<H3>Related Posts:</H3>
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2014</SPAN>
<LI><A class=crp_title
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2014</SPAN>
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30, 2014</SPAN> </LI></UL></DIV></DIV></FONT></DIV></BODY></HTML>